• 1.北京大學第三醫(yī)院藥劑科（北京 100083） 2.浙江大學醫(yī)學院附屬第二醫(yī)院藥劑科（杭州 310009）;

目的 　系統(tǒng)評價氨溴索霧化吸入治療肺炎的療效與安全性。
方法 　電子檢索MEDLINE、EMbase、Cochrane圖書館臨床對照試驗資料庫、CBM和CNKI等數(shù)據(jù)庫，收集氨溴索霧化吸入作為輔助治療與空白或其他藥物霧化吸入治療肺炎的隨機和半隨機對照試驗，對符合納入標準的臨床研究進行質(zhì)量評價和Meta分析。
結(jié)果 　共納入13個研究，均為中文文獻，所有研究均未描述具體的隨機方法，均未說明是否實施了分配隱藏和采用了盲法及進行隨訪，Juni評分均為C級。Meta分析結(jié)果顯示，與對照組比較，氨溴索霧化吸入在提高臨床總有效率、改善癥狀體征以及縮短住院時間方面均顯示出較好的療效，雖少數(shù)研究/亞組無統(tǒng)計學差異，但均顯示出有益趨勢。未檢索到評價氨溴索霧化吸入安全性方面的研究。
結(jié)論 　由于氨溴索霧化吸入治療肺炎的臨床研究質(zhì)量普遍較低，且缺乏安全性研究資料，因此對氨溴索霧化吸入治療肺炎的有效性和安全性尚不能得出肯定的結(jié)論，有必要設(shè)計良好的隨機雙盲對照研究進行論證。

引用本文： 樓洪剛,劉 芳,翟所迪. 氨溴索霧化吸入治療肺炎的系統(tǒng)評價. 中國循證醫(yī)學雜志, 2006, 06(6): 421-429. doi: 復(fù)制

1. 楊惠娣, 徐彬. 氨溴索的作用機制及臨床應(yīng)用. 中國醫(yī)院藥學雜志, 2002; 22(1): 44.
2. 中華醫(yī)學會呼吸分會. 社區(qū)獲得性肺炎診斷和治療指南 (草案). 中華結(jié)核和呼吸雜志, 1999; 22(4): 199~201.
3. 胡亞美, 江載芳. 諸福棠實用兒科學. 第7版, 北京: 人民衛(wèi)生出版社; 2002. 1144.
4. 吳俊峰, 吳明娥. 沐舒坦霧化吸入輔助治療60例嬰幼兒支氣管肺炎療效觀察. 福建醫(yī)藥雜志, 2003; 25(2): 177.
5. 鄭敬陽, 陳志宏, 楊儉治, 等. 氨溴索霧化吸入佐治嬰幼兒肺炎. 實用兒科臨床雜志, 2001; 16(5): 377~378.
6. 黃萍, 羅社聲, 汪天林, 等. 沐舒坦霧化吸入輔助治療嬰幼兒肺炎. 復(fù)旦學報 (醫(yī)學科學版), 2001; 28(5): 453~454.
7. 黃燦成. 沐舒坦霧化吸入輔助治療重癥肺炎. 中國現(xiàn)代醫(yī)學雜志, 2002; 12(9): 98.
8. 張麗. 沐舒坦霧化治療小兒喘憋性肺炎療效觀察. 小兒急救醫(yī)學, 2004; 11(增): 63.
9. 何金英. 沐舒坦霧化佐治小兒肺炎的療效觀察. 青海醫(yī)藥雜志, 2003; 33(supple 11): 13.
10. 王素香, 鄭忠實, 許嘉玲. 鹽酸氨溴索注射液泵霧化吸入佐治新生兒肺炎86例. 海峽藥學, 2003; 15(3): 58-59.
11. 潘曉蕓. 鹽酸氨溴索佐治嬰幼兒肺炎療效觀察. 浙江中西醫(yī)結(jié)合雜志, 2004; 14(12): 774.
12. 何淑貞, 鄭萍. 沐舒坦氧氣霧化吸入治療小兒支氣管肺炎療效觀察. 臨床醫(yī)藥實踐, 2003; 12(9): 683.
