中医经典方剂治疗特发性肺间质纤维化的贝叶斯网状Meta分析  

Bayesian Network Meta-Analysis of Classical Traditional Chinese Medicine Prescriptions in the Treatment of Idiopathic Pulmonary Interstitial Fibrosis

作　　者：罗成 彭艳茹 李舒 郭亚丽[1] 闫世艳 王玉光[1] LUO Cheng;PENG Yanru;LI Shu;GUO Yali;YAN Shiyan;WANG Yuguang(Dept.of Respiratory,Beijing Traditional Chinese Medicine Hospital,Capital Medical University,Beijing 100010,China;Graduate School,Capital Medical University,Beijing 100071,China;Graduate School,Beijing University of Chinese Medicine,Beijing 100105,China;College of Acupuncture and Moxibustion,Beijing University of Chinese Medicine,Beijing 100105,China)

机构地区：[1]首都医科大学附属北京中医医院呼吸科,北京100010 [2]首都医科大学研究生院,北京100071 [3]北京中医药大学研究生院,北京100105 [4]北京中医药大学针灸推拿学院,北京100105

出　　处：《中国医院用药评价与分析》2023年第11期1338-1343,1349,共7页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金项目(No.81973713);首都卫生发展科研专项项目(No.首发2020-2-2233);北京市卫生局高层次公共卫生技术人才培养计划项目(No.2022-01-016)。

摘　　要：目的:系统评价5种中医经典方剂单用或联合西医治疗特发性肺间质纤维化(IPF)的疗效及肺功能的改善程度。方法:检索中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase和the Cochrane Library等数据库中关于5种中医经典方剂治疗IPF的随机对照试验研究,检索时间为建库至2022年9月19日。通过NoteExpress软件处理文献,采用Excel软件提取数据,应用ROB 2.0进行偏倚风险评估以评价文献整体质量,最后通过RevMan 5.4软件进行传统Meta分析,通过R语言进行网状Meta分析。结果:共纳入26项研究,涉及10类干预措施,共1 882例患者。网状Meta分析结果显示,在治疗IPF有效率方面,排序概率最优的前5种干预措施为补阳还五汤联合西医常规治疗、补肺汤联合西医常规治疗、麦门冬汤、补阳还五汤、肺痹汤联合西医常规治疗;在改善一氧化碳弥散量占预计值百分比(DLCO%)方面,排序概率最优的前5种干预措施为补阳还五汤联合西医常规治疗、补肺汤联合西医常规治疗、补阳还五汤、血府逐瘀汤、肺痹汤联合西医常规治疗;在改善用力肺活量占预计值百分比(FVC%)方面,排序概率最优的前3种干预措施为血府逐瘀汤联合西医常规治疗、补阳还五汤联合西医常规治疗、补肺汤联合西医常规治疗。提示补阳还五汤联合西医常规治疗的疗效可能最佳,在改善患者肺功能方面,补阳还五汤联合西医常规治疗、血府逐瘀汤联合西医常规治疗能有效提高患者的DLCO%和FVC%。结论:中西医联合用药可能对IPF的治疗效果更好,其中推荐补阳还五汤联合西医常规治疗和血府逐瘀汤联合西医常规治疗。OBJECTIVE:To systematically evaluate the efficacy and improvement of pulmonary function of five traditional Chinese medicine prescriptions on idiopathic pulmonary interstitial fibrosis(IPF)alone or in combination with Western medicine.METHODS:CNKI,VIP,Wanfang Data,CBM,PubMed,Web of Science,Embase and the Cochrane Library databases were retrieved to collect randomized controlled trials of five traditional Chinese medicine prescriptions in the treatment of IPF.The search time was from database establishment to Sept.19th,2022.NoteExpress software was used to process the literature,Excel software was used to extract data,ROB 2.0 was applied to perform bias risk assessment to evaluate the overall quality of the literature,RevMan 5.4 software was used to conduct traditional Meta-analysis,and R language was used to perform network Meta-analysis.RESULTS:A total of 26 studies were enrolled,including 10 types of intervention measures,with a total of 1882 patients.Network Meta-analysis results showed that the top five intervention measures with the highest ranking probability in terms of effectiveness in the treatment of IPF were respectively Buyang Huanwu decoction combined with Western medicine,Bufei decoction combined with Western medicine,Maimendong decoction,Buyang Huanwu decoction,and Feibi decoction combined with Western medicine.In terms of improving DLCO%,the top five intervention measures with the highest ranking probability were respectively Buyang Huanwu decoction combined with Western medicine,Bufei decoction combined with Western medicine,Buyang Huanwu decoction,Xuefu Zhuyu decoction,Feibi decoction combined with Western medicine.In terms of improving FVC%,the top three intervention measures with the highest ranking probability were respectively Xuefu Zhuyu decoction combined with Western medicine,Buyang Huanwu decoction combined with Western medicine,and Bufei decoction combined with Western medicine.The results suggested that Buyang Huanwu decoction combined with Western medicine may have the best curative e

关 键 词：中医药 经典方剂 特发性肺间质纤维化 网状Meta分析 

分 类 号：R932[医药卫生—生药学]