【摘要】 目的:观察雷公藤甲素对糖皮质激素抵抗型(SR)支气管哮喘(哮喘)患者血清细胞因子水平、哮喘症状和肺功能的影响,探讨雷公藤甲素对SR哮喘有无治疗作用。方法:SR哮喘患者16例,随机分组为A及B两组,每组各8例。2组患者均予口服丙卡特罗50~100μg/d和茶碱400 mg/d,并急性发作时吸入沙丁胺醇200-800μg/d。A组患者同时联合应用雷公藤甲素每次33μg,口服,每日3次。疗程4周。疗程开始及结束时分别行血清干扰素(IFN)-γ、白细胞介素(IL)-4、IL-5水平测定,哮喘临床积分和肺功能检查。结果:治疗后,A组患者血清IFN-γ和肺功能指标用力肺活量(FVC%)、第1 s用力呼气容积(FEV1%)、最大呼气流量(PEF%)、50%肺活量时最大呼气流量(V50%)、25%肺活量时最大呼气流量(V25%)均显著增高,哮喘临床积分和血清IL-4、IL-5显著低于治疗前(P<0.01)和低于B组治疗后(P<0.05)。B组治疗后与治疗前比较,上述各项指标均无显著改变(P>0.05)。结论:雷公藤甲素与丙卡特罗和茶碱联合应用可能是治疗SR哮喘的有效方法。更多还原

【Abstract】 AIM:To evaluate the influences of triptolide on serum cytokines,symptoms and pulmonary func-tion in patients with steroid-resistant asthma,so as to investigate if there is therapeutic effect of triptolide on these pa-tients.METHODS:Sixteen patients with steroid-resistant asthma were randomly divided into two groups(Aand B,n=8 for each group).All of the patients took procaterol(50-100μg/d) and theophylline(400 mg/d) orally as baselinetreatment.Additionally,triptolide was prescribed for group A(33μg,orally,three times per day for4 weeks).Asthmaticsymptom score calculation,serum cytokines(interferon-γ,IFN-γ;interleukin-4,IL-4;and interleukin-5,IL-5)determination and pulmonary function test(FVC%,FEV1%,PEF%,V50% and V25%) were undertaken before and atthe end of the study.RESULTS:At baseline,no significant difference was found between group A and group B with re-spect to the above mentioned indices.Following the administration of triptolide,group A had significantly increased serumIFN-γlevel,FVC%,FEV1%,PEF%,V50% and V25%,and significantly decreased asthmatic symptom score and ser-um IL-4,IL-5 levels(P<0.01 compared with baseline in the same group,andP<0.05 compared with group B at theend of the study).Compared with baseline,no significant change was observed for group B regarding all the indices at theend of the study.CONCLUSION:Triptolide in combination with procaterol and theophylline may be a novel and effectivestrategy for the treatment of steroid-resistant asthma.更多还原