哮喘联盟

   摘要
   目的：为了界定维生素D在中-重度支气管哮喘患儿辅助治疗中的地位。
   方法：本研究纳入来自呼吸和哮喘门诊的100例任一性别的哮喘儿童。疾病诊断基于病史和临床检查。通过使用密封不透光信封的方法进行随机选择。除按照GINA指南的治疗方法，一组给予口服每月维生素D3(胆钙化醇) 60000IU 6个月治疗；另一组以小袋葡萄糖的形式给予安慰剂粉末，两组均采用双盲法设计。每一例患者均需每月随访，并在每一次随访期间对严重程度、控制水平、呼气流量峰值(PEFR)、激素用量，急性发作次数和急诊次数进行评估。
   结果：与安慰剂组相比，每月给予60000IU维生素D显著减少了急性发作的次数(p = 0.011)。治疗组患儿的PEFR显著增加(p = 0.000)。每月给予维生素D显著减少了激素的需要量(p = 0.013)以及急诊次数(p = 0.015)。每月给予维生素D的患者更早达到哮喘控制。6个月治疗后补充维生素D的患者显著减轻了其哮喘的严重程度(p = 0.016)。
   结论：维生素D作为辅助疗法，在中-重度持续支气管哮喘的管理中发挥着一定的作用。
 

（林江涛 审校）
Indian J Pediatr. 2013 Nov 6. [Epub ahead of print]

 

Effect of Vitamin D Supplementation on Moderate to Severe Bronchial Asthma.
 

Yadav M, Mittal K.
 

Abstract
OBJECTIVE: To define the therapeutic role of vitamin D in children with moderate to severe bronchial asthma as an adjunct to standard treatment.
METHODS: Hundred asthmatic children of either sex, attending the respiratory and asthma clinic were enroled in the study. Diagnosis was made on the basis of history and clinical examination. Randomization was done using sealed opaque envelop method. In addition to the treatment as per GINA guidelines, one group received oral vitamin D3 (Cholecalciferol) 60,000 IU per month for 6 mo and the other group received placebo powder in the form of glucose sachet with a double blinded design. Monthly follow up of every patient was done and during every visit change in severity, level of control, Peak expiratory flow rate (PEFR),steroid dosage, number of exacerbations and number of emergency visits were assessed.
RESULTS: Monthly doses of 60,000 IU vitamin D significantly reduced the number of exacerbations as compared to placebo (p = 0.011). PEFR significantly increased in the treatment group (p = 0.000). Monthly doses of vitamin D significantly reduced the requirement of steroids (p = 0.013) and emergency visits (p = 0.015). Control of asthma was achieved earlier in patients who received monthly vitamin D. Vitamin D significantly reduced the level of severity of asthma patients over 6 mo of treatment (p = 0.016).
CONCLUSIONS:Vitamin D has a definite role in the management of moderate to severe persistent bronchial asthma as an adjunct to standard treatment.
 

Indian J Pediatr. 2013 Nov 6. [Epub ahead of print]