布洛芬和对乙酰氨基酚治疗哮喘儿童发热的快速卫生技术评估

doi:10.5246/jcps.2026.05.034

中国药学(英文版) ›› 2026, Vol. 35 ›› Issue (5): 481-490.DOI: 10.5246/jcps.2026.05.034

布洛芬和对乙酰氨基酚治疗哮喘儿童发热的快速卫生技术评估

沈敏哲, 沈珑慧, 严荧燕^*()

宁波大学附属妇女儿童医院药剂科，浙江宁波 315012

收稿日期:2026-01-23 修回日期:2026-02-11 接受日期:2026-03-14 出版日期:2026-05-31 发布日期:2026-05-31
通讯作者: 严荧燕

Rapid health technology assessment of ibuprofen and acetaminophen in the treatment of fever in children with asthma

Minzhe Shen, Longhui Shen, Yingyan Yan^*()

Department of Pharmacy, Women and Children's Hospital of Ningbo University, Ningbo 315012, Zhejiang, China

Received:2026-01-23 Revised:2026-02-11 Accepted:2026-03-14 Online:2026-05-31 Published:2026-05-31
Contact: Yingyan Yan
Supported by:
Wu Jieping Medical Foundation Clinical Research Special Fund (Grant No. 320.6750.2023-25-3)

摘要/Abstract

摘要：

本文旨在通过评价布洛芬和对乙酰氨基酚治疗哮喘儿童发热的有效性、安全性和经济性，为临床用药决策及方案选择提供循证参考。研究采用快速卫生技术评估(rHTA)方法。检索PubMed、Embase、Cochrane Library、Web of Science、知网、万方等数据库及卫生技术评估(HTA)相关学术机构官方网站及数据库，经文献筛选、资料提取、质量评价后，对研究结果进行描述性分析。有效性方面，与单药治疗相比，联合或交替治疗更能降低体温，在4小时后具有更低的发热比例，更长的无热保持期。并且在发热最初的4小时内，单用布洛芬较对乙酰氨基酚更有效。安全性方面，联合用药、交替用药、单用治疗具有相似的药物不良反应总体发生率，而在哮喘发作或哮喘恶化发生率上，不同文献的结论不完全一致。经济性方面，由于未区分哮喘与非哮喘儿童，就发热儿童退热的角度，来源于英国的研究显示，对于英国国家医疗服务体系而言，联合治疗比单用治疗更具成本-效益优势；而对于父母而言，只有在治疗到第5天后，联合治疗才显示出成本-效益优势。与单药治疗相比，联合用药和交替用药治疗哮喘儿童发热具有良好的有效性，但在安全性和经济性方面尚需开展更多高质量研究。

关键词: 布洛芬, 对乙酰氨基酚, 哮喘儿童, 发热, 快速卫生技术评估

Abstract:

This study aimed to assess the efficacy, safety, and cost-effectiveness of ibuprofen and acetaminophen for managing fever in children with asthma, providing evidence-based guidance for clinical decision-making and treatment regimen selection. A rapid health technology assessment approach was employed. Following a comprehensive literature search of PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, official websites, and relevant health technology assessment databases, the retrieved studies were screened, and data were extracted and evaluated for quality. A total of nine studies were included, comprising two reviews, five systematic reviews/meta-analyses (SRs/MAs), one randomized controlled trial, and one health technology assessment report. Regarding efficacy, combined or alternating therapy demonstrated superior temperature reduction compared with monotherapy, resulting in a lower proportion of children remaining febrile and a longer afebrile period after 4 h. Within the initial 4-hour window, ibuprofen monotherapy was more effective than acetaminophen monotherapy. In terms of safety, the overall incidence of adverse drug reactions was comparable across combined therapy, alternating therapy, and monotherapy; however, the included studies reported inconsistent findings concerning the risk of asthma onset or exacerbation. Concerning cost-effectiveness, although specific analyses in asthmatic populations were lacking, evidence from the United Kingdom indicated that, from the perspective of the National Health Service, combined therapy was more cost-effective than monotherapy in reducing fever, whereas from the parental perspective, this advantage emerged only after 5 d of treatment. Overall, compared with monotherapy, combined and alternating therapies exhibit greater efficacy in treating fever in children with asthma; nonetheless, further high-quality studies are warranted to clarify their safety profile and cost-effectiveness.

Key words: Ibuprofen, Acetaminophen, Children with asthma, Fever, Rapid health technology assessment

Supporting:

沈敏哲, 沈珑慧, 严荧燕. 布洛芬和对乙酰氨基酚治疗哮喘儿童发热的快速卫生技术评估[J]. 中国药学(英文版), 2026, 35(5): 481-490.

Minzhe Shen, Longhui Shen, Yingyan Yan. Rapid health technology assessment of ibuprofen and acetaminophen in the treatment of fever in children with asthma[J]. Journal of Chinese Pharmaceutical Sciences, 2026, 35(5): 481-490.

图/表 3

参考文献 26

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布洛芬和对乙酰氨基酚治疗哮喘儿童发热的快速卫生技术评估

Rapid health technology assessment of ibuprofen and acetaminophen in the treatment of fever in children with asthma

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