苏黄止咳胶囊辅助治疗慢性阻塞性肺疾病急性加重期的系统评价  

Systematic Review of Suhuang Zhike Capsule in the Adjuvant Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

作　　者：杨锐锋 黄雨欣 綦向军 侯靖萱 莫嘉浩 赵雅然 杨帆[6] 吴余婉 李际强[7] YANG Ruifeng;HUANG Yuxin;QI Xiangjun;HOU Jingxuan;MO Jiahao;ZHAO Yaran;YANG Fan;WU Yuwan;LI Jiqiang(College of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 102488,China;College of the Fifth Clinical Medical,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;College of the First Clinical Medical,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;College of Humanities and Management,Heilongjiang University of Chinese Medicine,Harbin 150040,China;College of the Second Clinical Medical,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;College of the Fourth Clinical Medical,Guangzhou University of Chinese Medicine,Guangzhou 510006,China;Chao En-xiang Academic Experience Inheritance Studio,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China)

机构地区：[1]北京中医药大学中医学院,北京102488 [2]广州中医药大学第五临床医学院,广州510006 [3]广州中医药大学第一临床医学院,广州510405 [4]黑龙江中医药大学人文与管理学院,哈尔滨150040 [5]广州中医药大学第二临床医学院,广州510405 [6]广州中医药大学第四临床医学院,广州510006 [7]广东省中医院晁恩祥学术经验传承工作室,广州510120

出　　处：《中国医院用药评价与分析》2022年第12期1496-1501,共6页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：广东省自然科学基金项目(No.S2013010012179);广东省中医药局中医药科研项目(No.20211191,No.20212094)。

摘　　要：目的:对常规基础治疗联合苏黄止咳胶囊治疗慢性阻塞性肺疾病急性加重期(AECOPD)的疗效及安全性进行系统评价。方法:检索PubMed、the Cochrane Library、Embase、Web of science、中国知网、中国生物医学文献数据库、万方数据库和维普数据库等数据库中有关在常规基础治疗基础上联合苏黄止咳胶囊治疗AECOPD的随机对照试验,并手动检索纳入文献的参考文献等进行补充检索,检索时限为建库至2021年6月。筛选文献、评价纳入研究的质量和提取资料后,采用RevMan 5.3软件进行Meta分析,采用Stata 15.1软件检验发表偏倚。结果:纳入17项研究,共1680例AECOPD患者。Meta分析结果表明,在常规基础治疗基础上联合应用苏黄止咳胶囊在改善总有效率(RR=1.17,95%CI=1.12~1.22,P<0.00001)、第1秒用力呼气容积(FEV_(1))(MD=0.38,95%CI=0.26~0.49,P<0.00001)、第1秒用力呼气容积占用力肺活量百分比(FEV_(1)/FVC)(MD=11.44,95%CI=7.67~15.22,P<0.00001)和C反应蛋白(CRP)水平(SMD=-0.97,95%CI=-1.36~-0.59,P<0.00001)等方面的效果优于单纯采用常规基础治疗基础,差异均有统计学意义;两组治疗方案不良反应发生率的差异无统计学意义(RR=1.33,95%CI=0.85~2.08,P=0.21)。发表偏倚检验及非参数剪补法分析结果显示,总有效率结局指标存在偏倚,但可能存在的发表偏倚未对结果造成影响。结论:现有证据表明,苏黄止咳胶囊辅助治疗AECOPD的疗效肯定,能改善肺功能指标(FEV_(1)、FEV_(1)/FVC)水平,降低炎症指标(CRP)水平,安全性较好,但上述结果仍需谨慎看待。OBJECTIVE: To systematically review the efficacy and safety of conventional treatment combined with Suhuang Zhike capsule for acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS: Retrieved from PubMed, the Cochrane Library, Embase, Web of Science, CNKI, CBM, Wanfang Data, VIP database, etc., randomized controlled trials about conventional treatment combined with Suhuang Zhike capsule for AECOPD were collected, and the references of included literature were manually searched for supplementary retrieval from the inception to Jun. 2021. After literature screening, quality evaluation and data extraction of included studies, Meta-analysis was carried out by using RevMan 5.3 software, and Stata 15.1 software was used to evaluate publication bias. RESULTS: A total of 1 680 patients with AECOPD were enrolled in 17 studies. Meta-analysis results showed that conventional treatment combined with Suhuang Zhike capsule was better than conventional treatment in improving total response rate(RR=1.17,95%CI=1.12-1.22,P<0.000 01), forced expiratory volume at 1 second(FEV_(1))(MD=0.38,95%CI=0.26-0.49,P<0.000 01), the percentage of forced expiratory volume at 1 second in forced vital capacity(FEV_(1)/FVC)(MD=11.44,95%CI=7.67-15.22,P<0.000 01), and C-reactive protein(CRP) level(SMD=-0.97,95%CI=-1.36--0.59,P<0.000 01),with statistically significant difference;there was no statistical significance in the incidence of adverse drug reaction between two groups(RR=1.33,95%CI=0.85-2.08,P=0.21). Results of publication bias test and non-parametric trim and fill method showed bias in the outcome indexes of total effective rate, but the possible publication bias did not affect the results. CONCLUSIONS: Based on the existing evidence, Suhuang Zhike capsule has positive efficacy in the adjuvant treatment of AECOPD, can improve the levels of lung function indicators(FEV_(1), FEV_(1)/FVC) and reduce the level of inflammation index(CRP), and shows good safety, but the above results still need to be reviewed with caution.

关 键 词：苏黄止咳胶囊 常规基础治疗 慢性阻塞性肺疾病急性加重期 META分析 

分 类 号：R932[医药卫生—生药学]