寿而康和大剂量二丙酸倍氯米松治疗慢性阻塞性肺病的临床研究

作者	单位
董竞成	上海医科大学附属华山医院
沈自尹	上海医科大学附属华山医院
王文健	上海医科大学附属华山医院
施赛珠	上海医科大学附属华山医院
张玲娟	上海医科大学附属华山医院
陈素珍	上海医科大学附属华山医院
陈伟华	上海医科大学附属华山医院
李娅丽	解放军83304部队医院
张耀东	解放军83304部队医院
章启夫	解放军83304部队医院
金维岳	上海市纺织工业局第二医
汪秀娟	上海市纺织工业局第二医

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中文摘要:

大剂量二丙酸倍氯米松治疗慢性阻塞性肺病(COPD),尤其是哮喘患者的疗效高、副作用少,但长期用药仍可影响下丘脑—垂体—肾上腺皮质(HPA)轴的储备功能,患者的症状复发率也很高,缓解期小气道的功能仍有异常,而加用补肾中药寿而康后,临床疗效明显提高,复发率降低,HPA 轴的储备功能得到保护,与对照组比较差异显著(P<0.05～0.001)。

英文摘要:

106 chronic obstructive pulmonary disease (COPD) cases were divided into two groups,53 cases treated with Shou Er Kang (SEK) pill (Kidney-reinforcing regimen) and high dose beclomethasone dipropionate inhaler,and 53 cases in the control group with high dose beclomethasone dipropionate aerosol alone.64 patients were suffering from bronchial asthma and 42 patients from asthmatic bronchitis,sufficiently severe to be treated with inhaled corticosteroids.The results showed that the total effective rate was 100% and 96.9% in asthmatic patients of both groups;the total effective rates for asthmatic bronchitis patients were 85.7% in the SEK group and 52.4% in the control group. The Synaethen test showed that after the treatment,the adrenal cortex reserve power and secretive ability of the SEK group not only was intact but also improved markedly under high dose exogenous steroids.The adrenocortical secretive ability and reserve power of the control group were damaged with the inhalation of the newer steroids.The difference between the two groups was very significant (P<0.001);the relapse rate in the SEK group was 26.9%,but 40% in the control group.The results suggested that there were some occult disorders in COPD patients,especially asthmatic bronchitis patients at different levels on hypothalamus-pituitary-adrenocortical axis.

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