吗啡治疗慢性喘息 (MABEL) 在英国:多部位,并行组,剂量定位,双盲,随机,安慰剂对照试验
Miriam J Johnson1, Bronwen Williams1, Catriona Keerie2
1Hull York Medical School, University of Hull, Hull, UK.
The Lancet. Respiratory medicine
|October 1, 2025
概括
这项研究发现,口服吗啡在患有长期心肺呼吸系统疾病的患者中没有改善呼吸困难. 虽然它稍微改善了咳,但不良事件的风险表明它不适合这种用途.
科学领域:
- 这是心肺呼吸系统药物.
- 临床药理学 临床药理学
- 肺部病理学 肺部病理学
背景情况:
- 关于阿片类药物对喘息的有效性仍在争论中,实验室发现并未转化为临床试验.
- 长期的疾病往往会导致令人虚弱的喘息,影响生活质量.
研究的目的:
- 评估口服吗啡在患有慢性心肺呼吸系统疾病的患者呼吸困难的治疗效果.
- 为了比较吗啡和安慰剂组之间的呼吸困难得分,身体活动,咳和生活质量.
主要方法:
- 第三阶段,双盲,安慰剂对照试验,涉及143名心肺呼吸系统疾病和严重呼吸困难的成年人 (MRC评分≥3).
- 参与者接受了长期作用的口服吗啡 (5-10毫克每天两次) 或安慰剂56天.
- 主要结局:28日最严重的喘息 (数值评分表);次要结局:咳,体力活动,生活质量和不良事件.
主要成果:
- 吗啡 (6.19) 和安慰剂 (6.10) 组在28日最严重的喘息没有显著差异 (p=0.78).
- 吗啡在56日咳显著改善 (调整后平均差异为-1.41).
- 在吗啡组中报告了增加的不良事件 (251 vs 162) 和严重不良事件 (15 vs 3).
结论:
- 口服吗啡在患有长期心肺呼吸系统疾病的患者中没有有效地改善喘息强度.
- 研究结果不支持使用吗啡治疗慢性喘息,尽管对咳有一些好处.
- 需要进一步的研究来澄清吗啡在治疗慢性呼吸困难中的作用,如果有的话.
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