在喘管理方面要聪明:单次维护和缓解疗法
Alexander F Infante1, Christina Wells1, Julie Loza1
1From the University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, Illinois (AFI); University of Illinois College of Medicine at Chicago, Chicago, Illinois (CW); University of Illinois College of Medicine at Chicago, Chicago, Illinois (JL); University of Illinois College of Medicine at Chicago, Chicago, Illinois (KH); University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, Illinois (JBJ); University of Illinois Chicago College of Pharmacy, Department of Pharmacy Practice, Chicago, Illinois (ATE).
单次维护和缓解疗法 (SMART) 提供了一种有效的喘管理策略,使用联合吸入性皮质类固醇和长效β-激动剂. 避免仅使用短效β-激动剂的治疗方法,并考虑GINA步骤3或4患者的SMART治疗,优先考虑布索尼德-甲醇.
科学领域:
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 单次维护和缓解疗法 (SMART) 结合了吸入性皮质类固醇 (ICS) 和长效β-激动剂 (LABA) 用于喘管理.
- 尽管采用了指导方针,但SMART仍然是临床讨论的主题.
研究的目的:
- 审查支持SMART的证据.
- 为将SMART纳入综合性喘护理提供指导.
主要方法:
- 对SMART现有科学文献和临床指导方针的审查.
- 对特定的ICS/LABA组合和治疗步骤的证据分析.
主要成果:
- 仅使用短效β-激动剂 (SABA) 的疗法不建议用于任何喘严重程度 (SOR A).
- 建议GINA第三或第四步患者使用SMART,特别是那些有坚持问题 (SOR B) 患者.
- 布德胺-形式醇是SMART (SOR B) 的首选ICS/LABA组合.
结论:
- 对于中度至重度喘管理,SMART是一种有价值的方法.
- 临床医生应避免仅使用SABA的疗法,并考虑符合条件的患者使用SMART.
- 为了获得最佳的结果,应优先考虑特定的ICS/LABA组合,如布塞尼德-形式醇.
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