SALMETEROL PLUS/MINUS INHALED CORTICOSTEROIDS--SLIC PROTOCOL

吸入皮质类固醇是慢性哮喘治疗中最常用的抗炎药。尽管越来越多地使用高剂量吸入性皮质类固醇治疗引起了人们对长期使用可能产生不良反应的担忧，但吸入标准剂量的皮质类固醇似乎是安全有效的。吸入皮质类固醇被认为可以改变疾病进程；有证据表明，即使在减少或停止吸入皮质类固醇后，哮喘也能得到控制。沙美特罗是一种长效吸入β激动剂，可诱导支气管扩张，并可能具有抗炎特性。虽然早期对定期使用沙美特罗的研究表明，它可以减轻哮喘症状的严重程度，但其支气管扩张与抗炎作用的重要性尚不清楚。迄今为止的研究没有发现长期使用沙美特罗的有害影响。本研究将测试，在中度哮喘患者中，随着时间的推移，加入吸入沙美特罗是否可以减少或消除吸入皮质类固醇，而不会同时增加哮喘症状或降低对甲胆碱诱导的支气管收缩的保护。

Inhaled corticosteroids are the most commonly used anti-inflammatory agents used for chronic asthma therapy. Although increasing use of high-dose inhaled corticosteroid therapy has raised concerns about the potential for adverse effects with long-term use, standard doses of corticosteroids given by inhalation appear to be safe and effect. Inhaled corticosteroids are felt to modify the disease process; there is evidence of asthma control even after inhaled corticosteroids are reduced or stopped. A long-acting inhaled beta-agonist, salmeterol induces bronchodilation and may have anti-inflammatory properties. While early studies of the regular use of salmeterol suggest that it reduces the symptomatic severity of asthma, the importance of its bronchodilating versus anti-inflammatory activities is not known. Studies to date have found no deleterious effects of long-term use of salmeterol. This study will test, in patients with moderate asthma, whether the addition of inhaled salmeterol can reduce or eliminate inhaled corticosteroids over time without concomitant increase in asthma symptoms or a decrease in protection against methacholine induced bronchoconstriction.