中药治疗慢性阻塞性肺病TGF-β1、ET的系统综述

Treatment of Chronic Obstructive Pulmonary TGF-β1 and ET by Chinese Medicine:A Systematic review

目的:系统评价中药治疗对慢性阻塞性肺病患者转化生长因子β1(TGF-β1)、内皮素(ET)的临床疗效。方法:检索6个中英文数据库,检索时间截止至2016年4月,对符合的随机对照试验采用Rev Man 5.3软件进行数据分析。结果:中药联合西医常规治疗对照西医常规治疗的Meta分析显示:联合中药组对TGF-β1改善情况优于西医常规治疗组,差异具有统计学意义(MD=-29.69,95%CI[-44.16,-15.21],P<0.000 01,I2=98%,随机效应模型,260例,4项研究);中药干预组对ET水平的改善也较对照组明显,差异有统计学意义(MD=-7.7,95%CI[-10.97,-4.43],P<0.000 01,I2=80%,随机效应模型,304例,5项研究)。结论:本研究提示中药治疗对慢性阻塞性肺病患者炎性反应因子TGF-β1及ET具有一定在改善作用,但由于纳入研究质量偏低,尚不能得出肯定结论,有待于开展多中心、大样本、高质量的随机对照试验进一步加以验证。

Objective：To evaluate the efficacy of Chinese medicine （CM） on TGF-131 and ET of Chronic Obstructive Pulmonary Disease（COPD） systematically. Methods：Six electronic databases, either Chinese or English, were searched for randomized controlled trials （RCTs） published until April 2016. RevMan 5.3 was used to analysis the data of the included RCTs. Results：Com- pared with a conventional therapy used alone, treatment with CM as an additional intervention was more effective on TGF-131 （mean difference （MD） = - 29. 69, 95% confidence interval （CI） = （ - 44. 16, - 15. 21 ）, P 〈 0. 00001, I2 = 98%, random effects model, 260 cases, 4 studies） and so as to that of ET [ MD = - 7. 7, 95 % CI = （ - 10. 97, - 4.43 ）, P 〈 0. 00001, 12 = 80%, random effects model, 304 cases, 5 studies ]. Both of the difference were statistically significant. Conclusion ： CM improved TGF-β1 and ET of COPD. Considering the inherent limitations of the included studies, muhicenter and larger high-quality RCTs should be performed to validate these findings in the future.