β_2受体激动剂与抗胆碱能药物治疗儿童哮喘的评价

Systematic review ofβ2receptor agonists and anticholinergic drugs in children asthma

目的评价β2受体激动剂、抗胆碱能药物以及β2受体激动剂联合抗胆碱能药物在治疗急诊儿童急性哮喘中的应用。方法搜索自建库至今Pubmed、Embase和中国科技期刊数据库关于抗胆碱能药物、β2受体激动剂在治疗儿童急性哮喘中的随机对照试验,对纳入的研究进行质量评价与数据提取,采用Revman 5.0.2软件进行统计分析。结果β2受体激动剂组在治疗失败率和接受治疗60min后1s用力呼气容积（FEV1）变化量占预计值的百分比方面明显优于抗胆碱能药物治疗组,OR及95%可信区间（95%CI）分别为2.27（95%CI：1.08-4.75）和12.6（95%CI：6.61-18.59）,在住院率方面两组差异无统计学意义（P〉0.05）,OR及95%CI为1.11（95%CI：0.66-1.86）。β2受体激动剂联合抗胆碱能药物组在治疗失败率、住院率和接受治疗60min后FEV1变化量占预计值的百分比方面明显优于抗胆碱能药物治疗组,OR及95%CI分别为3.67（95%CI：1.41-9.50）、2.28（95%CI：1.39-3.73）、10.65（95%CI：5.87-15.43）。结论β2受体激动剂以及β2受体激动剂联合抗胆碱能药物在治疗急诊儿童急性哮喘中的效果明显优于单独使用抗胆碱能药物。

Objective To evaluate the application ofβ2receptor agonists,anticholinergic drugs andβ2receptor agonists combined with anticholinergic drugs in children acute asthma.Methods The randomized controlled trials（RCTs）on the application ofβ2receptor agonists and anticholinergic drugs in children asthma were retrieved from the Pubmed,Embase and CJFD（from database establishment to now）.The included RCTs were performed the quality evaluation and data extraction.The Revman 5.0.2software was adopted to conduct the statistical analysis.Results 14 RCTs involving 1028 patients were included.β2receptor agonists was significantly superior to the anticholinergic drugs in the aspects of the treatment failure rate and the percentage of FEV1 variation to the expected value at 60 min after treatment,ORand 95%CI were 2.27（95%CI：1.08-4.75）and 12.6（95%CI：6.61-18.59）,the hospitalization rate had no statistical difference between the two groups（P〉0.05）,ORand 95%CI were 1.11（95%CI：0.66-1.86）.β2receptor agonists combined with anticholinergic drugs was significantly superior to the anticholinergic drugs treatment group in the aspects of the treatment failure rate,hospitalization rate and the percentage of FEV1 variation to the expected value at 60 min after treatment,ORand 95%CI were 3.67（95%CI：1.41-9.50）,2.28（95%CI：1.39-3.73）and 10.65（95%CI：5.87-15.43）.Conclusion β2receptor agonists andβ2receptor agonists combined with anticholinergic drugs have better efficacy on children acute asthma than single anticholinergic drugs.