盐酸溴己新吸入溶液药理机制、临床应用及研究进展

Pharmacological Mechanism, Clinical Application and Research Progress of Bromhexine Hydrochloride Inhalation Solution

摘要: 我国慢性气道疾病与急性呼吸道感染发病率居高不下，气道黏液高分泌、气道慢性炎症及氧化应激损伤是呼吸系统疾病核心病理改变，祛痰、抗炎、肺保护一体化治疗是改善患者预后的关键。雾化吸入靶向治疗凭借局部浓度高、全身不良反应少、适用人群广泛的优势，已成为呼吸道疾病规范化治疗的重要手段。盐酸溴己新作为经典黏液溶解剂，其吸入溶液为国内新近获批的雾化祛痰新剂型，可直接作用于气道黏膜，兼具溶痰排痰、抗炎、抗氧化、肺组织保护等多重药理活性。目前国内针对该专属吸入剂型的系统性临床综述较为匮乏。本文系统梳理盐酸溴己新吸入溶液的双重祛痰核心机制、抗炎抗氧化分子通路、多场景临床应用价值、特殊人群用药安全性，结合近3~5年核心期刊循证数据与权威指南共识，分级明确不同适应症的临床推荐强度，总结当前临床应用优势与现存研究短板，并展望未来研究方向，旨在更新临床医师、药师用药认知，为该剂型的规范化、个体化临床应用提供循证参考，同时为后续基础与临床研究提供新思路。

Abstract: The incidence of chronic airway diseases and acute respiratory tract infections remains high in China. Airway mucus hypersecretion, chronic airway inflammation and oxidative stress injury are the core pathological changes of respiratory diseases. The integrated treatment of expectoration, anti-inflammation and lung protection is the key to improve patient prognosis. Targeted nebulized inhalation therapy has become an important method for standardized treatment of respiratory diseases due to its advantages of high local concentration, few systemic adverse reactions and wide applicable population. As a classic mucolytic agent, bromhexine hydrochloride inhalation solution is a newly approved nebulized expectorant dosage form in China, which can directly act on airway mucosa and has multiple pharmacological activities such as mucus dissolution and excretion, anti-inflammation, anti-oxidation and lung tissue protection. At present, systematic clinical reviews targeting this specific inhalation dosage form are scarce in China. This paper systematically summarizes the dual core expectorant mechanism, anti-inflammatory and anti-oxidant molecular pathways, multi-scenario clinical application value, and medication safety in special populations of bromhexine hydrochloride inhalation solution. Based on the evidence-based data of core journals and authoritative guidelines and consensus in recent 3~5 years, it clarifies the clinical recommendation strength of different indications in grades, summarizes the current clinical application advantages and existing research shortcomings, and prospects future research directions. It aims to update the medication cognition of clinicians and pharmacists, provide evidence-based reference for the standardized and individualized clinical application of this dosage form, and offer new ideas for subsequent basic and clinical research.