补肺益肾法治疗慢性阻塞性肺疾病稳定期有效性的Meta分析  

A Meta-analysis of Tonifying Lung and Benefiting Kidney Method for Treating Stable-stage Patients with Chronic Obstructive Pulmonary Disease

作　　者：张楚西 袁星与 杨朝晖 张春晓 朱振刚[1,2] ZHANG Chuxi;YUAN Xingyu;YANG Zhaohui;ZHANG Chunxiao;ZHU Zhengang(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine Tianjin 300073,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300073,China)

机构地区：[1]天津中医药大学第一附属医院,天津300073 [2]国家中医针灸临床医学研究中心,天津300073

出　　处：《实用中医内科杂志》2025年第4期26-29,I0005-I0008,共8页Journal of Practical Traditional Chinese Internal Medicine

基　　金：国家自然科学基金项目(81673900)。

摘　　要：目的系统评价补肺益肾法治疗慢性阻塞性肺疾病稳定期的疗效。方法通过Cochrane协作网提供的RevMan 5.3软件对纳入的16项RCTs进行Meta分析。结果与对照组相比,联合补肺益肾法可以改善COPD稳定期患者的肺功能:FEV_(1)%[MD=5.96,95%CI(3.64,8.29),P<0.00001],FEV_(1)/FVC[MD=5.53,95%CI(4.75,6.31),P<0.00001];调节免疫球蛋白:8周组IgA[MD=0.37,95%CI(0.27,0.48),P<0.00001]、12周组IgA[MD=0.35,95%CI(-0.01,0.72),P=0.05],IgG[MD=0.47,95%CI(0.39,0.55),P<0.00001];降低炎性因子:IL-6[MD=-6.67,95%CI(-9.64,-3.71),P<0.0001],TGF-β1[MD=-18.37,95%CI(-28.64,-8.11),P=0.0005],TNF-α[MD=-4.65,95%CI(-8.04,-1.26),P=0.007];改善T淋巴细胞亚群:CD^(+)_(4)[MD=3.76,95%CI(1.80,5.72),P=0.0002],CD^(+)_(8)[MD=-3.93,95%CI(-4.43,-3.42),P<0.00001];而对于免疫球蛋白IgM,8周组IgM[MD=0.25,95%CI(-0.04,0.54),P=0.09]差异无统计学意义、12周组IgM[MD=0.35,95%CI(-0.01,0.72),P=0.05],说明补肺益肾法治疗早期,对IgM的改善效果不明显,长期治疗才可初见疗效。结论联合补肺益肾法治疗COPD稳定期患者,在疗效方面基本肯定,但由于该研究纳入研究的质量限制,未来仍需设计更严格、质量更高、样本量更大、多中心的临床研究来对研究结果进行论证。Objective To systematically evaluate the efficacy of tonifying lung and benefiting kidney method in the treatment of chronic obstructive pulmonary disease(COPD)in stable stage.Methods A meta-analysis of 18 RCTs was performed using RevMan 5.3 software provided by the Cochrane Collaboration.Results Compared with the control group,the combined treatment with tonifying lung and benefiting kidney method could improve the lung function of patients with stable COPD:FEV_(1)%[MD=5.96,95%CI(3.64,8.29),P<0.00001],FEV_(1)/FVC[MD=5.53,95%CI(4.75,6.31),P<0.00001],IgA in 8-week group[MD=0.37,95%CI(0.27,0.48),P<0.00001],IgA in 12-week group[MD=0.35,95%CI(-0.01,0.72),P=0.05],IgG[MD=0.47,95%CI(0.39,0.55),P<0.00001];reduced IL-6[MD=-6.67,95%CI(-9.64,-3.71),P<0.0001],TGF-β1[MD=-18.37,95%CI(-28.64,-8.11),P=0.0005],TNF-α[MD=-4.65,95%CI(-8.04,-1.26),P=0.007];improved CD^(+)_(4)[MD=3.76,95%CI(1.80,5.72),P=0.0002],CD^(+)_(8)[MD=-3.93,95%CI(-4.43,-3.42),P<0.00001].There was no significant difference in IgM in the 8-week and 12-week groups[MD=0.25,95%CI(-0.04,0.54),P=0.09;MD=0.35,95%CI(-0.01,0.72),P=0.05],indicating that the improvement effect of tonifying lung and benefiting kidney method on IgM in the early stage was not obvious,and the initial effect of long-term treatment could be seen.Conclusion The treatment combined with tonifying lung and benefiting kidney method in the treatment of stable COPD patients is basically positive in terms of efficacy.However,due to the quality limitations of the included studies in this study,more strict,higher quality,larger sample size and multi-center clinical studies need to be designed in the future to demonstrate the results of this study.

关 键 词：补肺益肾法 慢性阻塞性肺疾病稳定期 肺肾气虚证 META分析 

分 类 号：R259[医药卫生—中西医结合]