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目的观察雾化吸入糖皮质激素治疗老年哮喘长期控制不佳患者的疗效。方法将老年哮喘长期控制不佳的患者66例随机分为观察组和对照组各33例。观察组均采用空气压缩雾化器,每次吸入沙丁胺醇5 mg和布地奈德混悬液1 mg,每天2次。对照组则给予吸入福莫特罗4.5μg和布地奈德160μg干粉吸入剂,每次2吸,每天2次。治疗期间,均使用临时缓解药物沙丁胺醇气雾剂。2组均连续治疗12周。对比2组呼气峰流速(PEF)变化值、哮喘控制测试(ACT)评分变化值、哮喘严重急性发作次数和日均使用缓解药物次数。对比2组咳嗽、喘息、肺哮鸣音、胸闷消失时间和不良反应情况。结果观察组PEF、ACT变化值显著高于对照组(P<0.05)。观察组哮喘严重急性发作次数及日均使用缓解药物次数均稍低于对照组,但组间比较差异无统计学意义(P>0.05)。观察组咳嗽、喘息、肺哮鸣音、胸闷消失时间均显著短于对照组,差异均有统计学意义(P<0.05)。2组声音嘶哑、咽部不适、口腔念珠菌病、真菌培养阳性率比较差异无统计学意义(P>0.05)。结论雾化吸入糖皮质激素治疗病情严重的老年哮喘长期控制不佳患者,能更好改善患者肺功能水平及临床症状,具有推广价值。
Objective To observe the efficacy of inhaled glucocorticoid in patients with long-term poor control of senile asthma. Methods Sixty-six patients with long-term poor control of asthma were divided into observation group (33 cases) and control group (33 cases). The observation group were used air compression nebulizer, inhalation of salbutamol 5 mg and budesonide suspension 1 mg, 2 times a day. The control group was given inhaled formoterol 4.5μg and budesonide 160μg dry powder inhaler, 2 suction twice a day. During treatment, are used to relieve the drug salbutamol aerosol. The two groups were treated for 12 weeks. The change of peak expiratory flow (PEF), the change of asthma control test (ACT) score, the number of serious acute asthma attacks and the number of daily relief drugs were compared between the two groups. Compare 2 groups cough, wheeze, lung wheeze, chest tightness disappear time and adverse reactions. Results The changes of PEF and ACT in the observation group were significantly higher than those in the control group (P <0.05). In the observation group, the number of severe acute asthma attacks and the average number of daily relief drugs were slightly lower than the control group, but there was no significant difference between the two groups (P> 0.05). The observation group cough, wheezing, lung wheeze, chest tightness disappear significantly shorter than the control group, the difference was statistically significant (P <0.05). No significant difference was found in the positive rate of fungal culture between the two groups (P> 0.05), with hoarseness, throat discomfort, oral candidiasis, and fungal culture. Conclusion Inhaled glucocorticoid treatment of elderly patients with severe asthma in patients with long-term poor control can better improve patients with pulmonary function and clinical symptoms, with the promotion of value.