中医药治疗上气道咳嗽综合征疗效的系统评价

Traditional Chinese Medicine in Treating Upper Airway Cough Syndrome:A Systematic Review

目的系统评价中医药治疗上气道咳嗽综合征/鼻后滴流综合征(UACS/PNDS)的临床疗效和安全性。方法计算机检索MEDLINE(1950～2011)、PubMed(1996～2011)、VIP(1989～2011)、WanFang Data(1998～2011)、CNKI(1979～2011)和CBM(1978～2011),收集中医药治疗UACS/PNDS的随机或半随机对照试验。由两位研究者独立按纳入排除标准筛选试验、评价质量和提取数据后,采用RevMan 5.0软件进行Meta分析。结果共纳入10个RCT,均为中文文献。定性研究结果显示:①无论成人或小儿UACS,还是成人PNDS,中西医结合治疗的疗效均优于单纯西药治疗。②对于成人PNDS,单纯中药治疗的疗效可能优于单纯西药治疗;但无论成人或小儿UACS,单纯中药治疗的效果并未显示出优于单纯西药治疗。10个纳入研究均未报道与中药相关的严重不良反应。结论现有研究结果初步提示,中西医结合治疗成人或小儿UACS/成人PNDS的疗效可能优于单纯西药治疗,而中医药治疗UACS/PNDS的疗效是否优于西药尚不确定。因本研究纳入文献数量少,中药、西药种类繁多,受纳入研究方法学质量以及干预手段不一等限制,以上初步结论尚需进一步开展更多高质量大样本的随机对照试验加以验证。

Objective To systematically assess the effectiveness of traditional Chinese medicines（TCM） in treating upper airway cough syndrome（UACS） or postnasal drip syndrome（PNDS）.Methods Such databases as MEDLINE（1950 to 2011）,PubMed（1996 to 2011）,VIP（1989 to 2011）,WanFang Data（1998 to 2011）,CNKI（1979 to 2011） and CBM（1978 to 2011） were searched for collecting the randomized controlled trials（RCT） or quasi-RCTs about TCM treating UACS/PNDS.The trials were screened according to the inclusive and exclusive criteria,and then after the quality assessment and data extraction were conducted,the statistical analysis was conducted by using RevMan 5.0 software.Results A total of 10 RCTs and quasi-RCTs in Chinese were identified.The results of analysis showed that： a） The integrated Chinese and western medicine was superior to western medicine alone,either for adults and children with UACS,or for adults with PNDS.However the effectiveness had to be further assessed due to lack of high-quality literatures;b） TCM alone was probably more effective than western medicine alone for adults with PNDS,but not for adults and children with UACS.No obvious adverse reaction related to TCM was reported.Conclusion The recent research outcomes show that the integrated Chinese and western medicine is superior to western medicine alone,either for adults and children with UACS,or for adults with PNDS,but no definite evidence is found to support the superiority of TCM in treating UACS/PNDS.More high-quality RCTs with large scale need to be conducted in future to verify this conclusion due to the overall low methodological quality and significantly different intervention of the included trials.