三伏贴治疗哮喘随机对照临床研究文献Meta分析

Meta-analysis on Randomized Controlled Clinical Trials of Dog Days Plaster for Asthma

目的:通过Meta分析评价三伏贴治疗哮喘的临床疗效。方法:计算机检索中国知网、维普全文数据库、万方数据库、Cochrane Library、PubMed、Web of Science,时间为建库至2017年8月18日,检索所有有关三伏贴治疗哮喘的临床随机对照试验,采用Review Manager 5.3进行Meta分析。结果:最终纳入11篇文献,Meta分析显示三伏贴治疗哮喘治疗组与对照组比较,总有效率[OR=3.27,95%CI(2.19,4.87),Z=5.82,P<0.00001],最大呼气流量(PEF)[OR=0.28,95%CI(0.08,0.47),Z=2.81,P=0.005<0.05],第一秒用力呼气容量比用力肺活量(FEV1/FVC)[OR=7.28,95%CI(5.97,8.60),Z=10.87,P<0.00001],三者组间比较差异有统计学意义;第一秒用力呼气容量(FEV1)[OR=-0.05,95%CI(-0.21,0.21),Z=0.01,P=0.99>0.05],组间比较差异无统计学意义。结论:三伏贴治疗哮喘有效且优于其他诸如西药、针刺等疗法,可改善PEF、FEV1/FVC,但对FEV1无明显影响。由于纳入的文献数量较少,缺乏高质量临床RCT研究,文献可能存在发表偏倚,故上述结论有待进一步考证。

Objective： To evaluate the clinical efficacy of dog days plaster in the treatment of asthma by meta-analysis. Methods： Computer was used to retrieval China national knowledge internet（CNKI）, VIP database（VIP）, Wanfang database（WF）, Cochrane Library, PubMed and Web of Science. Setting the search time was up to August 18, 2017. All randomized controlled trials of dog days plaster in the treatment of bronchial asthma was retrieved. Meta-analysis was performed using Review Manager 5.3. Results： A total of 11 articles were included. It was founded by meta analysis that treatment group compared with the control group：the total efficiency [OR=3.27,95% CI（2.19,4.87）,Z=5.82,P〈0.00001],maximum expiratory flow（PEF） [OR=0.28,95% CI（0.08,0.47）,Z=2.81,P=0.005〈0.05],the first second forced expiratory volume ratio the forced vital capacity（FEV1/FVC） [OR=7.28,95% CI（9.41,13.93）,Z=10.87,P〈0.00001] had statistically significant difference between the two groups. The first second forced expiratory volume（FEV1） [OR=-0.05,95% CI（-0.21,0.21）,Z=0.01,P=0.99〉0.05]had no statistically difference between the two groups. Conclusion： Dog days plaster is effective in treating asthma and is superior to other therapies, such as western medicine and acupuncture. Which can improve PEF, FEV1/FVC, but has no obvious effect on FEV1. Due to the small number of literature and the lack of high quality clinical RCT, and the literature may be exist published bias, so the conclusion should to be further researched.