支气管哮喘的药物治疗

近年来,支气管哮喘的发病率逐年提高,病因及发病机制复杂,大多数患者的哮喘症状不能得到及时的控制,严重影响了人们的生活质量．本文就目前哮喘常见的中药治疗及西药治疗药物予以综述,旨在为临床医生治疗支气管哮喘提供参考．     

小剂量异丙嗪氯丙嗪注射治疗支气管哮喘严重持续发作

支气管哮喘严重持续发作（展延式达到哮喘持续状态）是呼吸内科急重症。有些患者对目前常用的综合治疗措施无效。哮喘严重持续性发作成为治疗难题,几年来,我们应用小剂量异丙嗪、氯丙嗪注射配合治疗哮喘严重持续发作病人22例,收到良好的治疗效果。临床资料病例选择：按支气管哮喘重度发作标准（张口喘息,两肺广泛响亮哮鸣音）,且对常规治疗支气管哮喘措施治疗无效,哮喘仍严重持续发作者。治疗组22例（男10女12）,年龄34—65岁。治疗方法在常规综合治疗支气管哮喘措施（包括支气管解疫剂、抗生素、吸氧、纠正酸中毒和补液等）基础上,…     

孟鲁司特治疗30例中度支气管哮喘的临床研究

目的观察孟鲁司特治疗中度哮喘的临床效果。方法根据纳入和排除标准筛选30例中度哮喘患者参加了本试验,接受孟鲁司特治疗4周后判断其临床疗效。结果治疗前后日夜间无症状天数百分数、哮喘症状评分、最大呼气流量和喘乐宁气雾剂喷数有显著的统计学意义的改善(各项指标P<0.01)。结论孟鲁司特治疗中度哮喘有效。     

孟鲁司特治疗30例中度支气管哮喘的临床研究

目的 观察孟鲁司特治疗中度哮喘的临床效果.方法 根据纳入和排除标准筛选30例中度哮喘患者参加了本试验,接受孟鲁司特治疗4周后判断其临床疗效.结果 治疗前后日夜间无症状天数百分数、哮喘症状评分、最大呼气流量和喘乐宁气雾剂喷数有显著的统计学意义的改善(各项指标P＜0.01).结论 孟鲁司特治疗中度哮喘有效.     

支气管哮喘的综合治疗

支气管哮喘的综合治疗林书萍支气管哮喘（简称哮喘）是一种气道高反应性增高性疾病，其发病率有逐年增高的趋势，已引起国内外的关注，我们基层医院遇到哮喘病人发作时，在治疗上不易规范化，影响治疗效果。笔者根据临床摸索的经验，简介对慢性反复发作性哮喘进行综合治疗...     

异常黑胆质型哮喘维吾尔医特色疗法疗效观察

 观察维吾尔医特色疗法治疗异常黑胆质型哮喘患者的疗效。2012 年3 月-2013 年10 月,将新疆医科大学第一附属医院呼吸科门诊及病房内确诊为异常黑胆质型哮喘患者共75 例随机方法分为治疗组(n=38)和对照组(n=37)。治疗组为西医常规治疗基础上加用维吾尔医特色疗法,对照组则为单纯西医常规治疗,两组患者均接受一个疗程(1 个月)治疗。在治疗前与治疗后1 个月观察记录两组患者临床症状、体征,并进行哮喘日夜症状评分、哮喘控制测试(ACT)评分以及成人哮喘患者生存质量(AQLQ)评分。治疗后1 个月,两组患者哮喘症状得以控制者分别为91.9%和94.8%,差异无统计学意义(P>0.05);与治疗前相比,两组患者哮喘日夜症状评分及ACT 评分均有改善,差异有统计学意义(P<0.05),但在治疗后1 个月,两组患者间哮喘日夜症状评分及ACT 评分差异无统计学意义(P>0.05)。与治疗前比较,两组患者治疗后AQLQ 各项评分均有提高(P<0.05)。在治疗后1 个月,治疗组在活动受限、心理状况、对刺激源的反应、对自身健康的关心方面显著高于对照组,差异有统计学意义(P<0.05)。西医联合维吾尔医特色疗法在改善哮喘症状控制、ACT 评分及哮喘日夜症状评分上,与单纯西医治疗无显著差异。但是,西医联合维吾尔医特色疗法治疗异常黑胆质型哮喘在活动受限、心理状况、对刺激源的反应、对自身健康的关心方面的生活质量的提高改善显著,有一定的优势。     

