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Updated: Jul 20, 2026
14:39
Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
Published on: November 4, 2010
軽度または中程度の持続性喘息の薬理学的管理
Paul M O'Byrne1, Krishnan Parameswaran
1Firestone Institute for Respiratory Health, St Joseph's Healthcare and Department of Medicine, McMaster University, Hamilton, Ontario, Canada. obyrnep@mcmaster.ca
Lancet (London, England)
|August 29, 2006
まとめ
定期的な吸入用コルチコステロイド治療は,軽度の持続性喘息を効果的に管理し,多くの場合,追加の薬の必要性を防止します. 中程度の症例では,吸入用コルチコステロイドと長時間作用のβ2アゴニストを併用すると,喘息のコントロールが著しく改善され,悪化が軽減されます.
科学分野:
- 肺内科 肺内科 肺内科
- アレルギーと免疫学
- 薬理学 薬理学とは
背景:
- 軽度の持続性喘息は,患者と医師の接触が少ないため,しばしば治療が不十分である.
- 現在の治療ガイドラインでは,軽度の持続性喘息の主要な治療法として,吸入用コルチコステロイドを推奨しています.
研究 の 目的:
- 軽度の持続性喘息に対する吸入型コルチコステロイド療法を支持する証拠をレビューする.
- 併用療法を含む中等度持続性喘息の治療戦略を評価する.
- 耐火性喘息の症例に対する高度な治療ガイドラインを探求する.
主な方法:
- 大規模なランダム化臨床試験の結果のレビュー.
- 吸入用コルチコステロイド,ルコトリエン改変剤,および併用療法の比較分析.
- ブデソニドとフォルモテロールのメンテナンス治療と緩和治療の検討.
- 治療指針として,誘発性唾液における呼吸道炎症測定の検討.
主要な成果:
- 低用量の吸入用コルチコステロイドは,軽度の持続性喘息に有益であり,追加の薬はめったに必要ありません.
- レウコトリエン改変剤は,吸入用コルチコステロイドよりも効果が低い.
- 吸入用コルチコステロイドと長効β2アゴニストの併用療法により,コルチコステロイドの投与量を増加させた場合と比較して,中程度の持続性喘息のコントロールが改善されています.
- ブデソニドとフォルモテロールは,維持治療と緩和治療として,重度の悪化をさらに軽減します.
結論:
- ほとんどの喘息患者は,現在のエビデンスベースの戦略で良いコントロールを達成することができます.
- 誘発性唾液における呼吸道炎症の測定は,標準療法に反応しない患者の治療を導くことができます.
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