Novembre E, Frongia G, Lombardi E, Veneruso G, Vierucci A
Department of Pediatrics-Ospedale A. Meyer, Florence, Italy.
J Allergy Clin Immunol. 1994 Aug;94(2 Pt 1):201-6. doi: 10.1016/0091-6749(94)90041-8.
Recent evidence suggests that inhaled nedocromil and furosemide are effective in preventing asthma by ultrasonically nebulized distilled water, allergen, and exercise. There are, however, no studies that compare the effects of these two drugs. The aim of this study was to investigate the effect of inhaled furosemide (30 mg), nedocromil (4 mg), the combination of these two drugs, and placebo aerosol in preventing exercise-induced asthma.
Twenty-four children with exercise-induced asthma, aged 6 to 16 years, performed a treadmill test before and 20 minutes after a single dose of drug(s) in a double-blind trial. Lung function measurements were taken before drug administration, before the exercise test (20 minutes after drug administration), and then 2, 4, 6, 8, 10, 15, 20, and 30 minutes after the exercise test.
Both active drugs performed significantly better than placebo. In fact, the exercise challenge resulted in a mean maximum fall in forced expiratory volume in 1 second of 28.46% +/- 13.84% after administration of placebo, but of only 15.42% +/- 8.35% after administration of nedocromil (p < 0.001) and of 11.37% +/- 9.14% after administration of furosemide (p < 0.001). When the two drugs were given together, there was a statistically significant additive effect because the mean maximum fall in forced expiratory volume in 1 second was 5.75% +/- 3.57% (nedocromil vs nedocromil + fluorsemide: p < 0.001; furosemide vs nedocromil + furosemide: p < 0.01).
This study suggests that nedocromil and furosemide provide a comparable effect in preventing exercise-induced asthma in children. The combined administration of the two drugs significantly increases the protective effects, suggesting a potential therapeutic use.
最近有证据表明,雾化吸入奈多罗米和速尿对超声雾化蒸馏水、变应原和运动诱发的哮喘具有预防作用。然而,尚无比较这两种药物效果的研究。本研究旨在探讨雾化吸入速尿(30毫克)、奈多罗米(4毫克)、这两种药物的联合使用以及安慰剂气雾剂对运动诱发哮喘的预防作用。
在一项双盲试验中,24名6至16岁运动诱发哮喘儿童在单次给药前及给药后20分钟进行了跑步机测试。在给药前、运动测试前(给药后20分钟)以及运动测试后2、4、6、8、10、15、20和30分钟进行肺功能测量。
两种活性药物的效果均显著优于安慰剂。事实上,运动激发试验后,安慰剂组一秒用力呼气量平均最大下降28.46%±13.84%,而奈多罗米组仅为15.42%±8.35%(p<0.001),速尿组为11.37%±9.14%(p<0.001)。两种药物联合使用时,具有统计学意义的相加效应,因为一秒用力呼气量平均最大下降为5.75%±3.57%(奈多罗米组与奈多罗米+速尿组比较:p<0.001;速尿组与奈多罗米+速尿组比较:p<0.01)。
本研究表明,奈多罗米和速尿在预防儿童运动诱发哮喘方面效果相当。两种药物联合使用可显著增强保护作用,提示其具有潜在的治疗用途。