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【目的】观察吸入糖皮质激素（ICS ）对成人中‐重度哮喘急性发作的疗效，探讨更有效、安全的成人哮喘急性发作治疗方案。【方法】采用前瞻性、随机、双盲、平行对照研究方法，按照数字表法将60例28～45岁（男32例，女28例）因哮喘急性发作急诊的成年人随机分为两组：吸入激素组（31例）和常规治疗组（29例），吸入激素组常规应用可必特加2 mL布地奈德，常规治疗组应用可必特加2 mL生理盐水，治疗前、完成雾化吸入后0 h、1 h、2 h、24 h分别测定肺通气功能、心率（HR）、呼吸频率（RR）、经皮测动脉血氧饱和度（SaO2 ），进行临床计分。【结果】两组患者经雾化吸入治疗后的0 h、1 h、2 h、24 h的PEF、HR、RR、SaO2、临床计分（CS）、FEV1、FEV1％均较治疗前有明显改善，治疗前后比较有统计学意义（ P ＜0．05）。两组间在治疗前、治疗后0 h、1 h、24 h PEF、HR、RR、SaO2、CS、FEV1、FEV1％比较差异无统计学意义（ P ＞0．05）。但治疗后2 h吸入激素组的CS、PEF明显优于常规治疗组，两组间比较差异有统计学意义（ P＜0．05）。【结论】成人中‐重度哮喘急性发作时，高剂量、短时间间隔雾化吸入布地奈德能与吸入速效支气管舒张剂发挥协同作用，快速有效缓解哮喘急性发作症状，改善肺功能，减少全身糖皮质激素的使用，降低住院率，在非危及生命哮喘急性发作可替代或部分替代全身应用糖皮质激素。“,”0bjective To evaluate the effect of nebulized budesonide (BUD) in acute moderate to severe exacerbations of asthma in adults .[Methods]A total of 60 adults aged 28~45 years with acute moder‐ate‐to‐severe asthma were randomized into BUD and control groups .The BUD group received 2 ml BUD while the control group had 2 ml normal saline .Lung function ,respiratory rate (RR) ,heart rate (HR) ,oxygen saturation (SaO2 ) and clinical score (CS) were monitored both preoperatively and postoperatively .[Results]After 3 doses of nebulization ,CS ,RR ,SaO2 ,FEV1 and FEV1% significantly improved in both groups com‐pared with pretreatment (P0 .05) .However , at 2 h ,CS and PEF of BUD group were obviously better than those of control group .There were significant inter‐group differences ( P <0 .05) .[Conclusion] High‐dose nebulized BUD at short intervals plus rapid‐act‐ing bronchodilators have synergistic bronchodilator responses to achieve with more rapid and better improve‐ments in clinical symptoms and lung function .And it is preferred in the early management of acute moderate‐to‐severe exacerbation of asthma in adults .