清热解毒类中药注射液治疗慢性阻塞性肺疾病急性加重期的网状Meta分析  

Network Meta-analysis of heat-clearing and detoxifying Chinese medicine injections in treatment of acute exacerbation of chronic obstructive pulmonary disease

作　　者：赵贵香 王露[1] 杨昆 张海龙[1,2] 李建生[1,2] ZHAO Gui-xiang;WANG Lu;YANG Kun;ZHANG Hai-long;LI Jian-sheng(Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan&Education Ministry of China,Henan Key Laboratory of Chinese Medicine for Respiratory Disease,Henan University of Chinese Medicine,Zhengzhou 450046,China;the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学呼吸疾病中医药防治省部共建协同创新中心河南省中医药防治呼吸病重点实验室,河南郑州450046 [2]河南中医药大学第一附属医院,河南郑州450003

出　　处：《中国中药杂志》2022年第10期2788-2801,共14页China Journal of Chinese Materia Medica

基　　金：国家中医药管理局国家中医药传承与创新“百千万”人才工程-岐黄工程首席科学家项目(国中医药人教函[2021]7号);国家自然科学基金项目(81973781);河南省中医药科学研究专项(2019JDZX2004)。

摘　　要：系统评价清热解毒类中药注射液治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效与安全性。计算机检索中国知网(CNKI)、PubMed等8个数据库收录的清热解毒类中药注射液治疗AECOPD的随机对照试验(RCT),检索时间均自建库至2021年7月11日。提取合格文献相关信息,通过Cochrane风险偏倚评价工具对纳入研究进行质量评价。采用Stata SE 15.1、ADDIS 1.16.6软件进行数据分析。共纳入81项RCTs,7526例患者,其中试验组3782例,对照组3744例。依据统计学差异进行排序,网状Meta分析结果显示,(1)提高有效率方面,热毒宁注射液+西医常规>痰热清注射液+西医常规;(2)降低C-反应蛋白(CRP)方面,热毒宁注射液+西医常规>痰热清注射液+西医常规;(3)降低白细胞(WBC)计数方面,热毒宁注射液+西医常规>喜炎平注射液+西医常规>痰热清注射液+西医常规;(4)降低二氧化碳分压(PaCO_(2))方面,鱼腥草注射液+西医常规>热毒宁注射液+西医常规>痰热清注射液+西医常规;(5)提高氧分压(PaO_(2))方面,鱼腥草注射液+西医常规>热毒宁注射液+西医常规>痰热清注射液+西医常规>喜炎平注射液+西医常规;(6)缩短平均住院时间方面,清开灵注射液+西医常规>痰热清注射液+西医常规。安全性方面,5种中药注射液均未产生严重不良反应。结果表明,5种清热解毒类中药注射液均能有效治疗AECOPD、各有特点及侧重,其中热毒宁注射液+西医常规、痰热清注射液+西医常规总体治疗效果较好且全面。由于纳入研究数量及质量存在差异,结论可靠性尚需进一步验证。This study aims to evaluate the efficacy and safety of heat-clearing and detoxifying Chinese medicine injections in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Randomized controlled trial(RCT)on the treatment of AECOPD with heat-clearing and detoxifying Chinese medicine injections were retrieved from 8 databases including CNKI and PubMed(from establishment to July 11,2021).Related information in eligible articles was extracted,and the quality of the included articles was assessed by Cochrane collaboration′s tool for assessing risk of bias.Stata SE 15.1 and ADDIS 1.16.6 were employed for data analysis.A total of 81 RCTs were screened out,involving 7526 patients(3782 in the experimental group and 3744 in the control group).According to the statistical difference and network Meta-analysis,the injections are in the order of(1)Reduning Injection+conventional western medicine>Tanreqing Injection+conventional western medicine in improving the effective rate,(2)Reduning Injection+conventional western medicine>Tanreqing Injection+conventional western medicine in decreasing C-reactive protein(CRP),(3)Reduning Injection+conventional western medicine>Xiyanping Injection+conventional western medicine>Tanreqing Injection+conventional western medicine in reducing white blood cell count(WBC),(4)Yuxingcao Injection+conventional western medicine>Reduning Injection+conventional western medicine>Tanreqing Injection+conventional western medicine in lowering partial pressure of carbon dioxide(PaCO_(2)),(5)Yuxingcao Injection+conventional western medicine>Reduning Injection+conventional western medicine>Tanreqing Injection+conventional western medicine>Xiyanping Injection+conventional western medicine in improving partial pressure of oxygen(PaO_(2)),and(6)Qingkailing Injection+conventional western medicine>Tanreqing Injection+conventional western medicine in shortening mean hospital stay.In terms of safety,none of the five injections have serious adverse reactions.The five heat-clearing and de

关 键 词：清热解毒 慢性阻塞性肺疾病急性加重期 中药注射液 网状Meta分析 

分 类 号：R259[医药卫生—中西医结合]