13. 王桂蘭, 周群揚. 沐舒坦霧化吸入輔助治療嬰幼兒肺炎療效觀察. 海峽藥, 2003; 15(3): 61～62.
14. 鞠淑芬, 韓曉家, 張艷秋. 沐舒坦霧化吸入佐治病毒性肺炎38例療效觀察. 中華實用中西醫(yī)雜志, 2003; 16(3): 388.
15. 菅衛(wèi)中. 沐舒坦注射液霧化吸入治療嬰幼兒重癥肺炎. 醫(yī)藥論壇雜志, 2003; 24(12): 68.
16. 耿建梅, 刁士燕, 劉孝霞, 等. 氧氣驅(qū)動霧化沐舒坦治療新生兒肺炎療效觀察. 中國優(yōu)生與遺傳雜志, 2005; 13(6): 73~74.
17. Dolovich MB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest, 2005; 127(1): 335-371.
18. Labiris NR, Dolovich MB. Pulmonary drug delivery. Part II: the role of inhalant delivery devices and drug formulations in therapeutic effectiveness of aerosolized medications. Br J Clin Pharmacol, 2003; 56(6):600-612.
19. Yang HD, Xu B. Mechanism and clinical application of ambroxol. Chinese Journal of Hospital Pharmacy, 2002; 22(1): 44.
20. Respiration branch of Chinese Medical Association.Diagnostic and therapeutic guideline of community acquired pneumonia(protocol).Chinese journal of tuberculosis and respiration disease,1999,22(4):199-201.
21. Hu YM, Jiang ZF. Zhu FT Practical paidonosology of Zhu Futang. 7th edition. Beijing: People’s Medical Publishing House; 2002. 1144.
22. Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001; 323(7303):42-46.
23. Wu JF,Wu ME.Clinical effects of aerosol inhalating mucosolvan as a adjuvant therapy for infants with bronchopneumonia. Fujian medical journal, 2003,25(2):177.
24. Zheng JY, Chen ZH, Yang JZ, et al. Effects of aerosol inhalating ambroxol as adjuvant therapy for infants with pneumonia. Journal of applied Clinical Pediatrics, 2001,16(5): 377-378.
25. Huang P, Luo SS, Wan TL, et al. Adjuvant therapy of aerosol inhalating ambroxol for infants with pneumonia. Journal of Fudan university (medical science). 2001; 28(5): 453-454.
26. Wang CC. Adjuvant therapy of aerosol inhalating ambroxol for severe pneumonia. China Journal of Modern Medicine, 2002; 12(9): 98.
27. Zhang L. Effects of ambroxol by aerosol inhalation for infants with asthmatic suffocating pneumonia. Pediatric Emergency Medicine, 2004, 11(supply): 63.
28. He JY. Effects of aerosol inhalating ambroxol as adjuvant therapy for infants with pneumonia. Qinghai medical Journal , 2003, 33(11): 13.
29. Wang SX, Zheng ZS, Xu JL. Effects of 86 cases newborn’s pneumonia with inhalating ambroxol hydrochloride injection nebulized by pump. Strait Pharmaceutical Journal, 2003, 15(3): 58-59.
30. Pan XY. Effects of Ambroxol Hydrochloride as adjuvant therapy for infants with pneumonia. Zhejiang Journal of Integrated Traditional Combined Western Medicine, 2004; 14(12): 774.
31. He SZ, Zheng P. Effects of inhalating mucosolvan nebulized by oxygen for infants with bronchopneumonia. Clinical Medical Practice, 2003; 12(9): 683.
32. Wang GL, Zhou QY. Effects of aerosol inhalating ambroxol as adjuvant therapy for infants with pneumonia. Strait Pharmaceutical Journal, 2003; 15(3): 61-62.
33. Ju SF, Han XJ, Zhang YQ. Observation on treating viral pneumonia by aerosol inhalating mucosolvan in 38 cases. Chinese Journal of the practical of Chinese with Modern Medicine, 2003; 16(3): 388.
34. Jian WZ. Therapy of aerosol inhalating ambroxol injection for infants with severe pneumonia. Journal of Medical Forum, 2003; 24(12): 68.
