内科理论与实践2026，Vol.21Issue(3)：222-231,10.DOI:10.16138/j.1673-6087.2026.03.04
布地奈德不同吸入装置在初诊轻度支气管哮喘中的疗效比较
Comparison of the efficacy of different budesonide inhalation devices in newly diagnosed mild bronchial asthma
摘要
Abstract
Objective To compare the effects of regular inhaled corticosteroids(ICS)using different inhalation devices combined with on-demand short-acting β2-receptor agonist(SABA)on symptoms,respiratory impedance,lung function and airway inflammation in newly diagnosed patients with mild bronchial asthma.Methods A total of 53 patients with newly diagnosed mild bronchial asthma were prospectively enrolled.Using SAS software(version 9.4),the participants were randomly assigned in a 1:1 ratio to a pressurized metered-dose inhaler(pMDI)group of 26 patients and a dry powder inhaler(DPI)group of 27 patients.Both groups received budesonide 200 μg per dose twice daily for 4 weeks.Asthma control test(ACT)scores,lung function,impulse oscillometry(IOS)parameters,fractional exhaled nitric oxide(FeNO)and blood eosinophil(EOS)levels were assessed before and after treatment.Results There were no significant differences in baseline data,lung function,IOS,FeNO or EOS between the 2 groups(P>0.05).IOS parameters were correlated with lung function indicators.After 4 weeks of treatment,ACT scores increased,while FeNO and EOS decreased,and peak expiratory flow(PEF)increased compared with baseline in both groups(all P<0.05).The improvement in forced expiratory flow at 25%of forced vital capacity(FEF25%)in the pMDI group was significantly greater than that in the DPI group(P<0.05).Stratified analysis showed that in patients with small airway dysfunction(SAD),FeNO≥25 ppb,or EOS≥150 cells/μL,the pMDI group exhibited more significant FEF25%improvement after treatment(P<0.05).The proportion of patients achieving an ACT score of 25 in the pMDI group was significantly higher than that in the DPI group.Conclusions After 4 weeks of budesonide treatment in patients with newly diagnosed mild asthma,the change in FEF25%and the proportion with well-controlled symptoms were higher in the pMDI group than in the DPI group,while both are comparable in terms of airway inflammation improvement and safety.Baseline FEV1 reversibility and abnormalities in small airway function may predict a better therapeutic effect of pMDI.关键词
支气管哮喘/吸入糖皮质激素/小气道功能/吸入装置/气道炎症Key words
bronchial asthma/inhaled corticosteroids/small airway function/inhalation device/airway inflammation分类
医药卫生引用本文复制引用
郑琪,包婺平,王柠,宋雅君,张旻,周妍..布地奈德不同吸入装置在初诊轻度支气管哮喘中的疗效比较[J].内科理论与实践,2026,21(3):222-231,10.基金项目
中华国际医学交流基金会呼吸疾病青年实用研究项目(Z-2017-24-2301) （Z-2017-24-2301）
上海市第一人民医院特色研究项目面上项目(CCTR-2023B03). （CCTR-2023B03）
