百合固金汤加减治疗肺结核及改善肺部病灶情况的系统评价

A Systematic Review of Supplemented Baihe Gujin Decoction (百合固金汤) in the Treatment of Pulmonary Tuberculosis and Improvement of the Pulmonary Lesions

目的:系统评价百合固金汤治疗肺结核的临床疗效及对肺部病灶的影响。方法:检索中国期刊全文数据库(CNKI)、万方(Wanfang),维普数据库(VIP))和中国生物医学文摘数据库(CBM),收集百合固金汤联合西药治疗肺结核的随机或半随机对照试验(RCTs or CCTs),采用Cochrane风险偏倚评估工具对所纳入文献进行偏倚风险评估,并对临床总有效率、病灶吸收率、痰菌转阴率、空洞闭合有效率进行Meta分析。结果:纳入28篇文献,共2,844例患者,Meta分析结果显示,治疗组临床总有效率[RR=1.28,95%CI(1.23,1.33)],病灶吸收率[RR=1.28,95%CI(1.20,1.36)],痰菌转阴率[RR=1.21,95%CI(1.12,1.30)],空洞闭合率[RR=1.23,95%CI(1.10,1.37)]均优于对照组,且不良反应少。结论:百合固金汤联合西药治疗肺结核可提高临床疗效和改善肺部病灶情况,由于纳入文献研究方法学和报告质量较低,样本量少,仍需要严格、多中心、大样本的随机双盲对照试验加以验证。

Objective： To systematically evaluate the efficacy of supplemented Baihe Gujin decoction in the treatment of pulmonary tuberculosis and improvement of the pulmonary lesions. Methods： Such databases as CN- K1, VIP, CBM and Wanfang were searched for collecting randomized controlled trials （RCTs） or quasi-RCTs of supplemented Baihe Gujin decoction combined with western medicine treating for pulmonary tuberculosis. Cochrane risk assessment table was used for bias risk assessment of the test and the clinical comprehensive ef- ficacy, focal absorption rate, sputum negative rate and closure rate were given Meta-analysis. Results： Twenty- eight articles involving with 2,844 patients were included. The results of meta-analysis showed that treatment group was superior to the control group in improving clinical comprehensive efficacy [RR =1.28, 95% CI （1.23,1.33）], focal absorption rate [RR=1.28,95%CI（1.20,1.36）1, sputum negative rate [RR=1.21,95%CI（1.12,1.30）1 and closure rate [RR=1.23, 95%CI（1.10,1.37）], while fewer adverse reaction was found in the treatment group. Conclusion： Supplemented Baihe Gujin decoction combined with western medicine has high clinical efficacy as well as less adverse reaction than the western medicine alone in the treatment of Puhnonary Tuberculosis. How- ever due to the low quality in methodology and reports as well as small sample size of included RCTs in this study, more randomized double-blind trials with a large sample size are still required to verify the result.