Charpin J
Ann Med Interne (Paris). 1986;137(1):26-9.
The author summarises the modes of action of steroids in asthma and then reviews the treatment of acute asthmatic attacks and long-term steroid treatment. In acute situations steroids are very effective but their onset of action is relatively slow, even when administered intravenously. In practice, beta-2 adrenergic drugs have to be added to steroids for the treatment of acute asthmatic attacks. In long-term treatment, steroids are very effective but the risks of the treatment must also be considered. The first rule is to try and use intermittent treatment, either with alternative steroids or with treatment 5 or 7 days every fortnight. Synthetic ACTH can be added to steroids. Aerosols now play an important role which should become important when the dosages of the puffs are increased. These methods will enable the long-term use of steroids with fewer side effects. This may either be obtained rapidly by beta-2 adrenergic drugs or more slowly with steroids when there are inflammatory lesions of the bronchial mucosa.
作者总结了类固醇在哮喘中的作用方式，然后回顾了急性哮喘发作的治疗和长期类固醇治疗。在急性情况下，类固醇非常有效，但其起效相对较慢，即使静脉给药也是如此。实际上，治疗急性哮喘发作时必须将β-2肾上腺素能药物与类固醇联合使用。在长期治疗中，类固醇非常有效，但也必须考虑治疗风险。首要原则是尝试采用间歇治疗，要么交替使用类固醇，要么每两周治疗5天或7天。合成促肾上腺皮质激素可与类固醇联合使用。气雾剂现在发挥着重要作用，当增加喷雾剂量时其作用会更加显著。这些方法将使类固醇能够长期使用且副作用更少。当支气管黏膜有炎症病变时，这可以通过β-2肾上腺素能药物迅速实现，或者通过类固醇更缓慢地实现。
