痰热清注射液对慢性阻塞性肺疾病急性发作患者血清炎性因子影响的Meta分析

A Meta-analysis of the Effect of Tanreqing Injection on Serum Inflammatory Factors in AECOPD Patients

目的:评价痰热清注射液对慢性阻塞性肺疾病急性发作患者(AECOPD)的疗效性。方法:系统检索CNKI,VIP,WanFang,SinoMed,Medline,EMbase,Cochrane Library,检索时限为建库截止至2019年5月,收集痰热清注射液治疗慢性阻塞性肺疾病急性发作的的随机对照试验(RCT)。由2名研究者独立进行文献筛选、数据提取及偏倚风险评估,采用RevMan5.3软件进行数据分析。结果:共检索出612篇文献,最终纳入28个研究,涉及2376例患者,纳入研究总体质量偏低。Meta分析结果显示:在对患者血清炎性因子的影响方面,痰热清注射液联合常规西医观察组对C反应蛋白、肿瘤坏死因子和降钙素原的水平影响优于常规西医观察组,对白细胞介素水平的影响2组间差异无统计学意义。但由于纳入的研究数量少,且纳入的研究质量普遍偏低、存在发表偏倚等诸多局限性,以至于研究结果的证据质量较低,影响结论的可靠性,故需谨慎应用结论。结论:后期需要更多大样本、多中心、随机和盲法设计严谨、报告规范的临床试验来进一步验证其结论的准确性和安全有效性。

Objective:To evaluate the efficacy of Tanreqing Injection in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:Systematic retrieval of CNKI,VIP,WanFang,SinoMed,Medline,EMbase,Cochrane Library was conducted in this study,and the search time limit was from the construction of the database until May 2019.The randomized controlled trial(RCT)of Tanreqing injection for the treatment of AECOPD was collected from the database establishment to May 2019.Literature screening,data extraction and risk assessment of bias were conducted independently by 2 researchers,and data analysis was conducted by RevMan5.3 software.Results:A total of 612 literature were retrieved and 28 studies were eventually included,involving 2,376 patients.The overall quality of the included studies was low.The results of analysis showed that in terms of the effect on patients′serum inflammatory factors,Tanreqing injection combined with conventional Western medicine treatment group has better effects on the levels of C-reactive protein,tumor necrosis factor and procalcitonin than the conventional Western medicine treatment group.There was no statistically significant difference in the effect of interleukin levels between the 2 groups.However,due to the small number of included studies and the generally low quality of the included studies,there were many limitations such as low quality of research,publication bias etc.,so that the quality of the evidence for the research results was low,affecting the reliability of the conclusion.Thus the conclusion should be applied carefully.Conclusion:Therefore,more clinical trials with large samples,multi-centers,rigorous randomized and blind design,and standardized reporting are needed to further verify the accuracy and safety effectiveness of their conclusions.