痰热清注射液治疗慢性阻塞性肺疾病急性加重合并肺炎的Meta分析  

Meta-Analysis of Tanreqing Injection in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease(AECOPD)with Pneumonia

作　　者：王奕婷 李琰 杨珺超[2] WANG Yi-ting;LI Yan;YANG Jun-chao(The First School of Clinical Medicine,Zhejiang University of Traditional Chinese Medicine,Hangzhou 310000,China;The First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine,Hangzhou 310000,China)

机构地区：[1]浙江中医药大学第一临床医学院,浙江杭州310000 [2]浙江中医药大学附属第一医院,浙江杭州310000

出　　处：《云南中医中药杂志》2025年第4期30-38,共9页Yunnan Journal of Traditional Chinese Medicine and Materia Medica

基　　金：国家重点研发计划(2018YFC2002500)。

摘　　要：目的系统评价痰热清注射液治疗慢性阻塞性肺疾病急性加重(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肺炎的临床疗效。方法检索知网、万方、维普、中国生物医学文献、PubMed、The Cochrane Library、EMbase数据库由建库至2024年7月的所有文献,搜集有关痰热清注射液治疗AECOPD合并肺炎的临床随机对照试验(RCTs),运用RevMan 5.4软件对资料进行统计分析。结果共检索到15篇文献,共计病例数1475例。Meta分析发现:试验组临床总有效率[OR=4.63,95%CI=(3.23,6.63),P<0.05]、炎症因子PCT[SMD=-1.54,95%CI=(-2.08,-0.99),P<0.05]、TNF-α[SMD=-2.03,95%CI=(-3.06,-1.01),P<0.05]、免疫因子CD3+[SMD=1.35,95%CI=(0.74,1.96),P<0.05]、CD4+[SMD=0.81,95%CI=(0.60,1.03),P<0.05]、肺功能FEV1[MD=0.34,95%CI=(0.31,0.38),P<0.05]、FEV1/FVC(%)[MD=5.28,95%CI=(1.83,8.73),P<0.05]、FVC[MD=0.35,95%CI=(0.22,0.49),P<0.05]、症状体征(咳嗽、咳痰、气喘、肺部啰音)改善情况均优于对照组,差异有统计学意义(P<0.05);亚组分析提示疗程<14天较疗程≥14天效果更好;不良反应率2组无明显差别(P>0.05)。结论痰热清注射液可有效提高AECOPD合并肺炎患者的临床疗效、抗炎、增强免疫力、改善肺功能及症状体征,无需长疗程即可获得较好效果,安全性可。Objective:To systematically evaluate the clinical efficacy of Tanreqing Injection in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with pneumonia.Methods:Relevant literature was retrieved from CNKI,Wanfang,VIP,SinoMed,PubMed,The Cochrane Library and EMbase databases from inception to July 2024.Randomized controlled trials(RCTs)on the use of Tanreqing Injection for AECOPD with pneumonia were collected,and statistical analysis was conducted by using RevMan 5.4 software.Results:A total of 15 studies with 1,475 cases were included.The meta-analysis revealed that compared to the control group,the treatment group showed significant improvement in overall clinical efficacy(OR=4.63,95%CI:3.23-6.63,P<0.05),reduction in inflammatory markers including PCT(SMD=-1.54,95%CI:-2.08 to-0.99,P<0.05)and TNF-α(SMD=-2.03,95%CI:-3.06 to-1.01,P<0.05),and enhancement of immune markers including CD3+(SMD=1.35,95%CI:0.74-1.96,P<0.05)and CD4+(SMD=0.81,95%CI:0.60-1.03,P<0.05).Pulmonary function indices,including FEV1(MD=0.34,95%CI:0.31-0.38,P<0.05),FEV1/FVC(%)(MD=5.28,95%CI:1.83-8.73,P<0.05),and FVC(MD=0.35,95%CI:0.22-0.49,P<0.05),were also significantly improved.Symptoms such as cough,sputum production,dyspnea,and lung rales were better alleviated in the treatment group and the difference was statistically significant(P<0.05).Subgroup analysis suggested that a treatment duration of<14 days was more effective than≥14 days.The incidence of adverse reactions did not significantly differ between groups(P>0.05).Conclusion:Tanreqing Injection effectively improves clinical outcomes,reduces inflammation,enhances immunity,and improves lung function and symptoms in patients with AECOPD and pneumonia.It achieves good results without requiring long treatment duration and has a favorable safety profile.

关 键 词：痰热清注射液 慢性阻塞性肺疾病急性加重 肺炎 META分析 

分 类 号：R563.1[医药卫生—呼吸系统]