养阴清肺汤治疗慢性咳嗽和慢性阻塞性肺疾病疗效和安全性的Meta分析

Efficacy and safety of Yangyinqingfei decoction in the treatment of chronic cough and chronic obstructive pulmonary disease: a meta-analysis

目的系统评价养阴清肺汤治疗慢性咳嗽和慢性阻塞性肺疾病的有效性和安全性。方法计算机检索Pub Med、Web of Science、CBM、CNKI、VIP和Wan Fang Data数据库,搜集养阴清肺汤治疗慢性咳嗽和慢性阻塞性肺疾病的随机对照试验(RCT),检索时限均为建库至2016年8月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入24个RCT,包括2 268例患者。Meta分析结果显示:与对照组相比,养阴清肺汤联合常规治疗能提高治疗慢性阻塞性肺疾病的临床疗效[RR=1.21,95%CI(1.16,1.27),P<0.000 01]和改善患者肺功能[SMD=0.76,95%CI(0.59,0.94),P<0.000 01]。养阴清肺汤及养阴清肺口服液联合常规治疗在治疗成人慢性咳嗽方面的临床疗效也优于对照组[RR=1.41,95%CI(1.22,1.64),P<0.000 01]。在安全性方面,养阴清肺汤组出现不良反应7例,对照组出现13例,两组不良反应类型和程度基本一致。结论养阴清肺汤联合常规治疗能提高慢性咳嗽和慢性阻塞性肺疾病临床疗效,其安全性也尚可。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量研究予以证实。

Objective To systematically review the efficacy and safety of Yangyinqingfei decoction for chronic cough and chronic obstructive pulmonary disease （COPD） patients. Methods We electronically searched databases including PubMed, Web of Science, CBM, CNKI, VIP and WanFang Data for randomized controlled trials （RCTs） of Yangyinqingfei decoction for chronic cough and COPD patients from inception to August 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.3 software was used for meta-analysis. Results Twenty-four RCTs involving 2 268 patients with COPD and chronic cough were included. The results of meta-analysis showed that compared with the control group, Yangyinqingfei decoction combined with the conventional medicine could significantly improve clinical effective rate （RR= 1.21, 95%CI 1.16 to 1.27, P〈O.O00 01） and lung function （SMD=0.76, 95%CI 0.59 to 0.94, P〈0.000 01） in patients with COPD. Yangyinqingfei decoction combined with the conventional medicine group was superior to the control group （RR=I.41, 95%CI 1.22 to 1.64, P〈0.000 01） in clinical efficacy for adults patients with chronic cough. In terms of safety, seven cases occurred adverse reactions in the Yangyinqingfei decoction group, while 13 were found in the control group, the types and degree of adverse reactions in both groups were almost the same. Conclusion The combination of Yangyinqingfei plus conventional medicine may significantly improve the clinical efficacy for chronic cough and COPD with reliable safety. However, due to the limited quality and quantity of included studies, the above conclusions are needed to verify by more high quality studies.