Lee C H, Lee C J, Lan R S, Tsai Y H, Chiang Y C, Wang W J, Tsao T C
Department of Pulmonary Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1993 Mar;16(1):25-9.
Fifty-two patients with acute asthma requiring immediate therapy but not hospitalization were studied in an emergency department following conventional therapy with bronchodilators. After discharge, the patients were treated with a controlled regimen of long-acting theophylline and beta-agonist inhalation as necessary. They were randomly assigned to one of three groups using a double blind model. Group A received intramuscular and oral placebos. Group B received intramuscular dexamethasone injection along with oral placebo treatment. Group C received oral dexamethasone by a tapering schedule associated with placebo intramuscular injection. Follow-up was carried out 7 days after the treatment in the emergency room. There were no significant statistical differences in the relapse rate among the three groups. Those patients who received oral or intramuscular dexamethasone had a decrease in the need for beta-agonist inhalation and fewer respiratory symptoms. However, there was no significant statistical difference between groups B and C. It was concluded that repository steroids could reduce the respiratory symptoms and frequency of beta-agonist usage as effectively as oral steroid treatment. However, the steroids do not improve the relapse rate in patients with only mild symptoms.
52例需要立即治疗但无需住院的急性哮喘患者在急诊科接受支气管扩张剂常规治疗后进行了研究。出院后，患者根据需要接受长效茶碱和β受体激动剂吸入的对照治疗方案。采用双盲模型将他们随机分为三组。A组接受肌肉注射和口服安慰剂。B组接受肌肉注射地塞米松并同时口服安慰剂治疗。C组接受按递减方案口服地塞米松并同时注射安慰剂。在急诊室治疗7天后进行随访。三组之间的复发率无显著统计学差异。接受口服或肌肉注射地塞米松的患者对β受体激动剂吸入的需求减少，呼吸道症状也较少。然而，B组和C组之间无显著统计学差异。得出的结论是，长效类固醇与口服类固醇治疗一样有效地减轻呼吸道症状并减少β受体激动剂的使用频率。然而，类固醇并不能改善仅患有轻度症状患者的复发率。
