Gale A E, Harding P, Solomon E
Ann Allergy. 1981 May;46(5):268-72.
Because the simultaneous use of more than one form of topical corticosteroid involves higher cumulative doses and, therefore, more potential for absorption, this study was concerned primarily with effect on adrenal function. Seventeen adults whose asthma symptoms had been stable for at least three months on 100-400 microgram/day of beclomethasone dipropionate aerosol received flunisolide intranasal solution (200 microgram/day) combined with its intrabronchial form (1 mg/day) or with beclomethasone dipropionate bronchial aerosol (400 microgram/day). Utilizing a physician-blind, crossover design, each medication combination was administered for one month. Patient and physician evaluations revealed no significant differences in efficacy, adverse effects (complaints) or effect on adrenal function between the two combinations. Thus, the addition of intranasal flunisolide to intrabronchial flunisolide or beclomethasone did not appear to result in significant systemic absorption of corticosteroid above that which might have occurred as a result of the bronchial inhalation of corticosteroid medication alone during the pretrial period.
由于同时使用多种局部用皮质类固醇会导致更高的累积剂量,因而吸收的可能性更大,所以本研究主要关注其对肾上腺功能的影响。17名成年人,其哮喘症状在每天使用100 - 400微克二丙酸倍氯米松气雾剂至少三个月后保持稳定,他们接受了氟尼缩松鼻内溶液(每天200微克)与其支气管内剂型(每天1毫克)联合使用,或与二丙酸倍氯米松支气管气雾剂(每天400微克)联合使用。采用医生盲法交叉设计,每种药物组合给药一个月。患者和医生的评估显示,两种组合在疗效、不良反应(主诉)或对肾上腺功能的影响方面没有显著差异。因此,在支气管内使用氟尼缩松或倍氯米松的基础上加用鼻内氟尼缩松,似乎不会导致皮质类固醇的全身吸收显著高于在试验前期仅通过支气管吸入皮质类固醇药物可能发生的吸收量。