Effects Of Low-dose Inhaled Glucocorticoids On Growth And Lung Function In Asthmatic Children

Objective:Our aim is to investigate the effects of low dose inhaled glucocorticoid(inhaled glucocorticoids,ICS)on growth and lung function in children with mild and moderate asthma for one year.Height,weight,bone mineral density and serum 25-(OH)D,osteocalcin were observed as growth and development indicators.FEV1,FEV1/FVC% were observed as lung function indicators.We need to observe adverse drug reactions in during treatment.Methods: From June 2017 to January 2018,seventy children(6.0～10 years for females;6.0～10.5 years for males)diagnosed as mild and moderate bronchial asthma were treated in the outpatient clinic of the affiliated Hospital of Medical College Qingdao University.These children receive low doses of glucocorticoid after diagnosis.The forty-four asthmatic children were treated with salmeterol tecasone dry powder(one suction/times,two times/ d).Twenty-six asthmatic children were treated with budesonide formoterol dry powder(one suction/times,two times/ d).These children need regular outpatient visits and observe the adverse drug reactions.When the lung function of asthmatic children were significantly relieved for six months and above,ICS dose was reduced by 25%～50%,and gradually reduced to stop drug.When there is an acute attack during treatment,we need to mix the three drugs(terbutaline 1 m L,budesonide 1 m L,ipratropium 1 m L)and atomization for one week.At last,these children continue previous treatment after symptom control.Because of the children in this study were diagnosed as mild and moderate asthma,so the treatment effect is good,no remission.If there is no remission during treatment,we need to actively look for the etiology,such as infection factors,allergic factors.In the treatment of asthma at the same time to give etiological treatment,the treatment effect is good,all relief.The changes of height,body weight and bone mineral density were observed at the time of before treatment and three months,six months after treatment,and 1 year after treatment in children with asthma.At the same time,the changes of serum 25-(OH)D and osteocalcin were detected as the observation indicators to respond to bone metabolism.Before and after treatment,lung function examination was performed,and FEV1,FEV1/FVC% was selected as the observation index of clinical curative effect.At the same time,sixty healthy children were selected as control group.Results:1.Comparison of children treated with asthma and healthy control group,Before treatment,there was no significant difference in height and weight between pretherapy and three months,six months,twelve months after treatment(P>0.05).There was no significant difference in height growth rate(GV)and body mass growth rate between the two groups after one year(P>0.05).2.The BMD and serum 25-(OH)D,BGP were in the normal range before inhaled low dose glucocorticoid therapy and three,six,twelve months after treatment.There was no significant difference in different time points(F=0.953,0.255,0.769,P>0.05).3.The FEV1、FEV1/FVC% levels of three,six and twelve months after inhalation of low-dose glucocorticoids were significantly higher at each time point than before treatment(P<0.05).There was no significant difference in the time points FEV1 the third and sixth months after treatment(p﹥0.05),but have difference in the time points FEV1/FVC%.After six months of treatment,both indexes increased significantly,and there was no significant difference compared with twelve months of treatment(p﹥0.05).4.No adverse reactions such as headache,dizziness,tachycardia,muscle tremor,oral candida infection and hoarseness occurred in seventy children with asthma.Conclusion: A year of low dose inhaled glucocorticoid treatment had no significant effect on height,weight,bone mineral density and serum 25-(OH)D in asthmatic children.Moreover,It can effectively improve lung function and have high safety,there is no obvious adverse reactions during treatment.