35. Geng JM, Diao SY, Liu SX, et al. Observation on treating newborn’s pneumonia by aerosol inhalating mucosolvan drived by oxygen. Chinese Journal of aristogenesis and heredity, 2005; 13(6): 73-74.
36. Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995; 273(5): 408-412.
37. Moher D, Pham B, Jones A, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet, 1998; 352(9128): 609-613.
38. Merkus P, Romeijn SG, Verhoef JC, et al. Classification of cilio-inhibiting effects of nasal drugs. Laryngoscope, 2001; 111(4 Pt 1): 595-602.
39. Haidl P. Nebulized treatment-What is evidence-based? Atemwegs- und Lungenkrankheiten, 2004; 30(9): 432-439.
  1. 1. 楊惠娣, 徐彬. 氨溴索的作用機制及臨床應(yīng)用. 中國醫(yī)院藥學雜志, 2002; 22(1): 44.
  2. 2. 中華醫(yī)學會呼吸分會. 社區(qū)獲得性肺炎診斷和治療指南 (草案). 中華結(jié)核和呼吸雜志, 1999; 22(4): 199~201.
  3. 3. 胡亞美, 江載芳. 諸福棠實用兒科學. 第7版, 北京: 人民衛(wèi)生出版社; 2002. 1144.
  4. 4. 吳俊峰, 吳明娥. 沐舒坦霧化吸入輔助治療60例嬰幼兒支氣管肺炎療效觀察. 福建醫(yī)藥雜志, 2003; 25(2): 177.
  5. 5. 鄭敬陽, 陳志宏, 楊儉治, 等. 氨溴索霧化吸入佐治嬰幼兒肺炎. 實用兒科臨床雜志, 2001; 16(5): 377~378.
  6. 6. 黃萍, 羅社聲, 汪天林, 等. 沐舒坦霧化吸入輔助治療嬰幼兒肺炎. 復(fù)旦學報 (醫(yī)學科學版), 2001; 28(5): 453~454.
  7. 7. 黃燦成. 沐舒坦霧化吸入輔助治療重癥肺炎. 中國現(xiàn)代醫(yī)學雜志, 2002; 12(9): 98.
  8. 8. 張麗. 沐舒坦霧化治療小兒喘憋性肺炎療效觀察. 小兒急救醫(yī)學, 2004; 11(增): 63.
  9. 9. 何金英. 沐舒坦霧化佐治小兒肺炎的療效觀察. 青海醫(yī)藥雜志, 2003; 33(supple 11): 13.
  10. 10. 王素香, 鄭忠實, 許嘉玲. 鹽酸氨溴索注射液泵霧化吸入佐治新生兒肺炎86例. 海峽藥學, 2003; 15(3): 58-59.
  11. 11. 潘曉蕓. 鹽酸氨溴索佐治嬰幼兒肺炎療效觀察. 浙江中西醫(yī)結(jié)合雜志, 2004; 14(12): 774.
  12. 12. 何淑貞, 鄭萍. 沐舒坦氧氣霧化吸入治療小兒支氣管肺炎療效觀察. 臨床醫(yī)藥實踐, 2003; 12(9): 683.
  13. 13. 王桂蘭, 周群揚. 沐舒坦霧化吸入輔助治療嬰幼兒肺炎療效觀察. 海峽藥, 2003; 15(3): 61～62.
  14. 14. 鞠淑芬, 韓曉家, 張艷秋. 沐舒坦霧化吸入佐治病毒性肺炎38例療效觀察. 中華實用中西醫(yī)雜志, 2003; 16(3): 388.
  15. 15. 菅衛(wèi)中. 沐舒坦注射液霧化吸入治療嬰幼兒重癥肺炎. 醫(yī)藥論壇雜志, 2003; 24(12): 68.
  16. 16. 耿建梅, 刁士燕, 劉孝霞, 等. 氧氣驅(qū)動霧化沐舒坦治療新生兒肺炎療效觀察. 中國優(yōu)生與遺傳雜志, 2005; 13(6): 73~74.
  17. 17. Dolovich MB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest, 2005; 127(1): 335-371.
  18. 18. Labiris NR, Dolovich MB. Pulmonary drug delivery. Part II: the role of inhalant delivery devices and drug formulations in therapeutic effectiveness of aerosolized medications. Br J Clin Pharmacol, 2003; 56(6):600-612.
