CAJ | 학술논문

目的探讨高压氧(hyperbaric oxygen,HBO)联合药物治疗对激素依赖性哮喘患者血浆皮质醇(cortisol,Cor)的影响.方法经患者知情同意,采用随机单旨法将符合入选标准的患者分为HBO组有效病例54例)和对照组(有效病例48例).HBO组患者在常规治疗的基础上加HBO治疗,对照组采用常规治疗,分别于治疗前及治疗1、2、3个疗程后测定Cor和促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)的含量,并进行哮喘控制测试评分,记录不良反应和激素撤停反应.结果 HBO组患者治疗后各时间点血浆Cor均高于对照组(P＜0.05);2组ACTH于治疗第1个疗程均开始升高,但差异无统计学意义(P＞0.05).至治疗3个疗程,HBO组[(68.90±13.30) μg/L]与对照组[(30.52 ±10.50)μg/L]比较差异有统计学意义(P ＜0.05);HBO组症状改善迅速,治疗1个疗程的评分(17.1±1.1)、2个疗程的评分(20.5±1.1)与对照组的评分(12.3 ±0.8、16.5±1.1)比较差异均有统计学意义(P＜0.05),至治疗3个疗程时虽仍优于对照组,但差异无统计学意义(P＞0.05).2组不良反应比较差异无统计学意义(P＞0.05),但HBO组激素撤停反应的发生率明显低于对照组(P＜0.01).结论 HBO治疗可有效调节下丘脑-垂体-肾上腺皮质轴,促进ACTH的分泌,使血浆Cor明显升高,可以用于激素依赖性哮喘的治疗.
목적 탐토고압양(hyperbaric oxygen,HBO)연합약물치료대격소의뢰성효천환자혈장피질순(cortisol,Cor)적영향.방법 경환자지정동의,채용수궤단지법장부합입선표준적환자분위HBO조유효병례54례)화대조조(유효병례48례).HBO조환자재상규치료적기출상가HBO치료,대조조채용상규치료,분별우치료전급치료1、2、3개료정후측정Cor화촉신상선피질격소(adrenocorticotropic hormone,ACTH)적함량,병진행효천공제측시평분,기록불량반응화격소철정반응.결과 HBO조환자치료후각시간점혈장Cor균고우대조조(P＜0.05);2조ACTH우치료제1개료정균개시승고,단차이무통계학의의(P＞0.05).지치료3개료정,HBO조[(68.90±13.30) μg/L]여대조조[(30.52 ±10.50)μg/L]비교차이유통계학의의(P ＜0.05);HBO조증상개선신속,치료1개료정적평분(17.1±1.1)、2개료정적평분(20.5±1.1)여대조조적평분(12.3 ±0.8、16.5±1.1)비교차이균유통계학의의(P＜0.05),지치료3개료정시수잉우우대조조,단차이무통계학의의(P＞0.05).2조불량반응비교차이무통계학의의(P＞0.05),단HBO조격소철정반응적발생솔명현저우대조조(P＜0.01).결론 HBO치료가유효조절하구뇌-수체-신상선피질축,촉진ACTH적분비,사혈장Cor명현승고,가이용우격소의뢰성효천적치료.
Objective To explore the effects of comprehensive hyperbaric oxygen (HBO) on plasma cortisol of the patients with hormone-dependent asthma.Methods Patients who met the selection criteria were randomly divided into the HBO group and the control group.The patients of the control group were treated with HBO in addition to routine treatment,while the patients of the control group just received routine treatment.Levels of plasma cortisol and adrenocorticotropic hormone (ACTH) were measured just before treatment,after one course of treatment,after two courses of treatment and after three courses of treatment respectively.Then,symptoms were evaluated,side-effects of treatment and adverse effects of cortisol withdrawal reaction were registered.Results The levels of plasma cortisol in patients of the HBO group were all higher tham those of the control group at various time points ( P ＜ 0.05 ).The levels of ACTH in patients of both groups all began to elevate following one course of treatment,but without statistical significance.After three courses of treatment,statistical difference could be noted,when comparisons were made between the HBO group and the control group (P ＜0.05).Symptoms of the patients in the HBO group improved rapidly.After one and two courses of treatments,statistical significance could be noted,when comparisons were made between the two groups (P ＜0.05).And though it was still superior to that of the control group after three courses of treatments,there was no statistical difference between them (P ＞ 0.05 ).No differences were shown in side-effects between the 2groups.However,incidence of cortisol withdrawal reaction in patients of the HBO group was obviously lower than that of the control group ( P ＜ 0.01 ).Conclusions HBO could effectively regulate hypothalamuspituitary-adrenal cortex axis,promote the secretion of ACTH and increase the level of plasma cortisol,and it could be used for the treatment of hormone-dependent asthma.