热敏灸治疗慢性阻塞性肺疾病的荟萃分析

Meta analysis of heat-sensitive moxibustion in the treatment of chronic obstructive pulmonary disease

目的:运用循证医学系统评价方法评价热敏灸治疗慢性阻塞性肺疾病(COPD)的疗效与安全性,为临床实践和研究提供参考。方法:计算机检索考克兰图书馆(Cochrane Library)、PubMed医学文献检索服务系统、中国知网(CNKI)、维普资讯网(VIP)、万方数据知识服务平台,全面搜集热敏灸治疗COPD的随机对照试验(RCT),检索时限均从建库至2019年12月。提取文献数据后采用Revman5.3软件进行荟萃分析。结果:最终纳入8篇RCT,636例患者。荟萃分析结果显示治疗组中医临床总有效率均高于对照组,95%CI(2.27,13.28),且z=3.77,P=0.002,具有统计学意义。治疗组肺功能指标第1秒用力呼吸容积(FEV1)比用力肺活量(FVC)和血氧分压(PaO2)与对照组相比具有统计学意义(P均<0.01)。且未见热敏灸治疗COPD的不良反应报告。结论:热敏灸可有效缓解患者临床症状,提高生活质量。但因纳入文献普遍质量较低,其疗效优势尚需进一步研究,特别需要高质量、多中心、大样本的RCT来验证。

Objective:To evaluate the efficacy and safety of heat-sensitive moxibustion in the treatment of chronic obstructive pulmonary disease(COPD)by using an evidence-based medical systematic evaluation method,and to provide a reference for clinical practice and research.Methods:A computer search of the Cochrane Library,PubMed Medical Literature Retrieval Service System,China Knowledge Network(CNKI),VIP Information Network(VIP),and Wanfang Data Knowledge Service Platform was used to comprehensively collect randomization of heat-sensitive moxibustion for COPD in the randomized controlled trial(RCT),the search period was from the establishment of the database to December 2019.After extracting literature data,Revman 5.3 software was used for Meta analysis.Results:Eight randomized controlled trials were finally included,involving a total of 636 patients.The results of the meta-analysis showed that the total clinical effective rate of TCM in the treatment group was higher than that in the control group,with 95%CI(2.27,13.28),z=3.77,P=0.002,which was statistically significant.The two indicators of FEV1/FVC,and PaO2 in the treatment group were statistically significant compared with those in the control group.And there were no reports of adverse reactions of heat-sensitive moxibustion in the treatment of COPD.Conclusion:Heat-sensitive moxibustion can effectively relieve the clinical symptoms of patients and improve the quality of life.However,due to the generally low quality of the included literature,further research is needed for its efficacy advantages,especially high-quality,multi-center,large-sample RCTs are needed to verify.