证据
- In people with chronic obstructive pulmonary disease, what are the effects of integrated disease management interventions?
- How does longer corticosteroid treatment (>7 days) compare with shorter (≤7 days) in people with exacerbations of chronic obstructive pulmonary disease?
- How does umeclidinium bromide compare with placebo for people with chronic obstructive pulmonary disease (COPD)?
- How does long-acting muscarinic antagonist (LAMA) plus long-acting beta-agonist (LABA) compare with LABA plus inhaled corticosteroid (ICS) for people with stable chronic obstructive pulmonary disease (COPD)?
- How does tiotropium compare with ipratropium bromide for people with chronic obstructive pulmonary disease (COPD)?
- What are the longer-term (>6 months) effects of inhaled corticosteroids in people with stable chronic obstructive pulmonary disease?
- In people with chronic obstructive pulmonary disease (COPD), what are the effects of combined corticosteroid and long-acting beta-agonist (LABA) in one inhaler versus LABA alone?
- What are the effects of influenza vaccine in people with chronic obstructive pulmonary disease (COPD)?
- In people with chronic bronchitis or chronic obstructive pulmonary disease, how do mucolytic agents compare with placebo?
- What are the effects of pulmonary rehabilitation after exacerbation in people with chronic obstructive pulmonary disease?
- How does bronchoscopic lung volume reduction compare with medical therapy in people with chronic obstructive pulmonary disease?
- What is the impact of airway clearance techniques when treating acute exacerbations of COPD?
- What are the effects of airway clearance techniques in people with stable COPD?
- How does lung volume reduction surgery compare with usual medical care in people with diffuse emphysema?
证据评分
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证据 A
减少急性加重：有高质量的证据证实联合抗胆碱能药物和短效 β2 受体激动剂在 12 周时减少慢阻肺急性加重方面比单独应用 β2 受体激动剂更有效。这种联合治疗与单独应用抗胆碱能药物相比，在减少急性加重方面似乎没有更有效。
证据 A肺功能：有高质量的证据证实，与常规治疗相比，戒烟干预在慢阻肺患者 1-5 年时提高 FEV1 和14.5年时降低全因病死率方面更有效。
证据 A减少急性加重：有高质量的证据证实，β2 受体激动剂在减少 12-52 周急性加重方面比安慰剂更有效。
证据 A肺功能：有高质量的证据证实，茶碱在增加 FEV1 方面比安慰剂更有效。但是，它的应用因为不良反应和需要频繁监测血药浓度而受到限制。
证据 A肺功能：有高质量的证据证实，与安慰剂相比，短效 β2 受体激动剂在 1 周时增加 FEV1 和改善日间呼吸困难评分方面更为有效。
证据 A减少急性加重：有高质量的证据证实预防性应用阿奇霉素可以减少 II、III、IV 期慢阻肺患者急性加重的风险。但是，服用 1 年最显著的不良反应是听力受损。 [146]
证据 B肺功能：有中等质量的证据证实，一种短效抗胆碱能药物异丙托溴胺在提高 12 周 FEV1 方面较安慰剂更有效。
证据 B死亡率：有中等质量证据证明，在有严重日间低氧血症患者中，家庭氧疗比没有辅助氧疗可更有效地降低这些患者的死亡率，持续家庭氧疗比仅仅夜间家庭氧疗更有效。
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