中西医结合治疗小儿支气管哮喘46例

目的:探讨中西医结合治疗小儿支气管哮喘的疗效.方法:对46例支气管哮喘住院患儿选用西药抗感染平喘、雾化治疗的基础上,配合服用专方(麻黄、五味子、半夏、桔梗、牛膝、桃仁等)治疗.结果:经治疗显效42例,总有效率91.3%.结论:采用中西医结合治疗小儿支气管哮喘,标本兼治,临床疗效显著.     

星状神经节阻滞治疗支气管哮喘临床观察

目的：探讨星状神经节阻滞治疗支气管哮喘的疗效．方法：对近5年来接诊的23例支气管哮喘慢性持续期或急性发作的患者,用星状神经节阻滞的方法治疗．结果：23例支气管哮喘慢性持续期或急性发作的患者,用星状神经节阻滞的方法治疗,能迅速终止支气管哮喘的慢性持续期或急生发作,而经常发作的患者发作频率减小而症状也减轻,甚至不发作．结论：支气管哮喘的慢性持续期或急生发作的患者用星状神经节阻滞的方法治疗效果好．     

黄芪、硫酸镁、多巴胺、酚妥拉明联合治疗重度支气管哮喘32例疗效观察

近年来,支气管哮喘发病率逐年上升。哮喘发生后往往需要长期治疗,久眼氨茶碱、糖皮质激素,β受体激动剂常出现较多副作用及并发症而难以坚持。吸入制剂在重症哮喘时使用困难,致使部分哮喘,尤其是重度哮喘的治疗十分棘手。武威市人民医院急诊科联合应用黄芪、硫酸镁、多巴胺、酚妥拉明治疗重症支气管哮喘,取得较好效果,现报道如下：１临床资料１．１一般资料本文３２例支气管哮喘患者均为住院病人,其中男１８例,女１４例,年龄２４－６１岁,平均３９岁。病程２－２１年,平均１１年。按中华医学会制定的“支气管哮喘的诊断、严重度…     

傣药治疗哮喘研究进展

支气管哮喘是影响世界公共卫生健康的重要疾病之一,随着经济发展和人们生活方式的改变,该病发病率和死亡率呈快速上升趋势,严重危害人民健康和生活质量.傣医药具有完备的理论体系和丰富的临床应用经验,治疗范围广泛,治疗方法多样,疗效确切,是治疗哮喘的重要医疗资源.对傣医临床广泛用于治疗哮喘,基础研究深入的傣药品种研究进展进行综述,为傣医药治疗哮喘的研究提供参考.     

婴幼儿哮喘与肺炎支原体感染的关系

目的 通过分析婴幼儿哮喘发病情况，探讨婴幼儿哮喘与肺炎支原体感染的关系．方法 对75例婴幼儿哮喘患儿检测肺炎支原体抗体并与45例上呼吸道感染患儿及35例正常小儿作对照。结果 婴幼儿哮喘患儿MP-IgM检测阳性率达到25．3％，与对照组有显著差异．结论 婴幼儿哮喘中支原体感染率较高，应引起重视．     

吸入布地奈德对哮喘儿童肺功能的改善及安全性评价

目的探讨雾化吸入布地奈德对哮喘儿童肺功能的改善及安全性。方法选择95例6．48月的哮喘患儿持续（6月）吸入布地奈德,每日250μg,2次／d,治疗前及治疗6月后分别测定各项肺功能指标、血皮质醇及骨密度。结果治疗6月后,肺功能有明显改善,血皮质醇及骨密度无明显变化。结论吸入布地奈德能改善哮喘患儿肺功能,降低气道高反应性,对患儿肾上皮质功能及骨密度未见显著影响。     

郴州地区儿童哮喘患者血清过敏原检测分析

目的了解郴州地区儿童哮喘患者过敏原和总IgE分布情况及特点,为哮喘防治提供依据。方法采用体外过敏原检测系统计算过敏原阳性率sIgE和总IgE情况。结果136例儿童哮喘患者阳性率为72．06％,正常健康儿童阳性率为5．0％。最高的过敏原为户尘粉尘螨,占54．10％,其次为猫毛、狗毛、蟑螂、芒果、鸡蛋白、牛奶,牛肉羊肉。患儿血清总IgE水平明显高于正常健康儿童。结论郴州地区儿童哮喘患者过敏原以吸入为主,阳性率随年龄增长而升高,尘螨是重要的过敏原,检测并避免接触过敏原是防治的重要环节。     

