培土生金法治疗慢性阻塞性肺疾病稳定期疗效的Meta分析  

Therapeutic Effect of Therapy of Reinforcing Earth to Strengthen Metal for Stable Phase of Chronic Obstructive Pulmonary Disease:A Meta-Analysis

作　　者：李航[1] 黄慧婷[2] 詹少锋[2] 刘小虹[1,2] 

机构地区：[1]广州中医药大学,广东广州510405 [2]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2017年第1期132-139,共8页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药管理局科研项目(编号:2015102)

摘　　要：【目的】评价培土生金法治疗慢性阻塞性肺疾病(COPD)稳定期的疗效及安全性,为其治疗COPD提供依据。【方法】计算机检索中国生物医学文献光盘数据库(CBM)、中国期刊网(CNKI)、万方数据库(Wanfang)、Pub Med、EMBase、Cochrane Library等文献数据库,收集以培土生金方药联合常规西药为试验组、常规西药为对照组的治疗COPD稳定期的临床随机对照试验(RCT)。采用Cochrane协作网的偏倚风险评估工具进行文献质量评价,并采用Rev Man 5.3软件对主要结局指标临床有效率,次要结局指标肺功能如1 s用力呼气容积(FEV1)、FEV1占预计值的百分比(FEV1%)、FEV1占用力肺活量(FVC)的百分比(FEV1/FVC)以及生活质量问卷评分、BODE指数、体质量指数(BMI)等进行Meta分析。【结果】共纳入16个研究,包括1 296例患者。Meta分析结果显示,培土生金方药联合常规西药对COPD稳定期患者的临床有效率、FEV1%、FEV1/FVC、生活质量、BMI的改善情况均优于单纯常规西药治疗,差异有统计学意义(P<0.05),但对FEV1和BODE指数的影响两组比较差异无统计学意义(P>0.05)。纳入的研究对不良反应的报告不充分。【结论】培土生金法可改善COPD稳定期患者的肺功能,提高患者的生活质量和营养状态,但现有研究质量偏低,确切结论仍需开展更高质量的RCT加以验证。Objective To evaluate the effectiveness of the therapy of reinforcing earth to strengthen metal（RESM; invigorating spleen to strengthen lung） for the treatment of stable phase of chronic obstructive pulmonary disease（COPD）with Meta-analysis. Methods Databases of CBM,CNKI,Wanfang Database,Pub Med,EMBase and the Cochrane Library were searched for obtaining all randomized controlled trials（RCTs） of COPD stable phase treated by spleen-invigorating and lung-strengthening Chinese medicine and western medicine together in comparison to western medicine alone. The methodological quality of RCTs was evaluated with the Cochrane collaboration＇s bias risk assessment tool. The Meta-analysis was conducted using Rev Man 5.3 to assess the main outcome of clinical effective rate, and the secondary outcomes including lung function parameters of forced expiratory volume in one second（FEV1）,FEV1 predicted（FEV1%）and the ratio of FEV1 to forced vital capacity（FEV1/FVC）,life quality scores,BODE index and body mass index（BMI）. Results A total of 16 RCTs involving 1296 patients were included. The results indicated that the clinical efficiency rate, FEV1%, FEV1/FVC,life quality scores and BMI in the combined therapy group were much improved as compared with those in the western medicine group（P 0.05）, while there was no statistical difference in FEV1 and BODE index between the two groups（P 0.05）. No evident adverse effects were reported. Conclusion In the treatment of COPD,RESM with routine western medicine could improve the lung function,life quality and nourishment state of the patients. But for the relatively low quality of the methodology of the current studies, the conclusion needs more high-quality RCTs to offer clinical evidence.

关 键 词：培土生金法 慢性阻塞性肺疾病 稳定期 系统评价 META分析 

分 类 号：R256.1[医药卫生—中医内科学]