中药膏方治疗慢性阻塞性肺疾病稳定期随机对照试验的系统评价  

Traditional Chinese medicine paste in the treatment of chronic obstructive pulmonary disease in stable stage:a systematic review of randomized controlled trials

作　　者：曾艳[1] 颜敏[1] 易沁钰 吴丽华[1] 汪胜军[1] 蒋红丽[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》2017年第3期340-346,共7页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价中药膏方治疗慢性阻塞性肺疾病(COPD)稳定期的临床疗效和安全性。方法计算机检索EMbase、PubMed、The Cochrane Library(2016年12期)、VIP、WanFang Data、CNKI和CBM数据库,搜集中药膏方治疗COPD稳定期的随机对照研究,检索时限均为建库至2016年12月。由两位研究者独立按纳入与排除标准筛选文献、提取资料和评价纳入研究的偏倚风险后,采取Rev Man 5.3软件进行Meta分析。结果共纳入9个随机对照研究,合计605例患者。Meta分析结果显示:与单用西药常规治疗比较,中药膏方联合西药治疗能提高临床疗效[RR=1.20,95%CI(1.10,1.31),P<0.000 1]、改善生活质量[SGRQ评分:MD=–4.53,95%CI(–5.41,–3.65),P<0.000 01;CAT评分:MD=–2.45,95%CI(–3.38,–1.51),P<0.000 01]、改善肺功能[MD=3.80,95%CI(0.40,7.20),P=0.03]、减少急性加重频次(P<0.05)。两组均无严重不良反应发生。结论本研究结果显示,与单纯西医相比,中药膏方联合西医治疗可提高COPD稳定期患者疾病疗效、改善生活质量及肺功能和减少急性加重次数。受纳入研究的数量和质量限制,上述结论尚需更多研究予以证实。Objective To evaluate the efficacy and safety of traditional Chinese medicine（TCM） paste in treating chronic obstructive pulmonary disease （COPD） in stable stage. Methods We electronically searched databases including PubMed, EMbase, The Cochrane Library （Issue 12, 2016）, VIP, WanFang Data, CNKI and CBM to collect randomized controlled trials （RCTs） regarding TCM paste in combination with conventional Western therapy versus Western therapy alone in treating stable COPD from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. The meta-analysis was conducted by RevMan 5.3 software. Results A total of 9 RCTs involving 605 Chinese patients were included. The results of meta-analysis showed that： when compared with conventional Western medicine alone, TCM paste combined with the conventional Western medicine significantly improved clinical effective rate （RR=1.20, 95% CI 1.10 to 1.31, P〈0.000 1）, decreased SGRQ score （MD=-4.53, 95% CI -5.41 to -3.65, P〈0.000 01） and CAT score （MD=-2.45, 95% CI -3.38 to -1.51, P〈0.000 01）, increased FEV1% （MD=3.80, 95% CI 0.40 to 7.20, P=0.03）, and reduced the frequency of acute exacerbation （P〈0.05）. No serious adverse reaction occurred in both groups. Conclusion The current evidence shows that combination of TCM paste and conventional Western medicine may improve clinical effective rate, quality of life, increase FEV1%, and reduce the frequency of acute exacerbation in patients with stable COPD. Due to the limited quality and quantity of included studies, the above results are needed to verify by more studies.

关 键 词：慢性阻塞性肺疾病 中药膏方 系统评价 META分析 随机对照试验 

分 类 号：R259[医药卫生—中西医结合]