Namsirikul P, Chaisupamongkollarp S, Chantadisai N, Bamberg P
Pulmonary Dept, Pramongkutklao Hospital, Pramongkutklao Medical College, Bangkok, Thailand.
Eur Respir J. 1989 Apr;2(4):317-24.
The purpose of the study was to compare the anti-asthmatic efficacy of two doses of inhaled budesonide with two doses of oral prednisolone commonly used in clinical practice. The patients studied had not been taking regular inhaled glucocorticosteroids and so there was minimal interference from previous medication. The study was conducted as two double-blind crossovers with a washout period between them - firstly, comparing 400 micrograms budesonide with 5 mg prednisolone per day and secondly, 800 micrograms budesonide with 10 mg prednisolone per day. Lung function and symptoms were improved significantly from run-in by all treatments and improvement on both drugs was dose-dependent. When low-dose treatments were compared, mean morning peak expiratory flow rate was higher during budesonide treatment and, as a result, diurnal variation was significantly less than that during prednisolone treatment. At the higher doses, differences between the drugs were not observed, but this may have been due to the fact that a "ceiling effect" had been reached.
该研究的目的是比较临床实践中常用的两种剂量吸入布地奈德与两种剂量口服泼尼松龙的抗哮喘疗效。所研究的患者此前未规律使用吸入性糖皮质激素，因此既往用药的干扰极小。该研究以两次双盲交叉试验进行，中间设有洗脱期——首先，比较每日400微克布地奈德与5毫克泼尼松龙，其次，比较每日800微克布地奈德与10毫克泼尼松龙。所有治疗方法均使肺功能和症状较导入期有显著改善，且两种药物的改善均呈剂量依赖性。比较低剂量治疗时，布地奈德治疗期间平均晨起呼气峰值流速更高，因此昼夜变化显著小于泼尼松龙治疗期间。在较高剂量时，未观察到药物之间的差异，但这可能是因为已达到“天花板效应”。
