溴己新治疗慢性支气管炎的疗效评价

邓梓辛，张美祥，谭璐，汪曲，王树平

(黄冈市中心医院 438000)

摘要：目的 评价溴己新治疗慢性支气管炎的疗效及安全性。方法 通过检索PubMed、Cochrane library、中国期刊全文数据库(China National Knowledge Internet, CNKI)、维普数据库(Weip Database, VIP)和万方数字化期刊全文数据库；纳入随机对照试验(Randomized Controlled Trial，RCT)8篇，包括溴己新对比氨溴索、二陈汤、咳喘宁口服液、S-羧甲半胱氨酸和安慰剂组；利用Jadad质量评分工具进行方法质量评价。结果 溴己新组对比氨溴索组共4个RCT，临床总有效率比较：RR=0.83，95%CI(0.76，0.91)，P<0.000 1，差异有统计学意义。其余组由于文献数量少限制而进行描述性分析。结论 溴己新可以有效地治疗慢性支气管炎，但是质量评分以及Meta分析显示其疗效低于氨溴索。

关键词：溴己新 ；氨溴索；慢性支气管炎；Meta分析

Curative effect evaluation of bromhexine for the treatment of chronic bronchitis

DENG Zixin，ZHANG Meixiang，TAN Lu，WANG Qu，WANG Shuping (Huanggang Central Hospital 438000，China)

Abstract:ObjectiveTo assess the effect and safety of bromhexine for chronic bronchitis. MethodsWe retrieve the database including PubMed, the Cochrane library, China National Knowledge Internet (CNKI), Weip Database (VIP) and Wanfang Data. Eight randomized controlled trials(RCT) comparing bromhexine with ambroxol, Erchentang, Kechuanning oral liquid, S-carboxymethylcysteine and placebo were included in this research. The course of treatment was more than 5 days. The Jadad quality tools was used for the quality evaluation of each study. ResultsThere were 4 RCTs which compared bromhexine with ambroxol, with significant difference in clinical overall efficacy[RR=0.83，95%CI(0.76，0.91)，P<0.000 1].The rest groups required descriptive analysis for study quantity . Conclusion Chronic bronchitis can be treated effectively by bromhexine. However, compared with ambroxol, the result of quality grade and Meta-analysis reveals lower curative effect.

Key words: bromhexine；ambroxol；chronic bronchitis；Meta-analysis

慢性支气管炎是以咳嗽、咳痰或伴有喘息为主要症状、呈反复发作的慢性过程[1]。溴己新是一种具有系统活性的祛痰药，能使黏痰中的酸性糖蛋白纤维结构断裂，在降低痰液黏度的同时增加咳痰量[2]。早在20世纪临床上就有许多研究报道显示，口服剂量为8～16 mg的溴己新对慢性支气管炎有良好的治疗作用[3-5]。本研究系统地分析了溴己新对慢性支气管炎的治疗作用和安全性。

1资料和方法

1.1纳入标准

1.1.1文献类型随机对照实验(Randomized Controlled Trial, RCT)、系统评价(Systematic Review, SR)和Meta分析。

1.1.2患者类型根据Brunton, S.在2004年提出的《慢性支气管炎急性发作：初级保健共识指南》[6]或其他类似标准纳入符合标准的患者。

1.1.3干预措施试验组：溴己新；对照组：氨溴索、二陈汤、咳喘宁口服液、S-羧甲半胱氨酸或安慰剂。

1.1.4结局指标疗效指标：临床总有效率、临床显效率、临床有效率、临床治愈率、单独症状(如咳痰量、FEV1%(percentage of Forced Expiratory Volume in one second，1秒用力呼气量百分比))。

疗效判定标准：①治愈：咳嗽、咳痰、喘息及肺部哮鸣音消失，胸片检查明显好转，实验室指标恢复正常；……