糖皮质激素及支气管扩张剂治疗长期控制不佳哮喘患者的临床效果

董振岭

[摘要]目的 探討糖皮质激素及支气管扩张剂治疗长期控制不佳哮喘患者的临床效果。方法 选取2015年7月～2017年3月我院收治的104例哮喘患者，按治疗方案的不同将其分为常规组和研究组，每组各52例。常规组给予支气管扩张剂治疗，研究组在支气管扩张剂基础上给予糖皮质激素干预，并将两组临床总有效率、血清IL-8、TNF-α水平及住院时间进行比较，同时比较两组患者肺功能指标及用药后不良反应发生率。结果 研究组临床总有效率为96.15%，显著高于常规组（82.69%），差异有统计学意义（P<0.05）；研究组血清IL-8、TNF-α水平均显著低于常规组，差异有统计学意义（P<0.05）；研究组住院时间明显短于常规组，差异有统计学意义（P<0.05）；研究组患者不良反应发生率为5.77%，显著低于常规组（26.92%），差异有统计学意义（P<0.05）；研究组FEV1、PFE等肺功能指标明显优于常规组，差异均有统计学意义（P<0.05）。结论 与单一用药比较，用糖皮质激素联合支气管扩张剂对长期控制不佳支气管哮喘患者治疗，可有效缓解患者临床症状，降低血清IL-8、TNF-α水平，改善患者肺功能，缩短患者住院时间，进一步提升临床效果，且无明显毒副反应，用药安全性较高，具备临床意义与实施价值。

[关键词]糖皮质激素；支气管扩张剂；治疗；长期控制不佳；哮喘；疗效

[中图分类号] R562.25 [文献标识码] A [文章编号] 1674-4721（2018）5（a）-0038-04

[Abstract]Objective To explore the clinical efficacy of glucocorticoid and bronchodilator in the treatment of patients with long-term poorly controlled asthma.Methods From July 2015 to March 2017，104 asthma patients treated in our hospital were evenly divided into routine group and research group according to different therapeutic regimen.In the routine group，bronchodilator was used.In the research group，on the basis of using bronchodilator，glucocorticoid was added for intervention.The clinical total effectiveness rate，serum IL-8 and TNF-α levels，and hospital stay were compared in the two groups.Meanwhile，the indexes of pulmonary function and the incidence of adverse drug reactions were compared between the two groups.Results In the research group，the total effectiveness rate was 96.15%，which was significantly higher than that in the routine group accounting for 82.69% with a statistical difference（P<0.05）.The levels of serum IL-8 and TNF-α in research group were greatly lower than those in the control group（P<0.05）.With regard to hospital stay in the rcsearch group，was sherter than that in the routine group，with statistical difference （P<0.05）.In the research group，the incidence of adverse reactions was 5.77%，which was much lower than that in the routine group accounting for 26.92% with a statistical difference （P<0.05）.The pulmonary function indexes including FEV1 and PFE in the research group were displayed than that in the rautine group，with a statistical significance （P<0.05）.Conclusion Compared with single medication，combination of glucocorticoid and bronchodilator can effectively alleviate the clinical symptoms of patients with long-term poorly controlled bronchial asthma，decrease the levels of serum IL-8 and TNF-α，improve the pulmonary function，shorten the hospital stay，and further improve the clinical efficacy with advantages of absence of obvious toxic and side effects and high drug safety，which has clinical significance and application value.

[Key words]Glucocorticoid；Bronchodilator；Treatment；Long-term poor control；Asthma；Curative effect

支气管哮喘属于慢性呼吸道炎症，急性发作时患者可出现气促、喘息、胸闷、咳嗽等临床表现。引发支气管哮喘的不良因素较多，包括变应原、不良生活习惯、遗传、过度疲劳、感染等[1-2]。支气管哮喘具有病程迁延、难以根治、易反复等临床特点，治疗不及时极易引发多种并发症，其临床症状主要为胸闷、咳嗽、喘息、气急等，干预不及时极易导致气道狭窄，使患者病情加重。近年来哮喘在临床上发病率呈上升趋势，对人们的身心健康及生活质量均造成严重危害，且对患者肺功能造成直接影响[3]。雾化吸入为临床治疗哮喘患者常用治疗方式，尤其适用于哮喘急性发作患者，可有效减轻患者临床症状，改善患者呼吸功能。雾化吸入治疗原理主要是将药物分散成微粒使其悬浮于气体之中，具有药物用量小、起效迅速、不良反应少等优势，因此，对哮喘患者而言，寻求一种疗效确切、安全性更高的用药方案具有重要意义[4]。……