Pulmonary and Critical Care Division, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Curr Opin Pulm Med. 2010 Mar;16(2):150-4. doi: 10.1097/MCP.0b013e3283364378.
Dyspnea, a distressing symptom, in chronic obstructive pulmonary disease patients is often unrelieved. The purpose of this article is to examine the efficacy of opioids administered orally, in nebulized form and other routes in dyspnea relief. Additionally, factors that inhibit the prescription of opioids and use of opioids are explored.
Although there are multiple case reports and case series, there is a paucity of well designed, prospective, randomized controlled trials with large enough number of chronic obstructive pulmonary disease patients. One review of randomized controlled trials and another randomized controlled trial found opioids effective in relieving dyspnea without causing major adverse effects.
Opioid is an effective palliative drug in chronic obstructive pulmonary disease patients with distressing dypnea that is refractory to standard modalities of treatment.
呼吸困难是慢性阻塞性肺疾病患者的一种痛苦症状，往往无法缓解。本文旨在探讨口服、雾化和其他途径给予阿片类药物在缓解呼吸困难方面的疗效。此外，还探讨了抑制阿片类药物处方和使用的因素。
尽管有多项病例报告和病例系列，但缺乏足够数量的慢性阻塞性肺疾病患者进行的设计良好、前瞻性、随机对照试验。一项对随机对照试验的综述和另一项随机对照试验发现，阿片类药物在缓解呼吸困难方面有效，且不会引起主要不良反应。
对于标准治疗方法无效的呼吸困难的慢性阻塞性肺疾病患者，阿片类药物是一种有效的姑息性药物。
