清气化痰汤结合西医治疗慢性阻塞性肺疾病急性加重期疗效和证候变化的Meta分析

Therapeutic Effect and Symptom Changes of Phlegm-Clearing Decoction Combined with Western Medicine on COPD with Acute Exacerbation:A Systematic Review and Meta-Analysis

目的:系统评价清气化痰汤结合西医疗法对痰热壅肺证慢性阻塞性肺疾病急性加重期(AECOPD)临床疗效及证候积分变化的影响。方法:检索清气化痰汤结合西医疗法(清气化痰组)与单纯西医疗法(西医组)治疗痰热壅肺证AECOPD临床疗效的随机对照研究(RCT)文献,采用Jadad量表对纳入的文献质量进行评价,对各结局指标使用Rev Man 5.2软件进行分析。结果:符合条件的9项RCT中3项评价了证候评分的变化。与西医组相比,清气化痰汤结合西医疗法的临床疗效明显提高,RR值为1.24(95%CI:1.10~1.41),P<0.01;而咳嗽、咳痰证候积分下降也明显,RR分别为-0.84(95%CI:-1.56^-0.11)和-0.71(95%CI:-1.31^-0.12),P<0.01。结论:在西医常规治疗的基础上合用清气化痰汤可有效提高治疗痰热壅肺证AECOPD的临床疗效。

Objective： To make a systematic review of the effect of Phlegm-Clearing Decoction combined with western medical treatment on clinical therapeutic effect and symptom score changes of chronic obstructive pulmonary disease with acute exacerbation（ AECOPD）.Methods： To retrieve the randomized control trials（ RCT） references of Phlegm-Clearing Decoction combined with western medical treatment（ Phlegm-Clearing Decoction group） used to treat AECOPD with symptom type of phlegm-heat-blocking-lung,with comparison to routine western medical treatment（ western group）.Jadad scale was applied to evaluate the quality of included references,and Rev Man 5.2 software was used to analyze associated outcomes.Results： Nine RCTs were included in this review,of which 3 RCTs were evaluated with respect to changes of symptom scores.Compared to western group,the clinical therapeutic effect of Phlegm-Clearing Decoction group was much better,with RR of 1.21（ 95% CI： 1.12 - 1.30）,P〈0.01,and the cough and sputum scores were significantly decreased,with RR of-0.84（ 95% CI：-1.56 --0.11） and-0.71（ 95% CI：-1.31 --0.12）,respectively,P〈0.01.Conclusions： Phlegm-Clearing Decoction could upgrade the clinical therapeutic effect of western medical treatment in the treatment of AECOPD with phlegm-heat-blocking-lung symptom.