Lee Myoung Kyu, Lee Won Yeon, Yong Suk Joong, Shin Kye Chul, Kim Chong Whan, Lee Ji-Ho, Jung Saehyun, Jung Ye-Ryung, Kim Hyun Sik, Yu Tae-Sun, Kim Sang-Ha
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Tuberc Respir Dis (Seoul). 2012 Aug;73(2):93-9. doi: 10.4046/trd.2012.73.2.93. Epub 2012 Aug 31.
Local adverse events associated with inhaled corticosteroid use, including dysphonia, pharyngitis and oral candidiasis, can affect adherence for treatment. 'Mouth rinsing method' has been used for reducing local adverse events, but it cannot ensure complete prevention. The goal of this pilot study was to identify whether the 'immediate diet method' can reduce local adverse events in a limited number of patients.
The study was conducted in a total of 98 patients, who had been prescribed a medium-dose fluticasone propionate for the first time, from January to October in 2010. One training nurse had performed the education on how to use the inhaler, including the mouth rinsing method. And with follow-ups at one month intervals, any patient who experienced such adverse events were educated on the immediate diet method, having a meal within 5 minutes after using an inhaler and they were checked on any incurrence of adverse events with one month intervals for 2 months.
The mean age of patients was 65.9 years old. The local adverse events had incurred from 18.4% of the study subjects. When performed the follow-up observation in 18 patients with local adverse events after education on the immediate diet method, 14 patients (77.8%) had shown symptomatic improvements. Three of 4 patients did not show any improvement, in spite of implementing the immediate diet method. The other 1 patient did not practice the immediate diet method properly.
The immediate diet method may be useful in reducing the local adverse events, caused by the use of inhaled corticosteroid.
吸入性糖皮质激素使用相关的局部不良事件，包括声音嘶哑、咽炎和口腔念珠菌病，会影响治疗依从性。“漱口法”已被用于减少局部不良事件，但无法确保完全预防。这项初步研究的目的是确定“立即进食法”是否能在有限数量的患者中减少局部不良事件。
该研究共纳入了98例于2010年1月至10月首次开具中等剂量丙酸氟替卡松处方的患者。一名培训护士对如何使用吸入器进行了培训，包括漱口法。每隔一个月进行随访，对出现此类不良事件的任何患者进行立即进食法教育，即在使用吸入器后5分钟内进食，然后每隔一个月检查2个月内不良事件的发生情况。
患者的平均年龄为65.9岁。18.4%的研究对象出现了局部不良事件。对18例出现局部不良事件的患者进行立即进食法教育后进行随访观察，14例患者（77.8%）症状改善。4例患者中有3例尽管实施了立即进食法但未显示任何改善。另1例患者未正确实施立即进食法。
立即进食法可能有助于减少吸入性糖皮质激素使用引起的局部不良事件。
