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吸入性糖皮质激素联合长效茶碱或长效β受体激动剂治疗中重度哮喘患者的干预性研究:一项随机对照研究

Intervention Studies of Inhaled Corticosteroids Combined with Long-acting Theophylline or Long-acting β-agonists in Patients with Moderate to Severe Asthma: A Randomized, Controlled Study.

作者信息

Wang Yan, Chen Ping, Dai Anna, Shang Shengyun, Kong Lingfei

机构信息

The Institute Respiratory Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China.

Respiratory Medicine, General Hospital of Shenyang Military Region, Shenyang, Liaoning, China.

出版信息

Clin Ther. 2016 Dec;38(12):2622-2627.e1. doi: 10.1016/j.clinthera.2016.10.015. Epub 2016 Nov 29.

Abstract

PURPOSE

To evaluate and contrast the therapeutic effect and safety of fluticasone aerosol combined with theophylline tablets in patients with moderate to severe asthma, compared with salmeterol/fluticasone propionate aerosol.

METHODS

After a screening period, patients meeting the inclusion criteria were randomly assigned to the experiment group (fluticasone aerosol combined with theophylline tablets) or the control group (salmeterol/fluticasone aerosol combined with placebo tablets) for 12 weeks of treatment. The main outcome measurements were forced expiratory volume in 1 second and fractional concentration of exhaled nitric oxide value, whereas the secondary measures were forced vital capacity, peak expiratory flow value, and Asthma Control Test/Asthma Quality of Life Questionnaire score.

FINDINGS

Forty-four cases completed the course, with 23 cases in the experiment group and 21 cases in the control group. The forced expiratory volume in 1 second values of both groups were significantly improved from before (P < 0.05). The fractional concentration of exhaled nitric oxide values of both groups were significantly decreased from before (P < 0.05). The secondary outcome measurements after treatment achieved obvious improvement from baseline (P < 0.05) in both. There was no significant difference between the 2 groups in all measurements. In addition, the blood biochemistry results, ECG results, and vital signs of both groups had no significant abnormality.

IMPLICATIONS

There was no significant difference in therapeutic effect and safety between the 2 groups in treating patients with moderate to severe persistent asthma, which suggests that fluticasone aerosol combined with theophylline tablets is worth considering for use in primary hospitals or for low-income populations.

摘要

目的

评估并对比氟替卡松气雾剂联合茶碱片治疗中重度哮喘患者的疗效及安全性,并与沙美特罗/丙酸氟替卡松气雾剂进行比较。

方法

经过筛选期后,符合纳入标准的患者被随机分配至实验组(氟替卡松气雾剂联合茶碱片)或对照组(沙美特罗/氟替卡松气雾剂联合安慰剂片)进行为期12周的治疗。主要观察指标为第1秒用力呼气容积和呼出一氧化氮分数浓度值,次要指标为用力肺活量、呼气峰值流速值以及哮喘控制测试/哮喘生活质量问卷评分。

结果

44例患者完成疗程,其中实验组23例,对照组21例。两组的第1秒用力呼气容积值均较治疗前显著改善(P<0.05)。两组的呼出一氧化氮分数浓度值均较治疗前显著降低(P<0.05)。治疗后的次要观察指标较基线均有明显改善(P<0.05)。两组在所有测量指标上均无显著差异。此外,两组的血液生化结果、心电图结果及生命体征均无明显异常。

结论

两组在治疗中重度持续性哮喘患者时,疗效及安全性无显著差异,这表明氟替卡松气雾剂联合茶碱片值得在基层医院或低收入人群中考虑使用。

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