  19. 19. Yang HD, Xu B. Mechanism and clinical application of ambroxol. Chinese Journal of Hospital Pharmacy, 2002; 22(1): 44.
  20. 20. Respiration branch of Chinese Medical Association.Diagnostic and therapeutic guideline of community acquired pneumonia(protocol).Chinese journal of tuberculosis and respiration disease,1999,22(4):199-201.
  21. 21. Hu YM, Jiang ZF. Zhu FT Practical paidonosology of Zhu Futang. 7th edition. Beijing: People’s Medical Publishing House; 2002. 1144.
  22. 22. Juni P, Altman DG, Egger M. Systematic reviews in health care: Assessing the quality of controlled clinical trials. BMJ, 2001; 323(7303):42-46.
  23. 23. Wu JF,Wu ME.Clinical effects of aerosol inhalating mucosolvan as a adjuvant therapy for infants with bronchopneumonia. Fujian medical journal, 2003,25(2):177.
  24. 24. Zheng JY, Chen ZH, Yang JZ, et al. Effects of aerosol inhalating ambroxol as adjuvant therapy for infants with pneumonia. Journal of applied Clinical Pediatrics, 2001,16(5): 377-378.
  25. 25. Huang P, Luo SS, Wan TL, et al. Adjuvant therapy of aerosol inhalating ambroxol for infants with pneumonia. Journal of Fudan university (medical science). 2001; 28(5): 453-454.
  26. 26. Wang CC. Adjuvant therapy of aerosol inhalating ambroxol for severe pneumonia. China Journal of Modern Medicine, 2002; 12(9): 98.
  27. 27. Zhang L. Effects of ambroxol by aerosol inhalation for infants with asthmatic suffocating pneumonia. Pediatric Emergency Medicine, 2004, 11(supply): 63.
  28. 28. He JY. Effects of aerosol inhalating ambroxol as adjuvant therapy for infants with pneumonia. Qinghai medical Journal , 2003, 33(11): 13.
  29. 29. Wang SX, Zheng ZS, Xu JL. Effects of 86 cases newborn’s pneumonia with inhalating ambroxol hydrochloride injection nebulized by pump. Strait Pharmaceutical Journal, 2003, 15(3): 58-59.
  30. 30. Pan XY. Effects of Ambroxol Hydrochloride as adjuvant therapy for infants with pneumonia. Zhejiang Journal of Integrated Traditional Combined Western Medicine, 2004; 14(12): 774.
  31. 31. He SZ, Zheng P. Effects of inhalating mucosolvan nebulized by oxygen for infants with bronchopneumonia. Clinical Medical Practice, 2003; 12(9): 683.
  32. 32. Wang GL, Zhou QY. Effects of aerosol inhalating ambroxol as adjuvant therapy for infants with pneumonia. Strait Pharmaceutical Journal, 2003; 15(3): 61-62.
  33. 33. Ju SF, Han XJ, Zhang YQ. Observation on treating viral pneumonia by aerosol inhalating mucosolvan in 38 cases. Chinese Journal of the practical of Chinese with Modern Medicine, 2003; 16(3): 388.
  34. 34. Jian WZ. Therapy of aerosol inhalating ambroxol injection for infants with severe pneumonia. Journal of Medical Forum, 2003; 24(12): 68.
  35. 35. Geng JM, Diao SY, Liu SX, et al. Observation on treating newborn’s pneumonia by aerosol inhalating mucosolvan drived by oxygen. Chinese Journal of aristogenesis and heredity, 2005; 13(6): 73-74.
  36. 36. Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995; 273(5): 408-412.
  37. 37. Moher D, Pham B, Jones A, et al. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses? Lancet, 1998; 352(9128): 609-613.
  38. 38. Merkus P, Romeijn SG, Verhoef JC, et al. Classification of cilio-inhibiting effects of nasal drugs. Laryngoscope, 2001; 111(4 Pt 1): 595-602.
  39. 39. Haidl P. Nebulized treatment-What is evidence-based? Atemwegs- und Lungenkrankheiten, 2004; 30(9): 432-439.