特发性肺纤维化中的呼吸困难：系统评价。
Dyspnea in idiopathic pulmonary fibrosis: a systematic review.
机构信息
Department of Medicine, School of Medicine, University of California at San Francisco, San Francisco, CA, USA.
出版信息
J Pain Symptom Manage. 2012 Apr;43(4):771-82. doi: 10.1016/j.jpainsymman.2011.04.026. Epub 2012 Jan 30.
CONTEXT
Little is known about the treatment and correlates of dyspnea in idiopathic pulmonary fibrosis (IPF).
OBJECTIVES
The objective of this systematic review was to summarize the literature regarding the treatment and correlates of dyspnea in IPF.
METHODS
MEDLINE, EMBASE, and all Evidence-Based Medicine Reviews were searched for publications that evaluated treatment or correlates of dyspnea in IPF. Reference lists and recent review articles also were searched.
RESULTS
The heterogeneity of included studies did not permit meta-analysis. Dyspnea improved in studies of sildenafil, pulmonary rehabilitation, and prednisone with colchicine. Additional studies of these three treatments, however, found discordant results. One study suggested that assisted ventilation delivered by facemask improved exertional dyspnea. Oxygen and opioids improve dyspnea in other chronic lung diseases, but data in IPF are limited. Correlates of dyspnea included functional and physiological measures and comorbid diseases.
CONCLUSION
Sildenafil and pulmonary rehabilitation should be considered as potential therapies for dyspnea in selected patients with IPF. Supplemental oxygen and opioids may be additional potential therapies; however, the evidence supporting their use is weak. Additional research should focus on the management of functional status and comorbidities as potential treatments for dyspnea.
背景
对于特发性肺纤维化（IPF）患者的呼吸困难的治疗和相关因素知之甚少。
目的
本系统评价的目的是总结关于 IPF 患者呼吸困难的治疗和相关因素的文献。
方法
检索 MEDLINE、EMBASE 和所有循证医学评价，以评估 IPF 患者呼吸困难的治疗或相关因素的研究。还检索了参考文献列表和近期的综述文章。
结果
纳入研究的异质性不允许进行荟萃分析。西地那非、肺康复和泼尼松联合秋水仙碱的研究表明呼吸困难有所改善。然而，对这三种治疗方法的进一步研究得出了不一致的结果。一项研究表明，面罩辅助通气可改善运动性呼吸困难。在其他慢性肺部疾病中，氧气和阿片类药物可改善呼吸困难，但 IPF 中的数据有限。呼吸困难的相关因素包括功能和生理测量以及合并症。
结论
西地那非和肺康复可被视为治疗 IPF 患者呼吸困难的潜在疗法。补充氧气和阿片类药物可能是额外的潜在治疗方法；然而，支持其使用的证据较弱。应进一步研究功能状态和合并症的管理作为呼吸困难的潜在治疗方法。
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