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目的调查哮喘患者缓解期吸入糖皮质激素治疗的依从性,分析相关因素。方法随机选取134例2007年1月至2010年1月在我院呼吸科门诊和住院确诊的哮喘患者,通过电话或在门诊、病房调查其缓解期对吸入糖皮质激素治疗的依从性。结果 104例(77.6%)患者曾自行停用吸入糖皮质激素治疗,仅有30例(22.4%)患者能够一直坚持用药,但其中有6名患者有自行调整用药剂量的行为。停药的原因包括症状缓解(63.5%)、担心不良反应(50%)、间断按需使用(34.6%)、自认为治疗无效(19.2%)、感觉药粉未能吸入(13.5%)、担心糖皮质激素依赖(5.8%)、经济原因(7.7%)、社区医生错误指导(3.8%),无特殊原因而停药者占1.0%,无因不会用该吸入装置或买药不方便而停药的患者。坚持用药的原因包括因曾经停药后急性发作从此坚持用药(36.7%),担心停药后复发(23.3%),听从医师宣教坚持用药(66.7%),自认为治疗有效(6.7%)。结论哮喘患者缓解期吸入糖皮质激素治疗的依从性差。应继续加强对哮喘患者个性化的健康教育并建立哮喘患者之间的交流平台,提高患者依从性,使患者受益。此外还应该加强社区医生哮喘诊治知识的更新,提高对吸入糖皮质激素治疗在支气管哮喘治疗中地位的认识,避免错误指导患者。
Objective To investigate the compliance of inhaled glucocorticoid therapy during remission in asthmatic patients and analyze the related factors. Methods A total of 134 asthmatic patients diagnosed inpatients and inpatients from January 2007 to January 2010 in our hospital were randomly selected and investigated for compliance with inhaled glucocorticoid therapy by telephone or in the clinic and ward during their remission period. Results Of the 104 patients (77.6%) who had discontinued inhaled glucocorticoid therapy alone, only 30 (22.4%) patients were consistently able to adhere to medication, but 6 of these patients had self-adjusting doses. Reasons for discontinuation included symptomatic relief (63.5%), fear of adverse reactions (50%), discontinuity on demand (34.6%), treatment failure (19.2%), feeling inhaled powder (13.5%), fear of sugar Corticosteroid dependence (5.8%), economic reasons (7.7%), community doctor false guidance (3.8%), non-specific reasons for the withdrawal of those who accounted for 1.0%, no non-use of the inhalation device or medication inconvenient to stop Patient of medicine. The reasons for adherence to medication included adherence to medication (36.7%) due to an acute episode of withdrawal, fear of relapse after discontinuation (23.3%), follow-up to physician insistence on medication (66.7%), and treatment as effective (6.7%). Conclusions Patients with asthma have poor adherence to glucocorticoid therapy during remission. Should continue to strengthen the personalized health education for asthma patients and establish a platform for the exchange of patients with asthma to improve patient compliance, so that patients benefit. In addition, community doctors should strengthen the diagnosis and treatment of asthma updates, improve the inhaled glucocorticoid treatment in the treatment of bronchial asthma status awareness, to avoid mistaken guidance to patients.