清热化痰法联合西医常规治疗慢性阻塞性肺疾病疗效的Meta分析

Meta Analysis of the Efficacy on Method of Clearing Heat and Removing Phlegm Combined with Routine Western Medical Treatment for Chronic Obstructive Pulmonary Disease

目的评价清热化痰法联合西医常规治疗慢性阻塞性肺疾病的临床疗效。方法按Cochrane系统评价方法,计算机检索中国医院数字图书馆的中国期刊全文数据库(CNKI)、万方数据库、维普中文期刊数据库(VIP)、Pub Med数据库、Embase数据库从建库至2014年11月用清热化痰法联合西医常规治疗慢性阻塞性肺疾病临床试验的文献。按照纳入排除标准筛选文献,对文献进行评价质量,并提取资料,采用Rev Man 5.2软件进行Meta分析。结果纳入8个随机对照试验,共693例患者,其中试验组346例,对照组347例。Meta分析结果显示:清热化痰法联合西医常规可以明显改善慢性阻塞性肺疾病的临床症状,[OR=5.36,95%Cl(2.94,9.78),(P<0.00001)];Pa O2:[WMD=8.14,95%Cl(1.31,14.97),(P<0.05)]。Pa CO2:[WMD=-7.33,95%Cl(-13.75,-0.92),(P<0.05)]。FEV1/FVC:[WMD=2.75,95%Cl(0.85,4.65),(P<0.05)]。结论清热化痰法联合西医常规治疗慢性阻塞性肺疾病有效。问题与展望:前期研究质量不高,结果存在发表偏倚;目前对疗效尚不能得出最终结论,有待于高质量的临床研究,开展更多前瞻性、大样本、多中心的随机对照试验。

Objective Analysis of clinical trials of clearing heat and removing phlegm combined with routine Western medical treatment in treating chronic obstructive pulmonary disease by meta analysis. Methods The randomized or semi-randomized controlled studies involving treatment of COPD with clearing heat and removing phlegm combined with routine Western medical treatment were searched and identified from CNKI, Wanfang Data, VIP, PubMed and Embase. According to Cochrane methods, two reviewers independently screened literature, assessed methodological quality, extracted data, and analysis by RevMan 5.2 software. Results A total of 8 studies, including 693 cases of patients （346 in experimental group and 347 in control group） were included, The results of Meta analysis suggest that： Clearing heat and removing phlegm combined with routine Western medical treatment can significantly improve the clinical symptoms in patients with chronic obstructive pulmonary disease [OR=5. 36, 95%CI（2.94, 9.78）, （P〈0.00001）]; PaO2： [WMD=8.14, 95%CI（1.31, 14.97）, （P〈0.05）]. PaCO2： [WMD=-7.33, 95%CI（-13.75, -0.92）, （P〈0.05）]. FEV1/FVC：[WMD=2.75, 95%CI （0.85, 4.65）, （P〈0.05）]. Conclusion Clearing heat and removing phlegm combined with routine Western medical treatment in treating chronic obstructive pulmonary disease is effective. Problem and Prospect：The results of the previous research and the trial quality are low, the experiment potential publication bias. We cannot make a final conclusion of the effectiveness based on this Meta analysis. High quality trials with large sample size and multi-center are needed to verify its clinical effects.