Montuschi Paolo
Istituto di Farmacologia, Facoltà di Medicina e Chirurgia "A. Gemelli", Università Cattolica del Sacro Cuore, Roma.
Ann Ist Super Sanita. 2003;39(4):557-72.
None of the available drugs for chronic obstructive pulmonary disease is able to reduce the progressive decline in lung function which is the hallmark of this disease. Smoking cessation is the only intervention that has been shown so far to reduce disease progression. The current pharmacological therapy for chronic obstructive pulmonary disease is largely symptomatic and is based on bronchodilators including selective beta2-adrenoceptor agonists (short- and long-acting), anticholinergics, theophylline, or a combination of these drugs. Due to the lack of efficacy, side effects at high doses, and high costs, glucocorticoids should not be used routinely for management of stable chronic obstructive pulmonary disease, although they are effective for exacerbations. New pharmacological strategies for chronic obstructive pulmonary disease are needed because the current management is inadequate.
目前用于治疗慢性阻塞性肺疾病的药物均无法减缓肺功能的进行性下降，而这正是该疾病的标志。戒烟是迄今为止唯一已被证实能减缓疾病进展的干预措施。目前慢性阻塞性肺疾病的药物治疗主要是对症治疗，基于支气管扩张剂，包括选择性β2肾上腺素能受体激动剂（短效和长效）、抗胆碱能药物、茶碱或这些药物的组合。由于缺乏疗效、高剂量时的副作用以及高成本，糖皮质激素不应常规用于稳定期慢性阻塞性肺疾病的治疗，尽管它们对急性加重有效。由于目前的治疗方法存在不足，因此需要新的慢性阻塞性肺疾病药物治疗策略。
