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中国医药导刊 ›› 2024, Vol. 26 ›› Issue (11): 1163-1170.

• 医药信息学 • 上一篇    

氨茶碱口服制剂治疗喘息性疾病临床价值评价

颜毅1, 王芳旭1, 陶立波12*   

  1. 北京大学医学部 卫生政策与技术评估中心1,公共卫生学院卫生政策与管理学系2,北京 100191
  • 收稿日期:2024-08-23 修回日期:2024-09-14 出版日期:2024-11-28 发布日期:2024-11-28

Evaluation of the Clinical Value of Oral Aminophylline for the Treatment of Wheezing Diseases

  1. Center for Health Policy and Technology Evaluation1 Department of Health Policy and Management School of Public Health2 Peking University Health Science Center Beijing 100191, China
  • Received:2024-08-23 Revised:2024-09-14 Online:2024-11-28 Published:2024-11-28

摘要:

目的:评价氨茶碱口服制剂治疗喘息性疾病的临床价值,以期为临床提供循证依据,为保障临床合理用药提供参考。方法:检索中国学术期刊全文数据库(CNKI)、万方数据知识服务平台、PubMed英文数据库文献,利用临床医学和循证医学等研究方法,对氨茶碱口服制剂的有效性和安全性进行评估。结果:本研究共检索到相关文献1744篇,最终纳入有效文献55篇。相关文献表明,氨茶碱口服制剂治疗小儿哮喘和小儿毛细支气管炎有良好疗效;与布地奈德联合用药在提高治疗小儿毛细支气管炎效果、缩短住院时间以及缓解症状方面具有明显优势;治疗成人支气管哮喘时,布地奈德、沙美特罗替卡松等分别与氨茶碱口服制剂联用治疗总有效率显著高于单药组,多索茶碱在临床疗效和生活质量改善方面可能优于氨茶碱;治疗慢性阻塞性肺疾病(COPD)时,布地奈德、布地奈德福莫特罗、头孢他啶等分别联合氨茶碱口服制剂疗效均优于单药治疗组;单用布地奈德福莫特罗粉、噻托溴铵治疗COPD的总有效率高于氨茶碱。此外,在治疗支气管扩张、窦性心动过缓、咳嗽变异性哮喘、睡眠呼吸暂停综合征时,与氨茶碱口服制剂联用治疗效果均优于单药治疗组。氨茶碱口服制剂的不良反应与个体差异和剂量相关,常见的有恶心、呕吐、腹痛、头痛、胸痛、失眠、兴奋、心动过速、呼吸急促等,氨茶碱口服溶液剂型易于精确计量和个体化给药,适用于婴幼儿及儿童,可有效降低不良反应风险。结论:氨茶碱口服制剂治疗支气管哮喘、喘息型支气管炎、阻塞性肺气肿、心源性肺水肿引起的哮喘有效性和安全性良好,具有较好的临床价值。


关键词: 氨茶碱, 哮喘, COPD, 临床疗效, 安全性

Abstract:

Objective: To assess the clinical value of oral aminophylline in treating diseases with wheezing symptoms aiming to provide evidence-based support for its clinical use and reference for clinical rational drug use.Methods: Through searching the China National Knowledge Infrastructure CNKI), Wanfang Data Knowledge Service Platform and PubMed databases the efficacy and safety of oral aminophylline were evaluated using both clinical and evidence-based approaches.Results: A total of 1744 relevant literatures were searched with 55 valid ones ultimately included. Related literatures indicate that oral aminophylline has shown good efficacy in treating pediatric asthma and bronchiolitis. The combination treatment with aminophylline and budesonide shows significant advantages in improving the effectiveness of therapy for pediatric bronchiolitis shortening hospitalization time and alleviating symptoms. In the treatment of adult bronchial asthma the total efficacy rate of combining budesonide Salmeterol Xinafoate and Fluticasone Propionate with oral aminophylline are significantly higher than that of monotherapy. Additionally doxofylline may show superior clinical efficacy and quality of life improvement compared to aminophylline. In the treatment of chronic obstructive pulmonary disease COPD), the efficacy of oral aminophylline formulations combined separately with budesonide budesonide-formoterol or ceftazidime is superior to that of monotherapy. However the total efficacy rate of using budesonide and formoterol fumarate or tiotropium alone for the treatment of COPD is higher than that of aminophylline alone. Furthermore the combination therapy with oral aminophylline has shown superior outcomes in the treatment of bronchiectasis sinus bradycardia cough-variant asthma and sleep apnea syndrome compared to monotherapy. Adverse reactions of oral aminophylline are related to individual differences and dosage and common adverse reactions including nausea vomiting abdominal pain headache chest pain insomnia excitement tachycardia and shortness of breath. Aminophylline oral solution formulation allows for accurate dosage measurement and individualized administration making it suitable for infants and children which can effectively reduce the risk of adverse reactions.Conclusion: Oral aminophylline is effective and safe in the treatment of asthma caused by bronchial asthma asthmatic bronchitis obstructive emphysema and cardiogenic pulmonary edema which has good clinical value.

 

Key words:  , Aminophylline , Asthma , COPD , Clinical efficacy , Safety

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