Anti-inflammatory Activity and Mucolytic Effect of Ambroxol in Patients with Stable Chronic Bronchitis-A Preliminary Report

Ambroxol 對慢性支氣管炎病患的化痰與抗發炎效用

朱建民(Chien-Ming Chu) ； 于鍾傑(Chung-Chieh Yu) ； 吳黃平(Huang-Ping Wu) ； 姜伯潁(Bor-Yiing Jiang) ； 曾若琦(Jo-Chi Tseng) ； 花仲涇(Chung-Ching Hua) ； 游騰仁(Teng-Jen Yu) ； 劉育志(Yu-Chih Liu) ； 謝文斌(Wen-Pin Shieh)

《胸腔醫學》 27卷1期 (2012/02) Pp. 13-20

https://doi.org/10.29806/TM.201202.0002

摘要

慢性支氣管炎為慢性發炎呼吸道阻塞及黏液過度分泌的疾病，化痰劑可能降低痰液的黏稠度，進而減輕症狀。本研究探討ambroxol對慢性支氣管炎的效用；25個慢性支氣管炎的病人進入本研究，20個病人完成此試驗，經過2週的ambroxol口服後，其肺功能、尖峰氣流速及6分鐘步行測試並無變化；而痰液中巨嗜細胞的myeloperoxidase（MPO）的活性與IL-8的濃度有意義的下降；TNF-α及IL-1ß濃度則略有下降的趨勢。而臨床症狀如咳嗽頻率、咳痰的效能、痰的黃濃色澤及呼吸困難度則有意義的改善；但哮喘發生頻率，夜間睡眠中斷次數及日常生活的活動力無改善，試驗期間並無病人發生急性發作而須住院或到急診治療，也無明顯藥物副作用的報告。本報告的結論為ambroxol是一化痰劑同時也具抗發炎效用，對慢性支氣管炎病人的痰液清除及呼吸道發炎可能有助益。

關鍵字

慢性支氣管炎 ； 化痰劑 ； ambroxol ； myeloperoxidase (MPO) ； 第八細胞素 ； 腫瘤壞死因子 ； 第一乙型細胞素

並列摘要

Chronic bronchitis is a clinical disorder characterized by excessive mucus secretions and manifested by chronic or productive cough on most days, for a minimum of 3 months in a year and for not less than 2 successive years. Unfortunately, other disorders with similar manifestations, such as bronchiectasis, tuberculosis, and lung abscess, must be excluded. Patients with predominant asthma or emphysema may fit this definition, and many patients with pathological or physiological hallmarks or chronic bronchitis may not qualify, since they do not cough. Hyper-viscosity and overproduction of sputum often increase morbidity. Mucolytics might alleviate patients' symptoms and improve their daily activity. Ambroxol was first introduced as a mucoactive agent with anti-inflammatory activity. We investigated the benefits of this compound in reducing cytokine concentrations of sputum, sputum viscosity, and pulmonary symptoms in chronic bronchitis patients. Twenty-five chronic bronchitis patients were recruited and 20 completed the study. We found that 2-week oral administration of ambroxol did not improve static lung function (FVC, FEV1 and FEV1%) and 6-minute walking test distance. The sputum myeloperoxidase (MPO) activity and IL-8 level were reduced significantly, the sputum TNF-α and IL-1β levels had a tendency to decrease, and the measured sputum viscosity at 1 radian was significantly reduced. These preliminary results support the assumption that ambroxol is a mucolytic agent with anti-inflammatory activity, which might be helpful in terms of sputum clearance and reduction of airway inflammation in chronic bronchitis patients.

並列關鍵字

chronic bronchitis ； mucolytics ； ambroxol ； myeloperoxidase (MPO) ； IL-8 ； TNF-α ； IL-1β