舒喘灵和溴化异丙托品联合雾化吸入治疗儿童哮喘急性发作

目的：观察舒喘灵、溴化异丙托品联合吸入在儿童哮喘急性发作治疗中的疗效，方法：将62例患儿随机分为两组：联合组和单纯组，在相同基础治疗的前提下，观察联合组临床症状缓解情况，结果联合组对治疗儿童哮喘急性发作完全缓解率明显高于单纯组，两组对照有显著性差异，且对于不同年龄的哮喘患儿均有明显疗效，结论：舒喘灵、溴化异丙托品联合吸入对解除支气管痉挛、缓解喘息症状、缩短发作时间疗效显著。     

122例小儿肺炎伴明显喘憋的治疗体会

目的：分析总结小儿肺炎伴明显喘弊的治疗。方法：回顾分析收治１２２例肺炎伴明显喘憋的病儿具体临床表现,诊断治疗方法及治疗效果。结果：１０天内痊愈出院９６例（占７８．６％）,１０－２０天痊愈出院２３例（占１８．８％）,结论：酚妥拉明,维生素Ｋ１,氨茶碱,糖皮质激素,异丙肾上腺素及中药均有明显平喘作用,在抗感染的同时及时加用一种或多种平喘药,能收到满意效果。     

Dampness in dwellings and its associations with asthma and allergies among children in Chongqing: A cross-sectional study

The city of Chongqing has high outdoor temperatures and humidity throughout the year and consequently a high risk of dampness and mold problems in dwellings.As part of the China,Children,Homes,Health(CCHH),associations between home characteristics and children’s asthma,allergies,and related symptoms were investigated in Chongqing,China.A cross-sectional questionnaire survey on home characteristics including dampness and symptoms of asthma and allergies in 5299 children was performed.Data for 4754 children(3–6 years)and their homes were analyzed.Results showed that 35.1%of homes were reported to have"damp bedding",14.3%"condensation on window panes(higher than 5 cm)",11.6%"mouldy odor",9.3%"water leakage",8.3%"damp stains"and 5.3%"visible mould".Wheezing and rhinitis ever were reported for 27.0%and 51.1%children respectively,and rhinitis,wheezing,cough at night and eczema in the last 12 months were reported for 38.1%,20.5%,18.9%and 13.2%respectively.Doctor-diagnosed asthma was reported for 8.3%of children,and doctor-diagnosed rhinitis for 6.2%.Dampness in homes was generally strongly associated with asthma and allergies among Chongqing children.The strongest association was found between"visible mould"and doctor-diagnosed rhinitis,and the adjusted Odds Ratio(ORA)was 2.27(95%CI:1.48,3.49)."Damp bedding"was significantly associated with all asthma and allergic symptoms,but doctor-diagnosed asthma and rhinitis.The behavior of"putting bedding to sunshine"could effectively reduce the prevalence of asthma and allergic symptoms,and the risk of bedding affected with damp was reduced significantly when bedding was put to sunshine frequently.     

Indoor environmental quality and the prevalence of childhood asthma and rhinitis in Wuhan area of China

Indoor environmental quality is suspected to be at least part of the cause of the increasing prevalence of childhood asthma and allergy. This study is part of the China, Children, Homes, Health (CCHH) project, which was designed to identify the risk factors indoors that are associated with prevalence of asthma and allergy among children in China. A cross-sectional questionnaire study was carried out in Wuhan in 2011. The questionnaire was a modified (to Chinese building characteristics) version of a questionnaire used first in Sweden. The parents of 2193 children, aged 1–8 years, replied, a response rate of 91.4% (2193/2400). Prevalences of asthma and allergic symptoms were calculated, and a Chi-square test and multiple logistic regression were used to identify risk factors. Prevalences of health outcomes are “wheezing last 12 months” 18.5%, “cough at night last 12 months” 15.4%, “doctor-diagnosed asthma” 6.0%, “rhinitis last 12 months” 48.7%, “doctor-diagnosed allergic rhinitis” 17.5%. Factors associated with increased risk for asthma, allergy and related symptoms include living in an urban area, dampness (significant), use of gas for cooking, new dwelling decoration (paint and furniture obtained during pregnancy), keeping pets and breast feeding less than 3 months. Factors associated with reduced risk as installing an exhaust fan in the bathroom. Home environmental factors are significantly associated with the prevalence of childhood asthma and rhinitis in Wuhan. Urbanization and dampness problems at home are significant risk factors for doctor diagnosed asthma and allergic rhinitis among children in Wuhan.     

