清气化痰汤对COPD急性加重患者肺功能和动脉血氧分压影响的Meta分析

Effect Meta-analysis of Qingqi Huatan Decoction on Pulmonary Function and Blood Oxygen Partial Pressure of AECOPD Patients

目的:观察清气化痰汤对痰热壅肺型慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)肺功能和动脉血氧分压(Pa O2)的影响。方法:检索清气化痰汤结合西药疗法(清气化痰组)与单纯西药疗法(西药组)治疗痰热壅肺型AECOPD临床疗效的随机对照研究文献,采用Jadad量表和Rev Man 5.2软件分别对纳入的文献偏倚风险、第1秒用力呼气量(forced expiratory volume in first second,FEV1)、FEV1%和Pa O2等结局指标进行评价和分析。结果:纳入7个研究共740例患者。Meta分析结果显示,与西药组相比,清气化痰汤组FEV1%和FEV1均显著高于西药组,MD值分别为3.46(95%CI:1.60~5.31)和0.28(95%CI:0.07~0.50),而两组间PaO_2和PaCO_2均无显著差异。结论:清气化痰汤结合西药治疗可以促进痰热壅肺型AECOPD患者肺功能的改善。因纳入的研究质量不高,尚需设计良好、规模较大的多中心随机对照试验以进一步证实。

Objective：To make a systematic review of the effect of Qingqi Huatan Decoction on pulmonary function （FEV1% and FEV1 ） and arterial oxygen partial pressure （PaO2 ） in acute exacerbation of chronic obstructive pulmonary disease （AECOPD） with Phlegm Heat obstructed in Lung Symptom. Methods ： The research literature on randomized controlled studies of the clinical ef- ficacy of Qingqi Huatan Decoction combined with western medicine therapy （ Qingqi Huatan group） and western medicine alone （western medicine group） in treatment of Phlegm Heat obstructed in Lung syndrome （AECOPD） was searched, evaluated and an- alyzed. Jadad scale and RevMan 5.2 software were applied to evaluate and analyze the risk bias, the forced expiratory volume in first second （FEV1）, FEV1% and PaOz in the literature. Results：Seven studies with 740 patients were included. Meta-analysis showed that the FEV1% and FEV1 of Qingqi Huatan Decoction group were significantly higher than those of western medicine group and the MD values are 3.46 （95 % CI： 1.60 to 5.31 ） and 0.28 （95 % CI： 0.07 to 0. 50） respectively, but the differencesof PaO2 and PaCO2 between the two groups were not significant. Conclusion ： Qingqi Huatan Decoction can promote the pulmonary function of AECOPD patients with Phlegm Heat obstructed in Lung Symptom. More well-designed, large-scale and multi-center RCTs are needed in the future.