Evidence-based Evaluation of High-dose Ambroxol for Severe Pneumonia/Respiratory Distress
Objective To systematically evaluate the efficacy and safety of high-dose ambroxol hydrochloride in the treatment of severe pneumonia/respiratory distress syndrome in clinical application,and to provide evidence-based pharmacy reference for clinical practice.Methods PubMed,EMbase,Medline,Cochrance Library,CBM,VIP,CNKI and Wanfang database were searched by computer.The literature on the safety and effectiveness of the experimental group(adult:1000 mg/d＞daily dose＞90 mg/d;Infant:100 mg/kg＞daily dose＞30 mg/kg)and the control group(adult and infant daily dose were lower than the experimental group)in the treatment of severe pneumonia/respiratory distress syndrome was collected.The retrieval time limit was from the establishment of the database to September 16,2021.The included indicators included interleukin(IL-6),procalcitonin(PCT),oxygenation index(PaO2/FiO2).EndNote software was used for literature screening and management,data were extracted,and the quality of the literature was evaluated according to the jadad scale.RevMan5.3 software was used for Meta-analysis,and funnel plot was used for bias analysis.Results A total of 10 RCTs with 952 patients were included in this study,including 480 patients in the experimental group and 472 patients in the control group.After evaluation of literature quality using jadad score,3 articles scored 4 scores,4 articles scored 6 scores,and 3 articles scored 1 score.Therefore,the quality of the included literatures was generally good.Meta-analysis showed that the experimental group was superior to the control group in reducing IL-6(MD=-0.38,95％CI:-0.44 to-0.32,P＜0.000 01),PCT(MD=-0.47,95％CI:-0.79 to-0.15,P=0.004)and increasing PaO2/FiO2(MD=5.13,95％CI:2.57 to 7.68,P＜0.0001).Conclusion For patients with severe pneumonia/respiratory distress syndrome,high-dose ambroxol can effectively reduce the levels of interleukin and procalcitonin,improve oxygenation index,which is worthy of clinical application.
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维普
