中药复方治疗低氧相关性肺动脉高压的Meta分析  

Meta analysis of Chinese herbal compound in treatment of hypoxia-induced pulmonary hypertension

作　　者：曲妮妮 李思佳 郑忻 赵克明 石晓乐 束沛 QU Ni-ni;LI Si-jia;ZHENG Xin;ZHAO Ke-ming;SHI Xiao-le;SHU Pei(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110032;Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110847)

机构地区：[1]辽宁中医药大学附属医院

出　　处：《世界中西医结合杂志》2019年第9期1203-1208,1215,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局项目(SATCM-2015-BZ[037]);辽宁省科技厅项目(2011225016);沈阳市科技局项目(F12-277-1-76)

摘　　要：目的文章旨在评价中药复方治疗低氧相关性肺动脉高压患者的临床疗效及安全性研究。方法计算机检索国内外公开发表的关于中药复方治疗低氧相关性肺动脉高压相关随机对照试验,检索时间为2008年1月至2018年6月。由两位研究者独立进行文献筛选、数据提取及纳入研究的偏倚风险评价,然后采用RevMan5.3进行Meta分析。结果共纳入22篇研究,1642例患者,Meta分析结果显示中药复方治疗低氧相关性肺动脉高压患者的临床疗效明显高于对照组,且差异具有统计学意义(P=0.0002,RR=1.24,95%CI:1.11~1.40);在改善动脉血氧分压、肺动脉压、肺功能等方面,明显优于对照组,差异具有统计学意义;D-二聚体和ET-1的改善明显优于对照组,差异具有统计学意义;22篇纳入研究中有3篇报道了中药相关不良反应,未发生严重不良反应。结论中药复方能有效缓解低氧相关性肺动脉高压患者的临床症状,改善患者动脉血氧分压、肺动脉压、肺功能及D-二聚体等指标,加用中药治疗较单纯西药治疗效果更优。但由于本研究纳入研究质量和数量有限,期待高质量、大样本、多中心的随机对照试验进行论证。Objective To evaluate the clinical effect and safety of Chinese herbal compound in treatment of hypoxia-induced pulmonary hypertension.Methods The randomized controlled trials(RCTs)on hypoxia-induced pulmonary hypertension treated with Chinese herbal compound,published publicly at home and abroad were retrieved through computer.The searching time was from January 2008 through to June 2018.The article screening,data extraction and the evaluation of bias risk were accomplished by two research fellows independently.RevMan 5.3 was adopted in Meta analysis.Results A total of 22 articles on RCTs were included,with 1642 cases.Meta analysis showed that the clinical effect on hypoxia-induced pulmonary hypertension treated with Chinese herbal compound was higher obviously than the control group,indicating the significant difference(P=0.0002,RR=1.24,95%CI:1.11~1.40).Regarding the improvement in arterial oxygen partial pressure,pulmonary arterial pressure and pulmonary function,the results of Chinese herbal compound were better obviously than the control group,indicating the statistical significance.The improvements in D-dimer and ET-1 were better obviously than the control group,indicating the statistical significance.Of 22 included RCTs in 3 articles,the relevant adverse reactions were reported,but no case of serious adverse reaction.Conclusion Chinese herbal compound effectively relieves the clinical symptoms of hypoxia-associated pulmonary hypertension,improves in arterial oxygen partial pressure,pulmonary arterial pressure and pulmonary function as well as D-dimer and ET-1.The therapeutic effect with Chinese herbal compound supplemented is much superior to simple western medicine.But because of the limitation of the RCT quality and quantity,a high-quality,large-scale and multi-center RCT is required for a further verification.

关 键 词：低氧性肺动脉高压 中药复方 随机对照试验 META分析 

分 类 号：R542.54[医药卫生—心血管疾病]