文摘
防治的作用(NAC)治疗慢性支气管炎的尚不清楚。以来,许多研究已经出版关于这个主题,系统回顾已发表的研究似乎是合理的。系统搜索(Medline和Embase, Cochrane图书馆、文献资料,没有语言限制)发表的随机试验比较口服南汽和安慰剂的患者慢性支气管炎。二分预防数据恶化,改善症状和副作用提取原始报告。相对利益和number-needed-to-treat计算个人试验和综合数据。39试验检索;11(2011分析病人),1976 - 1994年出版,被认为是相关和有效的根据预设的标准。351年九个研究中,723名(48.5%)患者接受南京没有恶化与229年相比733年(31.2%)患者接受安慰剂(相对收益1.56(95%可信区间(CI) 1.37 - -1.77), number-needed-to-treat 5.8 (95% CI 4.5 - -8.1)。没有证据表明任何影响的研究期间(12 - 24周)或累积剂量的NAC功效。286年五个试验中,466名(61.4%)患者接受南京报道症状的改善与160年相比,462名(34.6%)患者接受安慰剂(相对收益1.78 (95% CI 1.54 - -2.05), number-needed-to-treat 3.7 (95% CI 3.0 - -4.9))。 With NAC, 68 of 666 (10.2%) patients reported gastrointestinal adverse effects compared with 73 of 671 (10.9%) taking placebo. With NAC, 79 of 1,207 (6.5%) patients withdrew from the study due to adverse effects, compared with 87 of 1,234 (7.1%) receiving placebo. In conclusion, with treatment periods of approximately 12-24 weeks, oral N-acetylcysteine reduces the risk of exacerbations and improves symptoms in patients with chronic bronchitis compared with placebo, without increasing the risk of adverse effects. Whether this benefit is sufficient to justify the routine and long-term use of N-acetylcysteine in all patients with chronic bronchitis should be addressed in further studies and cost-effectiveness analyses.