Hunt Loren W, Frigas Evangelo, Butterfield Joseph H, Kita Hirohito, Blomgren Judith, Dunnette Sandra L, Offord Kenneth P, Gleich Gerald J
Department of Internal Medicine, Division of Allergic Diseases, Mayo Clinic and Foundation, Mayo Graduate School of Medicine, Rochester, MN 55905, USA.
J Allergy Clin Immunol. 2004 May;113(5):853-9. doi: 10.1016/j.jaci.2004.02.039.
In 2 prior uncontrolled studies, nebulized lidocaine reduced oral glucocorticoid use in patients with severe glucocorticoid-dependent asthma.
We tested the safety and efficacy of nebulized lidocaine in a randomized, placebo-controlled study in patients with mild-to-moderate asthma.
We recruited 50 subjects (25 receiving lidocaine and 25 receiving placebo); all had a prebronchodilator FEV(1) of 64% to 125% of predicted normal value and were treated with daily inhaled glucocorticoids (but not systemic glucocorticoids) and bronchodilators for at least 2 months. Before treatment, subjects monitored their symptoms and peak flow values and maintained their medications for 2 weeks. At initiation, subjects inhaled either nebulized placebo (saline) or lidocaine (4%, 100 mg) 4 times daily. All subjects were instructed to reduce their inhaled glucocorticoid dosage by one half each week for 3 weeks and to discontinue glucocorticoid treatment at week 4. The subjects continued the nebulized lidocaine or placebo for a total of 8 weeks, monitored their symptoms, and used bronchodilators to control symptoms.
Indicators of asthma severity showed benefit for the lidocaine-treated group: changes in FEV(1) (P < or =.001), nighttime awakenings (P < or =.02), symptoms (P < or =.010), bronchodilator use (P < or =.010), and blood eosinophil counts (P < or =.020). Subjects in both groups reduced use of inhaled glucocorticoids comparably. Subjects receiving nebulized placebo showed increases in their symptom scores, bronchodilator use (P < or =.05 for both), and blood eosinophil counts (P < or =.01) and decreases in FEV(1) (P < or =.001).
Nebulized lidocaine provided effective and safe therapy in subjects with mild-to-moderate asthma.
在之前两项非对照研究中，雾化利多卡因减少了严重糖皮质激素依赖型哮喘患者口服糖皮质激素的用量。
我们在一项针对轻至中度哮喘患者的随机、安慰剂对照研究中测试了雾化利多卡因的安全性和有效性。
我们招募了50名受试者（25名接受利多卡因治疗，25名接受安慰剂治疗）；所有受试者支气管扩张剂前FEV(1)为预测正常值的64%至125%，并接受每日吸入糖皮质激素（而非全身用糖皮质激素）和支气管扩张剂治疗至少2个月。治疗前，受试者监测其症状和峰值流量值，并维持其用药2周。开始时，受试者每日吸入4次雾化安慰剂（盐水）或利多卡因（4%，100毫克）。所有受试者均被指示在3周内每周将吸入糖皮质激素剂量减半，并在第4周停止糖皮质激素治疗。受试者持续雾化利多卡因或安慰剂共8周，监测其症状，并使用支气管扩张剂控制症状。
哮喘严重程度指标显示利多卡因治疗组有获益：FEV(1)变化（P≤0.001）、夜间觉醒（P≤0.02）、症状（P≤0.010）、支气管扩张剂使用（P≤0.010）和血液嗜酸性粒细胞计数（P≤0.020）。两组受试者吸入糖皮质激素的用量减少程度相当。接受雾化安慰剂的受试者症状评分、支气管扩张剂使用量（两者P≤0.05）和血液嗜酸性粒细胞计数增加（P≤0.01），FEV(1)降低（P≤0.001）。
雾化利多卡因对轻至中度哮喘患者提供了有效且安全的治疗。
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