Lal S, Malhotra S, Gribben D, Hodder D
Eur J Respir Dis Suppl. 1986;147:136-42.
Fifty-one patients (22 male, 29 female) aged 22-60 years (mean age 41.2 years), predominantly extrinsic asthmatics, took part in this study, a follow-up to a 28-day, double-blind trial (Lal et al., Thorax 1984: 39: 809). Forty-four patients completed 12 months of treatment after a 4-week baseline; seven withdrew. A number of symptoms (e.g. coughing, wheezing, sore throat) were reported but none appeared particularly frequently; most were attributable to the technique of inhalation. After 4 weeks of treatment with nedocromil sodium (Tilade 4 mg q.i.d.), patients were encouraged to reduce use of inhaled corticosteroids (48 patients) and sodium cromoglycate (16). Inhaled bronchodilators were to be used as required and other medication was to continue as before. At the end of the study, 28 patients had stopped using inhaled steroids and 10 had significantly reduced the dosage (p less than 0.001, week 5 to end). Ten patients had stopped using sodium cromoglycate. Inhaled bronchodilator use was significantly reduced (p less than 0.001, weeks 1-8; p less than 0.05, weeks 9-12) early in the study but returned to baseline as inhaled steroid usage was reduced. Diary card assessments of wheezing and shortness of breath showed significant improvement, particularly in the early part of the study. Diary card PEFRs showed no marked changes but significant decreases, though small, were found in FEV1, FVC and PEFR on clinic visits. Clinical assessment showed improvement in the first half of the study; the differences were less marked as inhaled steroid usage declined. Final opinions of treatment effectiveness significantly favoured nedocromil sodium. This study demonstrates the acceptability, tolerability and safety of nedocromil sodium.(ABSTRACT TRUNCATED AT 250 WORDS)
51名年龄在22至60岁(平均年龄41.2岁)的患者(22名男性,29名女性)参与了本研究,这些患者主要为外源性哮喘患者,该研究是一项为期28天的双盲试验(拉尔等人,《胸腔》1984年:39:809)的后续研究。44名患者在4周的基线期后完成了12个月的治疗;7名患者退出。报告了一些症状(如咳嗽、喘息、喉咙痛),但均未特别频繁出现;大多数症状可归因于吸入技术。在用奈多罗米钠(替乐仙4毫克,每日4次)治疗4周后,鼓励患者减少吸入性糖皮质激素(48名患者)和色甘酸钠(16名患者)的使用。按需使用吸入性支气管扩张剂,其他药物继续按以前的方式使用。在研究结束时,28名患者停止使用吸入性类固醇,10名患者显著减少了剂量(第5周结束时,p<0.001)。10名患者停止使用色甘酸钠。在研究早期,吸入性支气管扩张剂的使用显著减少(第1至8周,p<0.001;第9至12周,p<0.05),但随着吸入性类固醇使用量的减少又恢复到基线水平。对喘息和呼吸急促的日记卡评估显示有显著改善,尤其是在研究早期。日记卡记录的呼气峰流速(PEFR)没有明显变化,但在门诊就诊时,第一秒用力呼气容积(FEV1)、用力肺活量(FVC)和PEFR虽有显著下降,但幅度较小。临床评估显示在研究的前半段有所改善;随着吸入性类固醇使用量的下降,差异不太明显。对治疗效果的最终评价明显倾向于奈多罗米钠。本研究证明了奈多罗米钠的可接受性、耐受性和安全性。(摘要截选至250字)