氨茶碱联合中药治疗支气管哮喘的Meta分析

Aminophylline combined with Traditional Chinese Medicine for Asthma:A Meta-analysis

目的系统评价氨茶碱联合中药治疗支气管哮喘的临床疗效。方法计算机检索The Cochrane Library(2015年第1期)、PubMed、EMbase、CNKI、VIP和WanFang Data数据库,搜集氨茶碱联用中药治疗支气管哮喘的相关随机对照试验(RCT),检索时限均为2005年1月至2014年12月。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入10个RCT,包括820例患者。Meta分析结果显示:在临床疗效方面,氨茶碱联合中药治疗支气管哮喘比单独应用氨茶碱治疗更优,其差异有统计学意义[RR=1.22,95%CI(1.11,1.33)];在第一秒用力呼气量(FEV1)方面,两种治疗方案差异无统计学意义[MD=0.53,95%CI(0.33,0.73)]。结论氨茶碱联合中药治疗支气管哮喘的临床疗效优于单独应用氨茶碱,其机制可能与提高FEV1有关。受纳入研究的数量和质量的限制,上述结论尚待更多高质量研究予以验证。

Objective To systematically review the effects of aminophylline combined with traditional Chinese medicine （TCM） in the treatment of asthma. Methods Databases including The Cochrane Library（Issue 1, 2015）, PubMed, EMbase, CNKI, VIP and WanFang Data databases were electronically searched from January 2005 to December 2014 to collect randomized controlled trials （RCTs） about the treatment of bronchial asthma combining aminophylline with TCM. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 10 RCTs involving 820 participants were included. The results of meta-analysis showed that： The total clinical effective rate in the aminophylline plus TCM group was higher than that of the aminophylline alone group （RR= 1.22, 95%CI 1.11 to 1.33）. The FEV1 in the aminophylline plus TCM group was also higher than that of the aminophylline alone group （MD=0.53, 95%CI 0.33 to 0.73）. Condusion Current evidence shows, the total clinical effective rate of aminophylline combined with TCM for asthma is better than that of aminophylline alone, and its mechanism may be related to the improvement of FEVI. Due to the limited quantity and quality of included studies, the above conclusion needs to be further verified by more high quality studies.