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目的:探讨小剂量激素结合茶碱对哮喘成年患者的临床疗效及安全性。方法:选取2014年1月-2016年12月绍兴市中心医院门诊就诊或住院后出院的哮喘成年患者124例,根据随机数字表法分为对照组和试验组,每组62例。对照组予茶碱缓释片口服;治疗组在对照组的基础上加用泼尼松片口服。两组患者试验期间禁止口服其他含有激素类药物,每4周复诊一次,一共复诊3次。于试验前一天及试验最后一天予患者检测肺功能、ACTH兴奋试验及代谢指标。结果:治疗后,两组患者的FEV1、MVV与治疗前相比略有改善,但差异无统计学意义(P>0.05);治疗组患者FEV1/FVC%、FVC较对照组明显改善,结果有统计学意义(P<0.05)。治疗后两组患者ACTH较前无明显差异,组间比较无统计学差异;治疗前皮质醇反应值较基础值显著升高(P<0.05),治疗后皮质醇反应值仍较基础值显著升高(P<0.05),组间比较无统计学差异。治疗前两组患者各代谢指标比较无统计学差异,治疗后两组患者空腹血糖、胆固醇及甘油三酯较前无统计学差异;组间比较差异也无统计学意义。结论:小剂量激素结合茶碱能显著改善成年哮喘患者的肺功能,临床疗效确切,且无明显不良反应。
Objective: To investigate the clinical efficacy and safety of low-dose hormone combined with theophylline in adult patients with asthma. Methods: One hundred and twenty-four adult patients with asthma discharged from outpatient department of Shaoxing Central Hospital from January 2014 to December 2016 were divided into control group and experimental group according to random number table method, with 62 cases in each group. Control group to theophylline sustained-release tablets oral; treatment group in the control group based on the use of prednisone tablets oral. Two groups of patients during the trial is prohibited oral administration of other hormonal drugs, referral every 4 weeks, a total of 3 referrals. Patients were tested for lung function, ACTH excitation test, and metabolic parameters on the day before the test and the last day of the test. Results: After treatment, the FEV1 and MVV of both groups improved slightly compared with that before treatment, but the difference was not statistically significant (P> 0.05). The FEV1 / FVC% and FVC of the treatment group were significantly improved compared with the control group Statistical significance (P <0.05). After treatment, there was no significant difference in ACTH between the two groups, with no significant difference between the two groups. The pre-treatment cortisol reaction value was significantly higher than the baseline (P <0.05), and the cortisol level after treatment was still significantly higher than the baseline High (P <0.05), no significant difference between the two groups. There was no significant difference in each metabolic index between the two groups before treatment. After treatment, there was no significant difference in fasting blood glucose, cholesterol and triglyceride between the two groups. There was no significant difference between the two groups. Conclusion: Low dose of hormone combined with theophylline can significantly improve the lung function of adult asthmatic patients with definite curative effect and no obvious adverse reactions.