中医药治疗咳嗽变异性哮喘随机对照试验的Meta分析

Meta Analysis of Randomized Controlled Trials of Traditional Chinese Medicine in the Treatment of Cough Variant Asthma

目的:本研究旨在评价中医药治疗对咳嗽变异性哮喘(CVA)的效果,并与目前推荐的西医常规治疗方案(吸入性糖皮质激素联合支气管舒张剂)进行比较。方法:检索数据库,按纳入标准选择文献,采用Cochrane系统评价员手册进行偏倚风险评估和Jdada评分,评估中医药治疗CVA的效果,同时与西医常规治疗方案对比。结果:共筛选出21篇随机对照试验研究,Jdada评分2~5分,高质量研究(4~5分)4篇。经过Meta分析提示中医药治疗CVA的总有效率、降低气道敏感性、减少咳嗽的复发等方面的效果均优于常规西药对照组,对于肺功能、外周血EOS、血清总Ig E、ECP、炎症因子指标的改善与常规西药组效果相当。结论:中医药治疗CVA的效果不亚于西医常规治疗方案,但是大部分文献质量不高,所有文献均未提及CVA发展成典型哮喘的比例,以后有必要对中医药治疗CVA进行更严谨设计的、大样本的双盲随机对照试验。

Objective： To evaluate the efficacy of traditional Chinese medicine （ TCM ） in the treatment of cough variant asthma （ CVA ）, and to compare it with the conventional Western Medicine （ Inhaled Cortieosteroid and Bronehodilator ） .Method： A database was selected in the literature.And the risk assessment and Jdada score were assessed using Cochrane system evaluation manual.The efficacy of Chinese medicine was evaluated in the treatment of CVA, compared with the routine treatment of Western medicine.Result： A total of 21 randomized controlled trials, Jdada score 2-5 points, high quality research （4-5 points ） for 4 were selected.The results of Meta analysis showed that the total effective rate of Chinese medicine in treating CVA could reduced the sensitivity of airway and reduced the recurrence of cough better than that of the control group.The improvement of lung function, peripheral blood EOS, serum total IgE, ECP and inflammatory factor index was the same as that of routine western medicine group.Conclusion： The curative effect of Chinese medicine on CVA is no less than that of conventional western medicine, but the quality of most of the literature is not high, all the literature does not mention the proportion of CVA developed into typical asthma.There is a need for a more rigorous, double-blind, randomized controlled trial of CVA in the treatment of traditional Chinese medicine.