Self-organized patchiness in asthma as a prelude to catastrophic shifts

Asthma is a common disease affecting an increasing number of children throughout the world. In asthma, pulmonary airways narrow in response to contraction of surrounding smooth muscle. The precise nature of functional changes during an acute asthma attack is unclear. The tree structure of the pulmonary airways has been linked to complex behaviour in sudden airway narrowing and avalanche-like reopening. Here we present experimental evidence that bronchoconstriction leads to patchiness in lung ventilation, as well as a computational model that provides interpretation of the experimental data. Using positron emission tomography, we observe that bronchoconstricted asthmatics develop regions of poorly ventilated lung. Using the computational model we show that, even for uniform smooth muscle activation of a symmetric bronchial tree, the presence of minimal heterogeneity breaks the symmetry and leads to large clusters of poorly ventilated lung units. These clusters are generated by interaction of short- and long-range feedback mechanisms, which lead to catastrophic shifts similar to those linked to self-organized patchiness in nature. This work might have implications for the treatment of asthma, and might provide a model for studying diseases of other distributed organs.     

Pet-keeping and its impact on asthma and allergies among preschool children in Shanghai, China

Whether early pet-keeping is a risk factor for children’s asthma and allergies remains controversial. To investigate associations between asthma, allergies and airway symptoms among children and the indoor environment, a cross-sectional study was conducted in 5 districts of Shanghai. A number of 13335 questionnaires (response rate: 85.3%) of 4-6 year old children were analyzed. Families in urban areas have more pets except for dogs than families in suburbs. Fish are the most common pets in urban districts. The prevalence of doctor-diagnosed asthma was 10.3%, wheeze (ever) 28.3%, rhinitis (ever) 54.1%, doctor-diagnosed hay fever 12.6% and eczema (ever) 22.9%. In logistic regression analyses, early furred pet-keeping was positively associated with most of the symptoms and significantly with rhinitis (ever, adjusted OR=1.41, 95% CI=1.14–1.76) and doctor-diagnosed hay fever (1.38, 1.02–1.88). Current furred pet-keeping was significantly negatively associated with doctor-diagnosed asthma (0.57, 0.39–0.83). Persistent furred pet-keeping was significantly positively associated with rhinitis on pet or pollen exposure. However, current pet-keeping is not randomly distributed in the population. Children in families with “allergy” or with “pet avoidance behavior” (due to allergies in the family) have more symptoms, but have avoided cats and dogs, leading to the conclusion that such animals are “protective”, namely the “Healthy Pet-Keeping” effect. Moreover, rodents and birds are risks for children’s health. Fish-keeping is also seemingly a risk. This study indicates that early pet-keeping is a risk factor for asthma and allergies in families with a history of allergies, and part of residents in Shanghai have pet-avoidance behavior.     

支气管哮喘患者常见吸入性变应原调查分析

目的：探索大兴安岭地区支气管哮喘患者的主要致敏原.方法：采用北京协和医院变应原生产研制中心提供的标准变应原皮试液对52例支气管哮喘患者进行12种常见吸入性过敏原的皮内试验,阴性对照为山西太原制药厂生产的溶媒,阳性对照为0.01 mg/ml的盐酸组织胺.结果：儿童组阳性率为81.8%,成年组阳性率为66.7%,P〈0.025,两组有显著性差异.无论是儿童组,还是成年组,尘螨都是支气管哮喘的首要过敏原,其次是屋尘.结论：尘螨是大兴安岭地区支气管哮喘的最主要的致敏原,它能引起许多过敏症状,特别是儿童.有效的去除尘螨,必要时进行尘螨标准变应原浸液作特异性免疫治疗,可使症状减轻到最低限度,能获得较好的疗效.