喘可治注射液治疗慢性阻塞性肺疾病急性加重期的系统评价  

Systematic review of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease

作　　者：陈诗琪[1] 杨欣宇[1] 唐潇旖[1] 李敏[1] 刘硕[1] 梁婧[2] 张晓雨[1] 商洪才[1] CHEN Shi-qi YANG Xin-yu TANG Xiao-yi LI Min LIU Shuo LIANG Jing ZHANG Xiao-yu SHANG Hong-cai(Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China The Southern District of Guang＇anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 102618, China)

机构地区：[1]北京中医药大学东直门医院中医内科学教育部和北京市重点实验室,北京100700 [2]中国中医科学院广安门医院南区,北京102618

出　　处：《中国中药杂志》2017年第14期2789-2795,共7页China Journal of Chinese Materia Medica

基　　金：中组部万人计划项目(W02020052)

摘　　要：计算机检索Pub Med,CNKI等7个中英文数据库,查找有关喘可治注射液治疗慢性阻塞性肺疾病急性加重期的随机对照试验(RCT),检索时限为建库至2016年11月。由2位研究者按纳入标准独立筛选文献、提取资料,并用Cochrane手册针对RCT的偏倚风险评价工具评价文献质量后,采用RevMan 5.3软件进行Meta分析,系统评价喘可治注射液治疗慢性阻塞性肺疾病急性加重期的炎症因子及肺功能改善情况、疗效及安全性。共纳入13篇RCT,包括1 016例患者。Meta分析结果显示:与对照组比较,喘可治组临床有效率更高[RR=1.15,95%CI(1.06,1.23),P=0.000 3];肺功能改善更明显,包括第1秒呼气量(FEV1)[MD=0.21,95%CI(0.15,0.27),P<0.000 01]、用力肺活量(FVC)[MD=0.36,95%CI(0.15,0.56),P=0.000 6]和第1秒呼吸容积占用力肺活量百分比(FEV1/FVC)[MD=6.85,95%CI(4.68,9.02),P<0.000 01];并且降低炎症因子水平,包括白细胞介素-6(IL-6)[MD=-6.35,95%CI(-8.23,-4.47),P<0.000 01]、白细胞介素-8(IL-8)[MD=-2.00,95%CI(-3.13,0.87),P=0.000 5]和肿瘤坏死因子-α(TNF-α)[MD=-2.79,95%CI(-4.61,-0.97),P=0.003]。除此之外,喘可治组不良反应发生率低,且无严重不良反应事件。研究表明,在常规对症治疗基础上加喘可治注射液治疗慢性阻塞性肺疾病急性加重期,可提高临床疗效,改善肺功能,有助于减少炎症发生,安全性好,但受纳入研究数量及质量的限制,尚需要更多高质量RCT进一步验证。To evaluate the inflammatory factors, the pulmonary function, the efficiency and the safety of Chuankezhi injection for treating acute exacerbation of chronic obstructive pulmonary disease （AECOPD）. The randomized controlled trials （RCTs） on Chua- nkezhi injection for treating AECOPD were collected from 7 databases （PubMed, CNKI, et al） between inception to November 2016. Two reviewers independently screened literature and extracted the data according to the inclusion and exclusion criteria, and assessedmethodological quality of included studies according to the criteria from Cochrane Reviewer＇s Handbook 5.3. Then, Meta-analysis was conducted by using RevMan 5.3 software. A total of 13 RCTs involving 1 016 patients were included. Meta-analysis results indicated that Chuankezhi group was superior to the control group in the clinical effectiveness [ RR = 1.15, 95% CI （1.06, 1.23）, P = 0. 000 3 ], improved pulmonary functions including forced expiratory volume in one second （FEV1） [ MD = 0. 21, 95% CI （0. 15, 0. 27 ）, P 〈 0. 000 01 ], forced vital capacity （FVC） [ M D = 0. 36, 95 % CI （0. 15, 0. 56）, P = 0. 000 6 ], the first seconds breathing volume percentage of forced vital capacity （FEV1/FVC） [ MD =6. 85, 95% CI（4. 68, 9.02）, P 〈0. 000 01 ] and decreased the lev- el of inflammatory factors including interleukin-6 （IL-6） [ MD = - 6. 35,95% CI （ - 8.23, - 4.47）, P 〈 0. 000 01 ], IL-8 [ MD = -2.00, 95% CI （ -3. 13,0.87）, P=0.0005], tumorneerosisfactor-α （TNF-α） [ MD= -2.79, 95% CI （-4.61,-0.97）, P = 0. 003 ]. Besides, there were no frequently happened or serious adverse reactions observed in Chuankezhi group. The results showed that Chuankezhi injection could improve the efficiency and the puhnonary function, reduce inflammation for AECOPD with a high safety on the basis of routine symptomatic treatment. However, due to limited quantity and quality of the included studies, the conclusion above should be further verified by conducting more high q

关 键 词：喘可治注射液 慢性阻塞性肺疾病 急性加重期 炎症因子 系统评价 

分 类 号：R563.9[医药卫生—呼吸系统]