Portex Department, 6th Floor, Cardiac Wing, Institute of Child Health, University College London, 30 Guilford Street, London WCIN 1EH.
Paediatr Respir Rev. 2013 May;14 Suppl 1:10-2. doi: 10.1016/j.prrv.2013.01.008. Epub 2013 Mar 26.
The global development of airway clearance techniques (ACTs) for cystic fibrosis (CF) and corresponding research spans over four decades. Five Cochrane reviews synthesising the evidence from a plethora of early short and medium term studies have not uncovered any superior method. Four recent long term RCT studies exposed fundamental shortcomings in the standard RCT trial design and the insensitivity of FEV1 in physiotherapy studies. Strong patient preference, lack of blinding and the requirement for effortful and demanding participation over long intervals will continue to derail efforts to find the best ACT for CF, unless they are addressed in future clinical trials.
气道清除技术（ACT）在囊性纤维化（CF）领域的全球发展和相关研究已经跨越了四十多年。五项 Cochrane 综述综合了大量早期短期和中期研究的证据，但并未发现任何优越的方法。四项最近的长期 RCT 研究暴露了标准 RCT 试验设计的基本缺陷，以及 FEV1 在物理治疗研究中的不敏感性。除非在未来的临床试验中得到解决，否则强烈的患者偏好、缺乏盲法以及对长时间努力和苛刻参与的要求，将继续破坏为 CF 寻找最佳 ACT 的努力。
