The Study On The Maintenance Therapy For Totally Controlled Asthmatic Patients And Evidence-based Medicine

PARTⅠTo compare the efficacy of two different strategieswith inhaled corticosteroid after asthma controlOBJECTIVE: To provide guidance for making long term preferred therapy plan throughcomparing the efficacy of two different treatment strategies.METHODS: Mild to moderate asthmatic individuals, who had been completelycontrolled, were enrolled, aged 14-60 years. They had been randomly divided into twogroups and treated with different strategies for six months. The first group with mild andmoderate asthma inhaled fluticasone 250μg/d and 500μg/d respectively or other isodoseglucocorticoid for 3 months, then reduced to 125μg/d and 250μg/d. The second groupinhaled fluticasone 250μg/d and 500μg/d respectively or other isodose glucocorticoid for6 months. We compare the efficacy of two different treatment strategies through studyingthe changes of symptom scores, PEF%, EOS% and IL-5 levels.RESULTS: 29 patients were enrolled in the study, 24 of them finished over a half year'sfollow-up. The other five subjects were dropped off. Asthma symptom scores and PEF%maintained at relative normal levels in a narrow range with both treatment strategiesduring the whole therapy course, and differences between groups were not significant(P＞0.05). EOS% and the concentration of the IL-5 at baseline and after each treatmentperiod were not different (P＞0.05).CONCLUSION: Differences were not significant in asthma symptom scores,PEF%, EOS% and IL-5 between groups with two treatment strategies. In order topreferably appraisal the efficacy of two strategies, we should continue following upand observing the recurrence rate and time of asthma. PARTⅡEvidence-based medicine on asthmaOBJECTIVE: In order to understand the update of asthma therapy, we searched theevidence and identified the best available therapy for two cases.METHODS: We have searched the evidence from the Cochrane Library, PubMed and soon. And evaluated the quality of the evidence according to the best evidence we couldreceive about asthma therapy. It may help our medical process.RESULTS: Thirty-one articles were enrolled. Twenty-five of them are systematicreviews. These evidences are best evidence (grade of recommendation A). Two articlesare randomized clinical trials (RCTs) (grade of recommendation B). Two articles arecohort studies (grade of recommendation B).Three articles are case control studies (gradeof recommendation B).CONCLUSION: We comprehend the current situation of bronchial asthma fromthe received evidences that provide guidance for the diagnosis and treatment ofasthma. Evidence-based medicine can help doctors find the meta-analysis andexperience summarize of the correlated studies in exterior and interior countriesin the shortest time. And it is the most evidence-based medicine practice thatclinicians make the best of network resource.