Chiu Kam Yu, Li Jian Guo, Lin Ying
Department of Respiratory Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China.
Department of Respiratory Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangdong, China.
Ann Allergy Asthma Immunol. 2017 Dec;119(6):518-523.e3. doi: 10.1016/j.anai.2017.08.013. Epub 2017 Oct 9.
For decades, calcium channel blockers (CCBs) have been believed to play a role in asthma treatment. However, the clinical efficacy of CCBs for lung function improvement in patients with asthma has not been qualitatively evaluated.
To assess the effect of CCBs vs placebo on lung function test results in adults with asthma.
Various databases were systematically searched to identify all randomized clinical trials with adults with asthma. We aimed to assess the influence of CCBs on forced expiratory volume in 1 second (FEV), forced vital capacity (FVC), peak expiratory flow rate (PEFR), and provocative concentration of bronchoconstrictive agents causing a 20% decrease in FEV (PC) compared with a placebo. All effect estimates were pooled by the generic inverse variance method with random-effects meta-analysis. Subgroup analysis, sensitivity analysis, and heterogeneity investigation were performed.
Thirty eligible articles with 301 patients were included in this meta-analysis. Our results revealed that in a standard exercise test CCBs could produce a mean maximal percentage decrease in FEV of 11.56% (95% confidence interval, 8.97%-14.16%; P < .001) and an increase in postdose FEV by 80 mL (95% confidence interval, 0.02-0.15 mL; P = .01). However, there was no statistical significance for CCBs in postdose FVC, PEFR, or PC of histamine and methacholine.
CCBs may be beneficial for lung function improvement in asthma, especially in exercise-induced asthma. However, there is a lack of evidence for CCBs protecting asthma patients from chemical irritation.
数十年来，人们一直认为钙通道阻滞剂（CCB）在哮喘治疗中发挥作用。然而，CCB对哮喘患者肺功能改善的临床疗效尚未得到定性评估。
评估CCB与安慰剂对成年哮喘患者肺功能测试结果的影响。
系统检索各种数据库，以识别所有针对成年哮喘患者的随机临床试验。我们旨在评估CCB与安慰剂相比，对1秒用力呼气量（FEV）、用力肺活量（FVC）、呼气峰值流速（PEFR）以及导致FEV下降20%的支气管收缩剂激发浓度（PC）的影响。所有效应估计值均采用通用逆方差法进行随机效应荟萃分析合并。进行亚组分析、敏感性分析和异质性研究。
本荟萃分析纳入了30篇符合条件的文章，共301例患者。我们的结果显示，在标准运动试验中，CCB可使FEV平均最大百分比下降11.56%（95%置信区间，8.97%-14.16%；P <.001），给药后FEV增加80 mL（95%置信区间，0.02-0.15 mL；P =.01）。然而，CCB在给药后的FVC、PEFR或组胺和乙酰甲胆碱的PC方面无统计学意义。
CCB可能有助于改善哮喘患者的肺功能，尤其是运动性哮喘。然而，缺乏CCB保护哮喘患者免受化学刺激的证据。
