[Investigation of treating steroids dependent asthmatic patients with kidney-tonifying herbs and high dose beclomethasone dipropionate aerosol].
The steroids dependent asthmatic(SDA) patients need prolonged oral steroids administration. Because of the significant adverse effects with long-term use of steroids, especially the damage of the hypothalamus-pituitary-adrenocortical(HPA) axis, long-term steroids administration should be avoided or withdrawn gradually. Many modes of withdrawing the oral steroids have be used. But, the results were not satisfactory. So far, recently, investigations have revealed that high dose corticosteroids inhalation, such as beclomethasone dipropionate (BDP), could provide an effective alternative; they were delivered locally in the airway and had minimal systemic absorption as well as side effects. On the other hand, it has been shown that the Kidney-Tonifying herbs (KTH) exert protective effect on the adrenocortical cells of the SDA patients by suppressing the exogenous steroids and could regulate the disorders in different levels on HPA axis in the patients. In order to provide the more effective alternative therapy for the patients, 30 SDA patients replaced their oral steroids with KTH and high dose BDP (1500 micrograms/day) inhalation were investigated. The changes of clinical features, pulmonary function and the Synacthen Test were followed up. The results showed that about 70% of the patients replaced their oral steroids successfully with the new therapy, the clinical features were improved in 16% of the patients and the ineffective rate was only 6.6%; the results also revealed that, after replacement, the pulmonary function of the patients were improved (P < 0.05); the data of Synacthen Test indicated, after alternative therapy for 3-6 months, the damaged reserve power and secretive ability of adrenal cortex of the patients were also improved partially (P < 0.001).
Dong
J C
JC
Huashan Hospital, Shanghai Medical University.
Shi
Z Y
ZY
Shen
Z Y
ZY
D000336:Aerosols; D001249:Asthma / Q000188:drug therapy*; D001507:Beclomethasone / Q000008:administration & dosage*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D011241:Prednisone / Q000009:adverse effects; D012129:Respiratory Function Tests; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control
D000336:Aerosols; D004365:Drugs, Chinese Herbal; D001507:Beclomethasone; D011241:Prednisone