N-乙酰半胱氨酸对呼吸道病毒辅助治疗的研究进展和药学监护  

Research Progress of N-acetylcysteine in Adjuvant Therapy of Respiratory Viruses and Pharmaceutical Care

作　　者：李少强 吕俊玲[1] 薛薇[3] 李可欣[3] 胡欣[1] Li Shaoqiang;Lv Junling;Xue Wei;Li Kexin;Hu Xin(Department of Pharmacy,Beijing Hospital,Assessment of Clinical Drugs Risk and Individual Application Key Laboratory,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Pharmacy Administration and Clinical Pharmacy,School of Pharmaceutical Sciences,Peking University,Beijing 100191,China;Clinical Trial Research Center,Beijing 100730,China)

机构地区：[1]北京医院药学部药物临床风险与个体化应用评价北京市重点实验室国家老年医学中心中国医学科学院老年医学研究院,北京100730 [2]北京大学药学院药事管理与临床药学系,北京100191 [3]北京医院临床试验研究中心,北京100730

出　　处：《中国药事》2020年第4期387-395,共9页Chinese Pharmaceutical Affairs

基　　金：“国家重大新药创制”科技重大专项(编号2017zx09101001002002)。

摘　　要：目的:采用文献检索的方法对N-乙酰半胱氨酸辅助治疗呼吸道病毒的研究进行汇总分析,评价其有效性与安全性,对现阶段临床辅助治疗新型冠状病毒肺炎提供理论依据和临床证据。方法:以"乙酰半胱氨酸""N-acetylcysteine""流感病毒"为关键词,系统检索CNKI、万方、维普、SinoMed、Pubmed数据库,筛选文章,提取数据,进行分析。结果:共纳入16篇研究论文,包括动物试验、细胞试验以及案例报道,病毒涉及流感病毒、呼吸道合胞病毒以及腺病毒。N-乙酰半胱氨酸主要通过抑制NF-κB向细胞核的移位和MAPK p38的磷酸化两条途径发挥其抗氧化作用,进而抑制减轻肺组织炎症、肺水肿。结论:相关的细胞研究与动物研究证明N-乙酰半胱氨酸对呼吸道病毒有一定的抑制作用,能够减轻流感和流感样发作。并且由于其良好的祛痰作用,对于新冠肺炎患者症状可能有较好的改善作用。Objective:To summarize the research of N-acetylcysteine(NAC)adjuvant therapy for respiratory virus by literature search,evaluate its effectiveness and safety,and provide theoretical basis and clinical evidence for clinical adjuvant treatment of new type of coronavirus pneumonia.Methods:By using"acetylcysteine"or"N-acetylcysteine"and"influenza virus"as keywords,the CNKI,Wanfang,Weipu,SinoMed,and Pubmed databases were systematically searched,articles were filtered,and data were extracted for analysis.Results:A total of 16 studies were included,including animal tests,cell tests and case reports.The virus involved influenza virus,respiratory syncytial virus and adenovirus.NAC exerted its antioxidative effect mainly by inhibiting the transfer of NF-κB to the nucleus and phosphorylation of MAPK p38,thereby inhibiting and alleviating inflammation and pulmonary edema of lung tissue.Conclusion:Related cell and animal studies have shown that NAC has a certain inhibitory effect on respiratory viruses and can reduce influenza and flu-like attacks.And because of its good expectorant effect,it may have a better effect on the symptoms of patients with coronavirus pneumonia.

关 键 词：N-乙酰半胱氨酸 呼吸道病毒 新型冠状病毒 

分 类 号：R95[医药卫生—药学]