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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Single-Dose Oral Dexamethasone Compared with Three Day Course of Oral Prednisolone in Children with Moderate Exacerbation of Asthma-A Pilot Double-Blinded Randomised Controlled Trial
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Single-Dose Oral Dexamethasone Compared with Three Day Course of Oral Prednisolone in Children with Moderate Exacerbation of Asthma-A Pilot Double-Blinded Randomised Controlled Trial

机译：小剂量中度哮喘加重患儿单剂量口服地塞米松与口服泼尼松龙三天疗程的比较-一项先导性双盲随机对照试验

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Corticosteroids are the mainstay of treatment for a child with acute exacerbation of asthma. Though, several guidelines suggest use of prednisolone for few days, recently single dose dexamethasone has been found to be equally efficacious. Studies comparing single dose dexamethasone with multiple doses of prednisolone in childhood asthma are lacking in India.Aim: To find out whether a single dose of dexamethasone is as efficacious as multiple doses of prednisolone in the management of moderate exacerbation of acute bronchial asthma in children.Materials and Methods: This is a double blinded, placebo controlled, pilot randomised controlled trial, conducted at a medical college and hospital in Southern India between November 2015 to August 2016. Sixty children aged two to twelve years diagnosed with moderate exacerbation of bronchial asthma, based on Paediatric Respiratory Assessment Measure (PRAM) score, were randomly divided into two groups of equal number; 30 children received a single dose of dexamethasone orally stat followed by second dose and third dose as placebo on days two and three while remaining 30 children received prednisolone for three days in single daily doses. The time taken for PRAM score to reach a value <2, number of bronchodilator nebulisations required and relapse within 24 hours of reaching PRAM<2 were assessed and analysed.Results: No statistically significant difference was found in the mean time (hours) required to attain PRAM score of <2 (prednisolone group 56.9±12.9 vs. dexamethasone group 58.6±11.5, p-value=0.3) and in the number of bronchodilator nebulisations required (prednisolone group 42.7±13.5 vs dexamethasone group 40.97±17.98, p-value=0.2).Conclusion: A single dose of oral dexamethasone is atleast as effective as three daily doses of prednisolone in children with moderate exacerbation of bronchial asthma. However, the results need to be confirmed with large randomised controlled trials in diverse settings.
机译：皮质类固醇是哮喘急性加重儿童的主要治疗药物。虽然，一些指​​南建议使用泼尼松龙几天，但最近发现单剂量地塞米松同样有效。印度尚缺乏将单剂量地塞米松与多剂量泼尼松龙在儿童哮喘中进行比较的研究。目标：寻找单剂量地塞米松在多发泼尼松龙中度加重急性支气管哮喘的治疗中是否有效材料与方法：这是一项双盲，安慰剂对照，先导性随机对照试验，于2015年11月至2016年8月在印度南部的医学院和医院进行。60例年龄在2至12岁的儿童被诊断患有根据小儿呼吸评估指标（PRAM）评分，支气管哮喘的轻度加重被随机分为两组，每组相等。 30名儿童在第2天和第3天接受了单剂量的地塞米松口服统计，随后第二和第三剂作为安慰剂，其余30名儿童则以单日剂量接受泼尼松龙三天。 PRAM评分达到值<2所需的时间，评估并分析了达到PRAM <2的24小时内所需的支气管扩张剂雾化次数和复发次数。结果：在平均时间（小时）中未发现统计学上的显着差异）达到PRAM得分<2（泼尼松龙组56.9±12.9与地塞米松组58.6±11.5，p值= 0.3）和所需的支气管扩张剂雾化次数（泼尼松龙组42.7±13.5与地塞米松组40.97±17.98， p值= 0.2）。结论：对于中度加重的支气管哮喘患儿，单次口服地塞米松的疗效至少与每日3次泼尼松龙相同。但是，结果需要通过在各种情况下进行的大型随机对照试验来确认。

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