O'Loughlin J M
Postgrad Med. 1987 Jul;82(1):231-8. doi: 10.1080/00325481.1987.11699911.
Many drugs with which to treat reversible obstructive airway disease are available. Beta-adrenergic aerosols are the first line of defense; these are followed, when necessary, by either timed-release theophylline or oral beta-adrenergics. Often, a combination of these drugs must be used to achieve effective relief of symptoms. Once-daily theophylline preparations can be extremely effective in patients who need regular medication and in whom gastrointestinal upset or compliance is a problem. In patients who have frequent setbacks, occasional courses of tapered doses of steroid are necessary. When oral steroids are necessary regularly, the physician should consider using an aerosol corticosteroid, cromolyn sodium, or both. These drugs can be used daily with relative safety. However, only a small amount (ie, no more than 12%) of an inhaled medication reaches the lungs. In selected patients, regular doses of cromolyn sodium are used for prophylaxis and may preclude the need for theophylline or oral beta-adrenergics, which can have deleterious effects in adults and children. Cromolyn sodium is most effective if used before exercise or exposure to animals. Research is continuing on more effective and longer-acting beta-adrenergic aerosols and oral preparations.
有许多药物可用于治疗可逆性阻塞性气道疾病。β-肾上腺素能气雾剂是一线治疗药物；必要时，可继以缓释茶碱或口服β-肾上腺素能药物。通常，必须联合使用这些药物才能有效缓解症状。每日一次的茶碱制剂对需要长期用药以及存在胃肠道不适或用药依从性问题的患者极为有效。对于病情频繁反复的患者，偶尔需要使用逐渐减量的类固醇药物疗程。当需要长期规律使用口服类固醇时，医生应考虑使用气雾剂皮质类固醇、色甘酸钠或两者联用。这些药物可相对安全地每日使用。然而，吸入药物仅有少量（即不超过12%）能到达肺部。在部分患者中，规律使用色甘酸钠进行预防，可能无需使用茶碱或口服β-肾上腺素能药物，因为这些药物对成人和儿童可能有不良影响。色甘酸钠在运动前或接触动物前使用最为有效。针对更有效、作用时间更长的β-肾上腺素能气雾剂和口服制剂的研究仍在继续。
