小青龙汤联合西药治疗成人哮喘随机对照试验的Meta分析

A Meta-analysis on randomized controlled trials of treating adult asthma with Xiaoqinglong Decoction combined with western medicine

目的:系统评价小青龙汤联合西药治疗成人哮喘的疗效和不良反应。方法:系统全面的检索Pub Med、中国期刊全文数据库、万方数据知识服务平台、维普中文科技期刊数据库,纳入于2015年10月以前发表的小青龙汤与安慰剂、西药等治疗哮喘的随机对照试验,用Cochrane协作网提供的Rev Man 5.3 Meta分析软件进行统计分析及文献质量评价。结果:共计37篇RCT文献符合纳入标准,但RCT方法学质量较低,纳入的RCT文献中未发现小青龙汤与安慰剂对照的研究。Meta分析结果表明,小青龙汤联合西药治疗咳嗽能提高疗效(Z=7.53,P<0.00001,R R=1.15,95%CI[1.11,1.19]),降低外周血EOS水平(Z=3.45,P=0.006,S M D=-0.78,95%CI[-1.23,-0.34]),降低喘息症状积分(Z=4.22,P<0.0001,SMD=-3.50,95%CI[-5.13,-1.87]),提高FEV1水平(Z=8.37,P<0.00001,SMD=0.31,95%CI[0.24,0.39]),提高FEV1/FVC比率(Z=3.99,P<0.0001,SMD=1.49,95%CI[0.76,2.22]),提高PEF水平(Z=3.70,P=0.0002,SMD=1.38,95%CI[0.65,2.11])。所有纳入RCT均未报告严重不良反应。结论:现有证据表明小青龙汤在改善哮喘患者善肺功能、降低EOS水平、改善喘息积分方面有一定疗效。

Objective：To evaluate the efficacy and adverse reaction of Xiaoqinglong Decoction combined with western medicine in the treatment of adult asthma.Methods：The randomized controlled trials with the treatment of Xiaoqinglong Decoction combined with western medicine published before October 31,2015 were included form Pub Med,Chinese National Knowledge Infrastructure（CNKI）,Wanfang and VIP databases.Review Manager 5.3 offered by Cochrane Collaboration was used for the statistical analysis and quality of literature evaluation.Results：Thirty-seven literatures were finally included into this current study,but their quality was low because there was no placebo controlled trials.Meta-analysis showed that Xiaoqinglong Decoction combined western medicine could improve the control rate of asthma（Z=7.53,P〈0.00001,RR=1.15,95%CI [1.11,1.19]）,decrease the level of eosinophil（Z=3.45,P=0.006,SMD=-0.78,95%CI [-1.23,-0.34]） and gasp scores（Z=4.22,P〈0.0001,SMD=-3.50,95%CI [-5.13,-1.87]）,improve the levels of FEV1（Z=8.37,P〈0.00001,SMD=0.31,95%CI [0.24,0.39]）,FEV1/FVC rate（Z=3.99,P〈0.0001,SMD=1.49,95%CI [0.76,2.22].and the levels of PEF（Z=3.70,P=0.0002,SMD=1.38,95%CI [0.65,2.11]）.Few adverse effects was reported in the included studies.Conclusion：There is evidence that Xiaoqinglong Decoction has acertain ef f ect in improving the lung function of patients with asthma,decreasing the level of EOS and improving gasp scores aspects.