Boskabady Mohammad H, Rezaeitalab Fariba, Rahimi Najmah, Dehnavi Damon
Department of Physiology, Ghaem Medical Centre, Mashhad University of Medical Sciences, Mashhad, Iran.
BMC Pulm Med. 2008 Dec 22;8:26. doi: 10.1186/1471-2466-8-26.
Global Initiative Strategy for Asthma Management (GINA) is poorly applied in undeveloped and developing countries. The current study examined the effects of applying GINA guidelines on treatment efficacy in asthmatic patients in Iran.
Twenty four asthmatic patients (usual care group) were treated as usual and 26 patients (intervention group) according to the GINA for 2 months. Asthma symptom score, asthma severity, frequency of symptoms/week and wheezing were recorded at the beginning (first visit), one month after treatment (second visit), and at the end of the study (third visit). Pulmonary function tests (PFTs) were performed by spirometry, and the patients' use of asthma drugs and their symptoms were evaluated, at each visit.
Asthma symptoms, frequency of symptoms/week, chest wheezing, and PFT values were significantly improved in the intervention group at the second and third visits compared to first visit (p < 0.001 for all measures). In addition, exercise induced cough and wheeze were significant improved in the third visit compared to the second visit in this group (p < 0.01 for both measures). In the second and third visits all symptoms were significantly lower, and PFT values higher, in the intervention group compared to the usual care group (p < 0.005 to p < 0.001). In the usual care group, there were only small improvements in some parameters in just the second visit (p < 0.01 for all measures). The use of asthma drugs was unchanged in the usual care group and significantly reduced in the intervention group (p < 0.01) by the end of the study.
Adoption of GINA guidelines improves asthma symptoms and pulmonary function in asthmatic patients in Iran.
全球哮喘防治创议（GINA）在不发达国家和发展中国家的应用情况不佳。本研究探讨了应用GINA指南对伊朗哮喘患者治疗效果的影响。
24例哮喘患者（常规治疗组）接受常规治疗，26例患者（干预组）按照GINA指南治疗2个月。在研究开始时（首次就诊）、治疗1个月后（第二次就诊）和研究结束时（第三次就诊）记录哮喘症状评分、哮喘严重程度、每周症状发作频率和哮鸣音情况。每次就诊时通过肺量计进行肺功能测试（PFTs），并评估患者哮喘药物的使用情况及其症状。
与首次就诊相比，干预组在第二次和第三次就诊时哮喘症状、每周症状发作频率、胸部哮鸣音及PFT值均有显著改善（所有指标p<0.001）。此外，该组第三次就诊时运动诱发的咳嗽和哮鸣音较第二次就诊时有显著改善（两项指标p<0.01）。与常规治疗组相比，干预组在第二次和第三次就诊时所有症状均显著减轻，PFT值更高（p<0.005至p<0.001）。在常规治疗组中，仅在第二次就诊时部分参数有小幅改善（所有指标p<0.01）。到研究结束时，常规治疗组哮喘药物的使用情况未变，而干预组显著减少（p<0.01）。
采用GINA指南可改善伊朗哮喘患者的哮喘症状和肺功能。
