Adelroth E, Rosenhall L, Glennow C
Allergy. 1985 Jan;40(1):58-64. doi: 10.1111/j.1398-9995.1985.tb04155.x.
Thirty-eight patients with chronic asthma requiring continuous oral corticosteroid treatment took part in a 2-year study. Budesonide, a new inhalation steroid with high topical activity and low systemic effects, was given in stepwise increasing doses from 200 micrograms daily up to 800-1600 micrograms daily and prednisolone doses were decreased gradually on an individual basis. After 2 years, 18 patients had been able to cease oral prednisolone treatment, 11 had decreased the dose by greater than or equal to 50%, three by less than or equal to 50% and two patients had increased their dose. At the end of the study the majority of patients (26) were using 800 micrograms budesonide daily and seven, 1200 micrograms or more daily. There were two dropouts, one due to local side effects and one to a severe pulmonary eosinophilia. Ten patients had local side effects in the form of hoarseness and/or sore throat, and 13 patients had steroid withdrawal symptoms such as arthralgia and myalgia. The asthma condition in all patients was improved, as indicated by the reduced need for hospital admissions. The results indicate that high doses of budesonide should be tried before starting maintenance therapy with oral steroids.
38名需要持续口服皮质类固醇治疗的慢性哮喘患者参与了一项为期2年的研究。布地奈德是一种新型吸入性类固醇，具有高局部活性和低全身效应，从每日200微克开始逐步增加剂量至每日800 - 1600微克，同时根据个体情况逐渐减少泼尼松龙的剂量。2年后，18名患者能够停止口服泼尼松龙治疗，11名患者的剂量减少了50%及以上，3名患者减少了50%及以下，2名患者增加了剂量。研究结束时，大多数患者（26名）每日使用800微克布地奈德，7名患者每日使用1200微克及以上。有2名患者退出研究，1名因局部副作用，1名因严重肺部嗜酸性粒细胞增多症。10名患者出现声音嘶哑和/或喉咙痛形式的局部副作用，13名患者出现关节痛和肌痛等类固醇撤药症状。所有患者的哮喘状况均有所改善，住院需求减少表明了这一点。结果表明，在开始口服类固醇维持治疗之前应尝试使用高剂量布地奈德。
