作者: Felix SF Ram , Paul Jones , Jose Jardim , Aldemar A Castro , Álvaro N Atallah
DOI: 10.1002/14651858.CD003902
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摘要: Background Oral theophylline has, for many years, been used as a bronchodilator in patients with COPD. Despite the introduction of new drugs, and its narrow therapeutic index, is still recommended COPD treatment. Objectives To determine effectiveness oral when compared to placebo stable COPD. Search methods We searched Cochrane Airways Group trial register Central Register Controlled Trials Clinical Registers were searched. Selection criteria All studies randomised controlled trials (RCTs). Data collection analysis Two reviewers independently abstracted data asessed methodological quality. Main results Twenty RCTs met inclusion criteria. Concomitant therapy varied from none any other plus corticosteroid (oral inhaled). The following outcomes significantly different placebo. Forced expiratory volume one second (FEV1) improved treatment: Weighted Mean Difference (WMD) 100 ml; 95% Confidence Interval (CI) 40 160 ml. Similarly forced vital capacity (FVC): WMD 210 ml 95%CI 320. Two reported an improvement maximum oxygen consumption (VO2 max); 195 ml/min, 113 278. At rest, arterial tension at rest (PaO2) carbon dioxide (PaCO2) both treatment (WMD 3.2 mm Hg; 1.2 5.1, -2.4 -3.5 -1.2, respectively). Walking distance tests did not improve (four studies, Standardised 0.30, -0.01 0.62), neither Visual Analogue Score breathlessness two small 3.6, -4.6 11.8). Relative Risk (RR) nausea was greater (RR 7.7; 1.5 39.9). However, patients' preference than that 2.27; 1.26 4.11). Very few participants withdrew these reason. Authors' conclusions Theophylline has modest effect on FEV1 FVC slightly improves blood gas tensions moderate severe These benefits seen receiving variety concomitant therapies. Improvement exercise performance depended method testing. There very low dropout rate could be included this review, which suggests recruited may have known by investigators tolerant . This limit generalisability studies.