Objective To assess the effectiveness and safety of salbutamol in the treatment of preterm labor. Methods We searched MEDLINE (1966-Jan. 2007), EMBASE (1966-Jan. 2007), Cochrane Central Register of Controlled Trials (Issue 4, 2006), CBMdisc (1978-Jan. 2007) and CNKI (1979-Jan. 2007). Randomized controlled trials (RCTs) or quasi-randomized controlled trials (quasi-RCT) involving salbutamol for preterm labor were collected. The quality of the retrieved trials was assessed using the Jadad Scale. Meta-analyses were conducted with The Cochrane Collaboration’s RevMan 4.2 software. Results A total of 19 RCTs and quasi-RCTs were included, of which 16 were published in Chinese and 3 in English. The quality of the 16 Chinese studies was low, scored less than 3 by the Jadad Scale. None of the 16 RCTs mentioned the method of randomization, allocation concealment, double-blinding or the long-term effect. The quality of the 3 English studies was high. Compared with basic treatment, salbutamol was more effective in prolonging pregnancy over 48 hours (RR=6.30, 95%CI 3.23 to 14.32), and preventing neonatal asphyxia (RR=0.44, 95%CI 0.33 to 0.59), but the incidence of adverse events in pregnant women was higher in the salbutamol group (RR=4.57, 95%CI 1.34 to 15.54). Salbutamol was as effective as magnesium sulfate in prolonging pregnancy over 48 hours (OR=1.60, 95%CI 0.92 to 2.76), but more effective in preventing neonatal asphyxia (OR=0.29, 95%CI 0.14 to 0.61). Salbutamol was similar to atosiban in terms of prolonging pregnancy over 48 hours (OR=1.18, 95%CI 0.42 to 3.37) and preventing neonatal asphyxia (OR=1.13, 95%CI 0.30 to 4.31). Conclusion Salbutamol is effective in prolonging pregnancy over 48 hours and preventing neonatal asphyxia, but may cause more adverse events in pregnant women. Salbutamol has similar effects to other commonly-used drugs in regard to prolonging pregnancy over 48 hours, but is better than magnesium sulfate in decreasing the incidence of neonatal asphyxia. Salbutamol may lead to more adverse events compared with atosiban, but fewer adverse events than magnesium sulfate.
Objective To systematically review the efficacy of salbutamol for infants with bronchiolitis. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2016), CBM, VIP, WanFang Data and CNKI were searched from inception to March 2016 to collect randomized controlled trials (RCTs) about salbutamol for infants with bronchiolitis. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 20 RCTs, involving 1 735 patients were included. The results of meta-analysis showed that, compared with the control group, the salbutamol group had shorter cough relief time (MD= –1.44 d, 95%CI –1.93 to –0.95, P < 0.000 01), dyspnear relief time (MD= –0.87 d, 95%CI –1.17 to –0.56, P < 0.000 01), asthmatic remission time (MD= –1.38 d, 95%CI –1.93 to –0.83, P < 0.000 01), pulmonary rales disappear time (MD= –1.58 d, 95%CI –2.00 to –1.17, P < 0.000 01) and average hospitalization time (MD= –1.40 d, 95%CI –2.12 to –0.68, P=0.000 1), but could not improve clinical severity score (MD= –0.17, 95%CI –0.35 to 0.00, P=0.05). Conclusion Current evidence indicates that salbutamol can significantly improve the bronchiolitis with cough, dyspnea and wheezes symptoms and lung’s signs, shorten the length of hospital stay, but can not improve the clinical severity score of infants with bronchiolitis. Due to the limited quality of included studies, more high quality studies are needed to verify the above conclusion.
Objective To explore the effect of salbutamol combined with Rho associated coiled-coil forming protein kinase (ROCK) inhibitor Y-27632 on airway smooth muscle and to find a new way for drug treatment of asthma. Methods Pig tracheal smooth muscle tissue strips were prepared, and after treatment they were divided into an electrical stimulation group (Fmax, 50%Fmax) and a blank group. The smooth muscle tissue strips were quickly frozen to determine the expression level of Rock-Ⅱ and the phosphorylation level of MLC20. The Fmax and 50%Fmax electrical stimulation groups were divided into a blank group, a salbutamol group, a Y-27632 group, and a salbutamol combined with Y-27632 group according to different intervention drugs. The relaxation of smooth muscle strips was observed. Results In the blank group, 50%Fmax group and Fmax group, the expression level of Rock-Ⅱ and the phosphorylation of MLC20 in smooth muscle tissue showed an increasing trend, with statistically significant differences (P<0.05). In the 4 subgroups of the 50%Fmax group intervention with different drugs (blank group, salbutamol group, Y-27632 group, salbutamol plus Y-27632 group), the diastolic ratio smooth muscle tissue strips showed an increasing trend. When the time reaches 10 min, the diastolic ratios were 0.7%, 2.5%, 6.0%, and 15.0%. the diastolic ratios were 1.8%, 4.5%, 7.5%, and 21.0% at the time of 20 min. the diastolic ratios were 1.9%, 7.5%, 7.9% and 22.0% at the time of 40 min. the diastolic ratios were 2.0%, 8.0%, 8.8%, and 22.5% at the time of 60 min. In the four subgroups of the Fmax electrical stimulation group, the relaxation ratio of smooth muscle tissue strips also showed an increasing trend. When the time reaches 10 min, the diastolic ratios were 1.0%, 3.0%, 7.0%, and 17.0%. the diastolic ratios were 2.6%, 5.5%, 9.0%, and 24.0% at the time of 20 min. the diastolic ratios were 2.8%, 9.0%, 9.5%, and 27.5% at the time of 40 min. diastolic ratios were 2.9%, 10.5%, 10.5%, and 28.0% at the time of 60 min. The analysis of difference between groups showed that at the same time, the diastolic ratio of smooth muscle in salbutamol combined with Y-27632 group was significantly higher than that in salbutamol alone group and Y-27632 group (P<0.05). In addition, the smooth muscle diastolic ratio of combined intervention was also better than the the mathematical sum effect of both single drug intervention (P<0.05). Conclusions The contractility and intensity of smooth muscle are positively correlated with the expression level of ROCK and the phosphorylation level of MLC20. Salbutamol combined with Y-27632 can enhance the relaxation of porcine airway smooth muscle, which may have a synergistic effect.