Calpin C, Macarthur C, Stephens D, Feldman W, Parkin P C
Pediatric Outcomes Research Team, The Hospital for Sick Children and the Department of Pediatrics, University of Toronto, Ontario, Canada.
J Allergy Clin Immunol. 1997 Oct;100(4):452-7. doi: 10.1016/s0091-6749(97)70134-9.
There has been no systematic appraisal of the evidence regarding the effectiveness of prophylactic inhaled steroids in childhood asthma.
We sought to evaluate the effectiveness of prophylactic inhaled steroids in childhood asthma.
A MEDLINE search from January 1966 through December 1996 was used to identify pertinent English-language publications. All randomized, double-blind, placebo-controlled trials of prophylactic inhaled steroid therapy for childhood asthma that included data on clinical outcomes (symptom scores and concomitant drug use) or laboratory outcomes (peak expiratory flow rate) were included.
In total, 24 of 93 studies retrieved met the inclusion criteria. The overall weighted relative improvement in mean total symptom score (inhaled steroid vs placebo) was 50% (95% confidence interval [CI]: 49%, 51%), the overall weighted relative decrease in mean concomitant beta2-agonist use (inhaled steroid vs placebo) was 37% (95% CI: 36%, 38%), and the overall weighted relative decrease in mean concomitant oral steroid use (inhaled steroid vs placebo) was 68% (95% CI: 66%, 70%). The overall weighted absolute improvement in mean peak expiratory flow rate (inhaled steroid vs placebo) was 38 L/min (95% CI: 34.3 L/min, 41.7 L/min).
Prophylactic inhaled steroids are effective, compared with placebo, in improving both clinical and laboratory outcomes in childhood asthma.
尚无关于预防性吸入类固醇治疗儿童哮喘有效性证据的系统评估。
我们旨在评估预防性吸入类固醇治疗儿童哮喘的有效性。
利用1966年1月至1996年12月的MEDLINE检索来识别相关英文出版物。纳入所有关于儿童哮喘预防性吸入类固醇治疗的随机、双盲、安慰剂对照试验，这些试验需包含临床结局（症状评分和伴随药物使用）或实验室结局（呼气峰值流速）的数据。
总共检索到的93项研究中有24项符合纳入标准。平均总症状评分（吸入类固醇与安慰剂相比）的总体加权相对改善为50%（95%置信区间[CI]：49%，51%），平均伴随β2激动剂使用（吸入类固醇与安慰剂相比）的总体加权相对减少为37%（95%CI：36%，38%），平均伴随口服类固醇使用（吸入类固醇与安慰剂相比）的总体加权相对减少为68%（95%CI：66%，70%）。平均呼气峰值流速（吸入类固醇与安慰剂相比）的总体加权绝对改善为38升/分钟（95%CI：34.3升/分钟，41.7升/分钟）。
与安慰剂相比，预防性吸入类固醇在改善儿童哮喘的临床和实验室结局方面是有效的。
