儿童哮喘控制联合用药的选择

摘要

哮喘是儿童最常见的异质性慢性疾病,需要长期规律的治疗.哮喘发病机制复杂,多种环境因素同时作用,治疗更是复杂多样.目前,除了避免接触可能诱发哮喘的各种变应原和刺激物外,药物治疗仍然是最基本、最重要的方法.吸入糖皮质激素治疗是控制哮喘的基石,但总体说来单一糖皮质激素吸入治疗,哮喘控制仍然不佳,而加入第2种药物联合治疗可改善症状,达到很好的控制水平.联合治疗包括吸入糖皮质激素联合长效β2受体激动剂、联合白三烯受体拮抗剂以及氨茶碱等治疗.通过比较这些联合治疗用于儿童哮喘的有效性及安全性的研究,可找到最佳治疗途径.%Asthma is the common chronic disease in children which is complex and heterogeneous, and requires long-term regular treatment. Due to the complex pathogenesis and multiple contributing environmental factors, the treatment is complex and diverse. For now, in addition to avoiding contact with various allergens and stimuli which may trigger asthma, drug therapy remains the most fundamental and important approach. Inhaled corticosteroids (ICS)therapy is the cornerstone of asthma control, but the control effect still remains poor. Adding a second drug to inhaled corticosteroids can ameliorate symptoms, and achieve a good level of control. The combination therapy includes ICS therapy with long-acting β2-adrenergic agonists, with leukotriene receptor antagonist, and with the aminophylline. By comparision, The effectiveness and safety of these combination therapies for childhood asthma was assessed, trying to find the best therapeutic approach.