Northfield M, Patel R K, Richardson A, Taylor M D, Richardson P D
Medical Department, Astra Pharmaceuticals Ltd., Kings Langley, England.
Curr Med Res Opin. 1991;12(7):441-9. doi: 10.1185/03007999109111515.
Beta 2-agonist therapy effectively relieves asthmatic symptoms, but an improvement in patient lifestyle has not been demonstrated. This open study in which patients acted as their own controls, assessed the efficacy and acceptability of intermittent symptom-related use of terbutaline inhaled via 'Turbohaler', and its influence on the lifestyle of 1133 inhaler-naive, mild asthmatics treated in general practice. A 1-week run-in period was followed by 4-weeks' treatment with inhaled terbutaline (500 micrograms as required). Peak expiratory flow rate (PEFR) and 'Turbohaler' technique were assessed at clinic visits. Diary cards, completed daily, assessed: the number of terbutaline inhalations, the relief obtained after use, the severity of asthma symptoms (cough, morning wheeze, nocturnal wheeze and wheeze on activity), and lifestyle indices (sleep disturbance, work/school days lost, limitation of normal activity). After terbutaline treatment, PEFR increased by 54 +/- 2 l/min (p less than 0.001), the severity of asthma symptoms was almost halved (p less than 0.001), with over two-thirds (65% to 76%) of patients reporting improvements in each variable, and the adverse effect of asthma on lifestyle was at least halved (p less than 0.001). Improvements in lung function, asthma symptoms and lifestyle were comparable for all sub-groups: adults (greater than 16 years), school-age children (6 to 16 years) and preschool children (less than or equal to 5 years). This study not only confirmed the efficacy and acceptability of intermittent symptom-related use of terbutaline inhaled via 'Turbohaler', but also demonstrated that its use enhanced patients' lifestyles.
β2 激动剂疗法能有效缓解哮喘症状，但尚未证实其能改善患者的生活方式。这项开放性研究中，患者自身作为对照，评估了通过“都保”间歇性按需吸入特布他林对1133例初用吸入器的轻度哮喘患者在全科医疗中治疗时的疗效、可接受性及其对生活方式的影响。在1周的导入期后，进行为期4周的吸入特布他林治疗（按需吸入500微克）。在门诊就诊时评估呼气峰值流速（PEFR）和“都保”使用技术。患者每天填写日记卡，记录：特布他林吸入次数、使用后获得的缓解情况、哮喘症状的严重程度（咳嗽、晨起哮鸣、夜间哮鸣和活动时哮鸣）以及生活方式指标（睡眠障碍、误工/误学天数、正常活动受限）。特布他林治疗后，PEFR增加了54±2升/分钟（p<0.001），哮喘症状的严重程度几乎减半（p<0.001），超过三分之二（65%至76%）的患者报告各项指标均有改善，哮喘对生活方式的不良影响至少减半（p<0.001）。所有亚组（成人（大于16岁）、学龄儿童（6至16岁）和学龄前儿童（小于或等于5岁））在肺功能、哮喘症状和生活方式方面的改善情况相当。这项研究不仅证实了通过“都保”间歇性按需吸入特布他林的疗效和可接受性，还表明其使用改善了患者的生活方式。
