Gurwitz D, Levison H, Mindorff C, Reilly P, Worsley G
Ann Allergy. 1983 Mar;50(3):166-70.
We compared the pulmonary response to fenoterol delivered by a conventional MDI with the response after MDI plus the aerochamber (AC). Twelve children with moderate to severe asthma (mean age 10.8 years) participated in this double-blind crossover study. On two consecutive days, in random order, subjects received one puff of fenoterol hydrobromide (200 mcg) either by MDI or MDI plus AC. Pulmonary function, cardiovascular response and tremor were assessed over a period of four hours. In a similar fashion, the children received one puff of fenoterol three times a day for six weeks by either method in a randomized open study. Daily symptoms and peak flows before and after drug were recorded in daily diaries. The patients returned to the pulmonary function laboratory at 6 and 12 weeks for four hour pulmonary function tests. In the short-term study, the magnitude and time course of pulmonary response was similar for both treatment regimens (p greater than 0.4). No significant effects on blood pressure or pulse or differences in tremor assessment were seen. Similarly, in the long term study the baseline pulmonary function and pulmonary response were markedly consistent between the two treatment regimens (p greater than 0.05). Peak flows were significantly higher in the evening than in the morning (p less than 0.001) and the magnitude of the response to drug was higher in the morning than the evening (p less than 0.001). There were no differences between MDI and MDI plus AC in daily symptom scores or use of concomitant medication. We conclude that acute or chronic administration of fenoterol aerosol to asthmatic children by MDI with or without the AC produces similar benefits in pulmonary function, symptomatology and concomitant medication. The AC device would be a useful adjunct for a child who has difficulty in coordinating the metered dose inhaler.
我们比较了使用传统定量吸入器（MDI）递送的非诺特罗与MDI加贮雾罐（AC）后的肺部反应。12名中度至重度哮喘儿童（平均年龄10.8岁）参与了这项双盲交叉研究。在连续两天，受试者随机接受通过MDI或MDI加AC吸入一剂氢溴酸非诺特罗（200微克）。在4小时内评估肺功能、心血管反应和震颤情况。在一项随机开放研究中，以类似方式，儿童通过两种方法之一每天吸入一剂非诺特罗，持续6周。在每日日记中记录用药前后的每日症状和峰流速。患者在6周和12周返回肺功能实验室进行4小时肺功能测试。在短期研究中，两种治疗方案的肺部反应程度和时间过程相似（p大于0.4）。未观察到对血压或脉搏有显著影响，也未发现震颤评估有差异。同样，在长期研究中，两种治疗方案之间的基线肺功能和肺部反应明显一致（p大于0.05）。峰流速在晚上显著高于早上（p小于0.001），对药物的反应程度在早上高于晚上（p小于0.001）。MDI和MDI加AC在每日症状评分或伴随药物使用方面没有差异。我们得出结论，对于哮喘儿童，无论有无AC，通过MDI急性或慢性给予非诺特罗气雾剂在肺功能、症状学和伴随药物使用方面产生相似的益处。贮雾罐装置对于难以协调定量吸入器使用的儿童将是一种有用的辅助工具。
