中药治疗咳嗽变异性哮喘的系统评价  

Traditional Chinese Medicine for Cough Variant Asthma: A Systematic Review

作　　者：吴丽华[1] 蒋红丽[1] 闵捷[1] 樊涛[1] 李官红[1] 刘玮[1] 董守金[1] 蔡林俐 瞿波[1] 毛兵[1] 

机构地区：[1]四川大学华西医院中西医结合科,成都610041

出　　处：《中国循证医学杂志》2015年第9期1084-1089,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价中药治疗咳嗽变异性哮喘(CVA)的临床疗效和安全性。方法计算机检索MEDLINE(Ovid)、Pub Med、EMbase、The Cochrane Library、VIP、Wan Fang Data、CNKI和CBM数据库,搜集中药治疗CVA的随机对照试验(RCT),检索时限截至2014年5月。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.2软件进行Meta分析。结果共纳入17个RCT。定性分析结果显示:在改善咳嗽症状方面,4个RCT中有3个显示中药疗效优于单纯西药治疗;而对于改善气道高反应性及总体疗效方面,中药与单纯西药比较疗效尚不确切。17个纳入研究均未报告与中药相关的严重不良反应。结论基于当前临床证据,部分试验显示中药在改善咳嗽症状方面较单纯西药治疗有一定疗效优势,而对于改善气道高反应性及总体疗效方面与单纯西药比较尚难确定。因本研究纳入文献中药、西药种类繁多,受纳入研究方法学质量以及干预手段不一致等限制,以上初步结论尚需进一步开展更多高质量大样本的RCT进一步明确。Objective To systematically review the clinical effect and safety of traditional Chinese medicine （TCM） in the treatment of cough variant asthma （CVA）. Methods We searched MEDLINE （Ovid）, PubMed, EMbase, The Cochrane Library, VIP, WanFang Data, CNKI and CBM databases to collect randomized controlled trials （RCTs） about TCM for CVA from inception to May 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was performed by RevMan 5.2 software. Results A total of 17 RCTs were included. The results of qualitative analysis showed that： in improving cough symptom, three of four RCTs showed that TCM was superior to western medicine alone. In improving airway hyper responsiveness and overall treatment effect, the difference between TCM and western medicine alone remained uncertain. No serious adverse reactions related to TCM was reported in 17 RCTs. Conclusion Based on the current evidence, some trials suggest the TCM is superior to western medicine alone in improving cough symptom, however in the improvement of airway hyper responsiveness and overall efficacy, the difference between TCM and western medicine alone remains uncertain. Due to the variety of TCM and western medicine as well as limited methodological quality and different intervention of the included studies, more high-quality RCTs with large scale are needed to verify the above conclusion.

关 键 词：咳嗽变异性哮喘 中药 系统评价 随机对照试验 

分 类 号：R259[医药卫生—中西医结合]