行气化痰法中药汤剂治疗阻塞性睡眠呼吸暂停低通气综合征的系统评价  

A systematic review on the decoctions of promoting the circulation of Qi and reducing phlegm on obstructive sleep apnea hypopnea syndrome

作　　者：蒋紫云 陶海澜 肖超烈 朱晓珏 周谨希 连乐燊 JIANG Ziyun

机构地区：[1]东莞市中医院,广东东莞523000 [2]广州中医药大学研究生院,广东广州510000

出　　处：《中医临床研究》2021年第31期135-139,共5页Clinical Journal Of Chinese Medicine

基　　金：广东省中医药局科研项目(20202223);广东省名中医传承工作室建设项目(粤中医办函〔2018〕5号);东莞市第四批名中医师承项目(东卫函〔2020〕4号)。

摘　　要：目的:系统评价行气化痰法中药汤剂治疗阻塞性睡眠呼吸暂停低通气综合征的有效性及安全性。方法:用计算机系统检索建库至2021年4月间中国知网、万方、维普、中国生物医学文献服务系统数据库的中文文献,收集行气化痰法中药汤剂联合西医常规治疗阻塞性睡眠呼吸暂停低通气综合征的随机对照试验,由2名研究人员根据纳入及排除标准,筛选文献并进行质量评价及数据提取,采用RevMan 5.3进行Meta分析;主要结局指标包括有效率、呼吸暂停低通气指数;次要结局指标:中医证候积分、Epworth嗜睡量表评分;炎症指标:C反应蛋白、白细胞介素-6、肿瘤坏死因子-α;氧化应激指标:丙二醛、超氧化物歧化酶。结果:纳入12个研究,包括913病例。在有效率、呼吸暂停低通气指数、中医证候积分、Epworth嗜睡量表评分、C反应蛋白、白细胞介素-6、肿瘤坏死因子-α、丙二醛、超氧化物歧化酶方面,行气化痰法中药汤剂联合西医常规治疗的效果优于单纯西医常规治疗(P<0.05)。3项研究报道未见明显不良反应。结论:行气化痰法中药汤剂联合西医常规治疗阻塞性睡眠呼吸暂停低通气综合征比西医常规治疗更有效,能改善临床症状和睡眠呼吸监测指标,减轻炎症反应及氧化应激,无明显不良反应,安全性高,由于目前文献质量有限,尚需更多高质量的临床随机对照试验提供可靠证据。Objective:To evaluate the efficacy and safety of the traditional Chinese medicine decoctions of promoting the circulation of Qi(气)and reducing phlegm on obstructive sleep apnea hypopnea syndrome.Methods:The Chinese literature from 4 databases,CNKI,VIP,Wanfang and SinoMed from the establishment of the database to April 2021 was searched by computer system.The randomized controlled trial of the treatment of OSAHS by TCM decoction plus traditional Western medicine was collected.Two researchers selected the literature and carried out quality evaluation and data extraction according to the inclusion and exclusion criteria.The meta-analysis was carried out by RevMan 5.3;the main outcome indicators included efficiency,apnea hypopnea index;the secondary outcome indicators included TCM syndrome score,Epworth sleepiness score;the inflammatory indexes included C reactive protein,interleukin 6,tumor necrosis factor;oxidative stress indexes:malondialdehyde and superoxide dismutase.Results:12 studies were included,including 913 cases.In terms of efficiency,AHI,TCM syndrome score,ESS score,CRP,IL-6,TNF,MDA and SOD,the decoctions of promoting the circulation of Qi and reducing phlegm plus Western medicine was better than the Western medicine alone(P<0.05).No serious adverse reaction was found in three studies.Conclusion:The traditional Chinese medicine plus Western medicine is more effective than Western medicine alone,which can improve the clinical symptoms and AHI,reduce inflammation and oxidative stress,without obvious adverse reaction.Due to the limited literature quality,more high-quality randomized clinical trials are needed to provide reliable evidence.

关 键 词：行气化痰 阻塞性睡眠呼吸暂停低通气综合征 系统评价 

分 类 号：R255[医药卫生—中医内科学]