Effiect of inhaled glucocorticosteroid in acute episode of childhood asthma

Yang Ting; Rao Huaping; Jin Shijie; Ding Niu; Xu Chang; Wu Bichen

doi:10.3760/cma.j.issn.1673-4777.2015.06.012

Abstract：Objective To evaluate the effect of inhaled glucocorticosteroid (ICS) in treatment of acute episode of childhood asthma.Methods Totally 80 children with moderate to severe acute episode of asthma were enrolled and randomly divided into ICS group (40 cases) and control group (40 cases).All the children were administrated with nebulized 0.5％ salbutamol (150 μg/kg,maximum dose of 5 mg/time) ±0.025％ ipratropiun bromide (250 μg);in addition,ICS group received nebulized 0.05％ budesonide and control group received nebulized 2 ml saline chloride (at half-hourly interval for 3 times,respectively).The lung function,respiratory rate (RR),heart rate (HR),oxygen saturation (SaO2) and clinical score (CS) were tested and compared between the two groups before and 0,1,2 h after treatment.Results After treatment,the CS,RR,SaO2,FEV1 and FEV1 ％ in the two groups were all improved.Two hours after treatment,the CS in ICS group was much lower than that in control group [(0.00 ± 0.00) scores vs (0.55 ± 0.20) scores,Z =3.418,P =0.021].There were no significant differences in RR,HR and SaO2 between two groups (P ＞ 0.05) after treatment.Two hours after treatment,the complete remission rate of ICS group was much higher than that of control group [95.0％ (38/40) vs 47.5％ (19/40)] (x2 =22.029,P＜0.001).Five cases (12.5％) in ICS group and 10 cases (25.0％) in control group required systemic hormone therapy with statistical differences (x2 =3.114,P =0.028);1 case in ICS group and 5 cases in control group required hospitalization.Conclusion Using of nebulized ICS with high dose and short interval and bronchodilators can effectively relieve the clinical symptoms,improve the lung function,reduce glucocorticosteroid and hospitalization in acute moderate to severe exacerbation of childhood asthma.