痰热清注射液对慢性阻塞性肺疾病急性加重期患者炎性递质影响的Meta分析

Meta-analysis for Impact of Tanreqing Injection on Inflammatory Mediators of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的评价痰热清注射液对慢性阻塞性肺疾病急性加重期(AECOPD)患者炎性递质的影响。方法计算机检索Pub Med、中国知网(CNKI)、维普网(VIP)、万方数据知识服务平台等数据库,筛选关于痰热清注射液对AECOPD患者炎性递质影响的随机对照研究,检索时间为2000年1月—2016年4月;对照组患者给予常规治疗,试验组患者在对照组基础上给予痰热清注射液治疗;采用Rev Man 5.2软件进行Meta分析。结果共纳入13篇文献,均为中文文献,包括1 203例患者,其中对照组598例、试验组605例。Meta分析结果显示,试验组患者临床疗效〔相对危险度(RR)=1.23,95%CI(1.14,1.33),P<0.000 01〕优于对照组,白介素6(IL-6)〔标准均数差(SMD)=-0.64,95%CI(-0.94,-0.34),P<0.000 1〕、白介素8(IL-8)〔SMD=-0.81,95%CI(-0.94,-0.68),P<0.000 01〕、肿瘤坏死因子α(TNF-α)〔SMD=-1.07,95%CI(-1.19,-0.94),P<0.000 01〕和C反应蛋白(CRP)〔SMD=-1.37,95%CI(-1.71,-1.03),P<0.000 01〕水平低于对照组,白介素10(IL-10)〔SMD=1.13,95%CI(0.57,1.68),P<0.000 1〕和转化生长因子β(TGF-β)〔SMD=0.60,95%CI(0.20,1.00),P=0.003〕水平高于对照组。结论现有文献证据表明,痰热清注射液治疗AECOPD的临床疗效确切,可有效降低患者IL-6、IL-8、CRP和TNF-α水平,提高IL-10和TGF-β水平。

Objective To evaluate the impact of tanreqing injection on inflammatory mediators of patients with acute exacerbation of chronic obstructive pulmonary disease（ AECOPD）. Methods Computer was used to search RCTs about impact of tanreqing injection on inflammatory mediators of patients with AECOPD that reported from January 2000 to April 2016 in Pub Med,CNKI,VIP and Wanfang Data,thereinto patients of control group received conventional treatment,while patients of test group received extra tanreqing injection based on conventional treatment. Rev Man 5. 2 software was used to conduct the meta- analysis. Results A total of 13 literatures were involved,including 1,203 patients（ 598 in control group and 605 cases in test group）, all of the literatures were reported in Chinese. Meta- analysis results, the clinical effect of test group was statistically significantly better than that of control group 〔RR = 1. 23,95% CI（ 1. 14,1. 33）,P 〈 0. 000 01〕,IL-6 〔SMD =- 0. 64,95% CI（- 0. 94,- 0. 34）,P 〈 0. 000 1〕,IL-8 〔SMD =- 0. 81,95% CI（- 0. 94,- 0. 68）,P 〈 0. 000 01〕,TNF-α 〔SMD =- 1. 07,95% CI（- 1. 19,- 0. 94）,P 〈 0. 000 01〕 and CRP 〔SMD =- 1. 37,95% CI（- 1. 71,- 1. 03）,P 〈 0. 000 01] of test group were statistically significantly lower than those of control group,while IL-10 [SMD =1. 13,95% CI（ 0. 57,1. 68）,P 〈 0. 000 1] and TGF-β [SMD = 0. 60,95% CI（ 0. 20,1. 00）,P = 0. 003] of test group were statistically significantly higher than those of control group. Conclusion According to existing literatures, tanreqing injection has certain clinical effect in treating AECOPD,can effectively reduce IL-6,IL-8,CRP and TNF-α,increase IL-10 and TGF-β.