中医药治疗阻塞性睡眠呼吸暂停综合征的系统评价  

Traditional Chinese Medicine in Treatment of Obstructive Sleep Apnea Syndrome: A Systematic Review

作　　者：颜敏[1] 冯娟[2] 蒋红丽[1] 刘玮[1] 吴丽华[1] 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,四川成都610041 [2]成都中医药大学附属医院,四川成都610075

出　　处：《现代预防医学》2016年第14期2672-2677,共6页Modern Preventive Medicine

摘　　要：目的系统评价中医药治疗阻塞性睡眠呼吸暂停综合征(Obstructive Sleep Apnea Syndrome,OSAS)的临床疗效及安全性。方法计算机检索CNKI数据库,Wan Fang Data数据库、CBM、Pubmed、web of science、EMbase、The Cochrane Library,收集中医药治疗OSAS的随机对照试验,检索时间限定为2003年1月-2015年11月。由2位研究员独立进行文献筛选、提取数据、评价质量并交叉核对结果,采用Rev Man 5.3软件进行Meta分析。结果共纳入12篇中文随机对照试验文献,Cochrane偏倚风险为高风险。结果显示:在一般健康指导或持续气道正压通气(Continuous Positive Airway Pressure,CPAP)治疗基础上加用中医药治疗,可改善患者多导睡眠图(Polysomnography,PSG)指标中的睡眠呼吸暂停指数(Apnea-Hypopnea Inde,AHI)、夜间最低氧饱和度(Lowest Oxygen Saturation at night,LSa O)以及2Epworth嗜睡评分表(Epworth Sleepness Scale,ESS)评分。12篇文献均未报道与中药治疗相关的严重不良反应。结论中医药可在一定程度上改善患者PSG指标及ESS评分,但缺乏高质量的研究,有待设计更多大样本、多中心、严格遵循循证医学原则和药物临床试验管理规范的高质量的随机对照试验。Objective This work was to systematically assess the efficacy and safety of traditional Chinese medicine （TCM） in treating obstructive sleep apnea syndrome （OSAS）. Methods Six databases （CNKI, WanFang Database , CBM, Pubmed, web of science, EMbase, The Cochrane Library） were searched for randomized controlled trials （RCTs） of TCM in treating OSAS from January 2003 to November 2015. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, then extracted data, and assessed the methodological quality of the included studies. Meta-analyses were conducted by the RevMan 5.3 software. Results A total of 12 RCTs were identified. All were conducted in China and of high risk of bias. In the treatment of OSAS, TCM combined with general health guidance or with the CPAP therapy was superior in the improvement of the AHI, LSaO2, ESS. Conclusion The current available evidence indicated that some Chinese herbal medicines may be effective and safe in treating OSAS. More high-quality RCTs of large scale was needed.

关 键 词：阻塞性睡眠呼吸暂停综合征 中药 随机对照试验 系统评价 

分 类 号：R332[医药卫生—人体生理学]