Effect of combined glucocorticoid therapy on bronchial asthma dynamics

This work is aimed to compare the effectiveness of parenteral and inhalation bronchial asthma treatment in combination with glucocorticosteroids and bronchodilators. The study was conducted in 2020 in Botkin City Clinical Hospital (Moscow, the Russian Federation). Case histories of 106 patients diagnosed with bronchial asthma exacerbation of moderate severity were analyzed. Patients were divided into two equal groups based on the therapy method: (1) Group 1 received systemic glucocorticosteroids parenterally in combination with inhalation glucocorticosteroids; (2) Group 2 received systemic glucocorticosteroids parenterally, but inhalation therapy was performed with a nebulizer. Clinical manifestations of bronchial asthma have been recorded. During hospital admission, the breath rate was 22.0 for Group 1 and 21.5 for Group 2, P ≥ 0.05, and heart rates were 93.0 and 92.5, respectively (P ≥ 0.05). All indices (blood saturation, breath rate, peak output rate) in Group 1 remained unchanged 4 h after the start of the therapy, while in Group 2, peak flow rate changed to 53.5% with a median increase of 72.0 ml over 4 h, P ≤ 0.05. On Day 3, patients of Group 1 demonstrated a peak flow rate of 59.5%, P ≤ 0.05, and on Day 10, patients of Group 2 had a peak output rate of 53.0 and 59.5%, respectively (P ≤ 0.05). Systemic glucocorticoids were eliminated in 47 patients of Group 1 and in all patients of Group 2. The treatment tactics applied in Group 2 resulted in faster and more significant improvement in patients diagnosed with bronchial asthma exacerbation. Both treatment regimens showed high results.