Lien T C, Wang J H, Ho L I
Respiratory Therapy Department, Veterans General Hospital-Taipei.
Zhonghua Yi Xue Za Zhi (Taipei). 1993 Jul;52(1):41-7.
Disodium cromolyn is effective in preventing asthma, but its steroid sparing effect remains controversial. In this prospective cross-over study, we used two different brands of disodium cromolyn, Intal and Ticromil, each for 4 weeks on 7 adult patients with chronic asthma. The dosage was 20 mg qid via a special inhaler. The whole course of the study was 12 weeks for each patient, including 2 run-in weeks and 2 wash-out weeks. Patients were followed up by the same physician at outpatient clinics every 2 weeks to measure FEV1, FVC, peak expiratory flow rate (PEFR), and reversibility after bronchodilator. The physician also assessed the severity of the patients' symptoms via a special score system. Patients recorded symptom severity and frequency of medications at home on daily diary cards. Patients also measured PEFR twice a day. At the end of the treatment, FEV1 was improved more in Intal group; daily prednisolone dosage was markedly reduced in Ticromil group; PEFR was improved in both group; but neither symptom severity nor airway reversibility was significantly changed. When two groups were calculated as a whole, PEFR increased significantly from 294 +/- 20 l/min to 342 +/- 19 l/min (p = 0.0225). The daily prednisolone dosage reduced from 5.87 +/- 0.91 mg to 3.91 +/- 0.60 mg in the 3rd week and to 4.05 +/- 0.63 mg in the 4th week. The differences between these 2 dosages and the baseline dosage were statistically significant (both p < 0.05). Side effects were minimal in all patients. We concluded that after the use of disodium cromolyn for 4 weeks, PEFR was markedly improved and daily prednisolone dosage was also significantly reduced.
色甘酸钠对预防哮喘有效,但其激素节省作用仍存在争议。在这项前瞻性交叉研究中,我们对7例成年慢性哮喘患者使用了两种不同品牌的色甘酸钠,因他宁(Intal)和替米罗米(Ticromil),每种用药4周。剂量为通过特殊吸入器每日4次,每次20毫克。每位患者的研究全程为12周,包括2周导入期和2周洗脱期。每2周由同一位医生在门诊对患者进行随访,测量第一秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEFR)以及支气管扩张剂后的可逆性。医生还通过特殊评分系统评估患者症状的严重程度。患者在家中使用每日记录卡记录症状严重程度和用药频率。患者还每天测量两次PEFR。治疗结束时,因他宁组的FEV1改善更明显;替米罗米组的每日泼尼松龙剂量显著降低;两组的PEFR均有改善;但症状严重程度和气道可逆性均无显著变化。将两组作为一个整体计算时,PEFR从294±20升/分钟显著增加至342±19升/分钟(p = 0.0225)。每日泼尼松龙剂量在第3周从5.87±0.91毫克降至3.91±0.60毫克,在第4周降至4.05±0.63毫克。这两个剂量与基线剂量之间的差异具有统计学意义(均p < 0.05)。所有患者的副作用均极小。我们得出结论,使用色甘酸钠4周后,PEFR显著改善,每日泼尼松龙剂量也显著降低。