Aintree Chest Centre, University Hospital Aintree, Lower Lane, Liverpool, UK.
Br Med Bull. 2010;93:217-27. doi: 10.1093/bmb/ldp050. Epub 2009 Dec 22.
Oral mucolytics are now recommended in some treatment guidelines for the management of chronic obstructive pulmonary disease (COPD). This article reviews the evidence for their use and their possible benefits.
The review is based upon peer reviewed publications relating to the use of mucolytics in COPD cited in PubMed.
Much of the published evidence is of somewhat poor quality and many studies include patients with both chronic bronchitis and COPD. Mucolytics reduce exacerbations by up to 0.8 exacerbations per year, but have little additional benefit in those on standard maximum therapy.
Data that mucolytics improve symptoms, alter mucus or impact health-related quality of life in COPD patients receiving other standard therapy are unconvincing. In those on little or no other treatment, they may reduce exacerbation rate.
The use of mucolytics to treat acute exacerbations is promising.
Head-to-head trials of mucolytics versus long-acting bronchodilators and/or inhaled corticosteroids are lacking. Even in patients with severe COPD who remain symptomatic despite maximal inhaled therapy the role of mucolytics remains unproven.
口腔黏液溶解剂现在被一些慢性阻塞性肺疾病（COPD）治疗指南推荐用于治疗。本文综述了其使用的证据及其可能的益处。
本综述基于在 PubMed 中引用的有关黏液溶解剂在 COPD 中的使用的同行评议出版物。
大量已发表的证据质量较差，许多研究包括慢性支气管炎和 COPD 患者。黏液溶解剂可使每年的恶化次数减少多达 0.8 次，但对接受标准最大治疗的患者几乎没有额外益处。
黏液溶解剂改善 COPD 患者在接受其他标准治疗时的症状、改变黏液或影响健康相关生活质量的数据并不令人信服。在那些接受很少或没有其他治疗的患者中，它们可能会降低恶化率。
黏液溶解剂治疗急性加重的作用很有前途。
黏液溶解剂与长效支气管扩张剂和/或吸入皮质类固醇的头对头试验仍然缺乏。即使在症状仍然存在的严重 COPD 患者中，黏液溶解剂的作用也尚未得到证实，尽管他们接受了最大吸入治疗。
