摘要
目的:系统评价大剂量盐酸氨溴索对肺部的保护作用,以为临床提供循证参考。方法:计算机检索Cochrane图书馆、PubMed、EMBase、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库,并辅以手工检索,收集大剂量盐酸氨溴索对肺部的保护作用的随机对照试验(RCT),采用Cochrane协作网提供的Rev Man 5.0统计软件对符合纳入标准的RCT进行Meta分析。结果:共纳入20项RCT,合计1 266例患者。Meta分析结果显示,与对照组比较,大剂量盐酸氨溴索可降低胸部创伤所致的肺不张发生率[OR=0.31,95%CI(0.13,0.76),P=0.01]、肺感染发生率[OR=0.29,95%CI(0.15,0.57),P<0.000],升高呼吸窘迫综合征患者的动脉血氧分压[MD=11.06,95%CI(8.95,13.18),P<0.000]、氧合指数[MD=28.55,95%CI(22.82,34.47),P<0.000],并缩短呼吸窘迫综合征患者使用呼吸机进行机械通气的时间[MD=-4.91,95%CI(-6.99,-2.84),P<0.000],此外还可提高慢性阻塞性肺疾病患者治疗的有效率[OR=1.71,95%CI(1.05,2.80),P=0.03]。结论:大剂量盐酸氨溴索对肺部有较好的保护作用。由于纳入研究方法学质量上的局限性,该结论尚需要大样本、多中心、前瞻性的RCT进一步验证。
OBJECTIVE： To evaluate the protective effects of large-dose of ambroxol hydrochloride on lung tissue systematical- ly, and to provide evidence-based reference for clinical use. METHODS： Retrieved from Cochrane library, PubMed, EMBase, CBM, Chinese sci-tech periodical full-text database, CNKI, RCT about protective effects of large-dose of ambroxol hydrochloride on lung tissue were collected, and Meta-analysis of included RCT were conducted by using Cochrane systematic Rev Man 5.0 evaluation method. RESULTS： A total of 20 RCT were included, involving 1 266 patients. Meta-analysis showed, compared with con- trol group, large-dose of ambroxol hydrochloride decreased the incidence of atelectasis [OR = 0.31, 95 % CI （0.13,0.76）, P= 0.01], the incidence of lung infection [OR=0.29, 95% CI（0.15, 0.57） , P〈0.000] and the duration of mechanical ventilation [MD= - 4.91, 95 % CI （ - 6.99, - 2.84）, P〈0.000], while increased arterial pb, （O2） [MD = 11.06, 95 % CI （8.95, 13.18）, P〈 0.000] and PaOJFiO2 [MD=28.55,95%CI（22.82,34.47,P〈0.000] ; besides, the effective rate of therapy had been improved [OR=1.71, 95% CI（1.05, 2.80） ,P=0.03]. CONCLUSIONS： Large-dose ambroxol hydrochloride plays an positive role in lung protection. However, due to methodology limitations of the included trials, large-scale, multiple-center and prospective RCT are required.
出处
《中国药房》
CAS
CSCD
2014年第32期3041-3045,共5页
China Pharmacy
