益气活血法治疗AECOPD有效性与安全性的Meta分析

A Meta-analysis of the Efficacy and Safety of Supplementing Qi and Promoting Blood Circulation in the Treatment of AECOPD

目的:系统评价益气活血法治疗慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效和安全性。方法:检索中国学术期刊全文数据库(CNKI)、PubMed等7大中英文数据库,检索时间限定为自建库至2020年8月30日,检出所有益气活血法治疗AECOPD患者的临床随机对照试验(RCT)并按照纳排标准进行筛选。对纳入的文献采用RevMan 5.3软件进行分析和质量评价。结果:共纳入符合纳排标准的RCT研究中文文献19篇,1735例患者,Meta分析结果显示:在常规治疗基础上加用益气活血法可明显提高AECOPD患者的临床有效率[OR=4.31,95%CI(3.10,6.01),P<0.00001];改善血气分析指标PaO_(2)[MD=7.08,95%CI(5.87,8.30),P<0.00001],PaCO_(2)[MD=-5.06,95%CI(-6.33,-5.06),P<0.00001],改善肺功能指标FEV1(L)[MD=0.39,95%CI(0.17,0.61),P=0.0004],FEV1%[MD=5.75,95%CI(1.84,9.67),P=0.004],FEV1/FVC%[MD=4.96,95%CI(3.72,6.21),P<0.00001];减轻炎症指标,CRP[MD=-6.02,95%CI(-6.51,-5.53),P<0.00001],IL-8[MD=-7.51,95%CI(-10.60,-4.43),P<0.00001];与对照组相比,其差异均有统计学意义。结论:益气活血法治疗AECOPD具有一定的优势。但由于所纳入研究存在局限性,质量不高,尚需更多高质量的随机对照研究予以证实。

Objective To systematically evaluate the efficacy and safety of supplementing qi and promoting blood circulation in the treatment of AECOPD.Method Such databases as CNKI,PubMed,VIP,Wan Fang and CBM were electronically searched to collect the randomized controlled trials(RCT)about supplementing qi and promoting blood circulation in the treatment of AECOPD.We retrieved literature from self-built database to Augest 30th,2019 and appraised the quality of the data and used RevMan 5.3 to get the Meta-analysis.Result A total of 19 RCT studies were included,involving 1735 patients.The results of meta-analysis showed that the clinical effective rate of AECOPD patients could be significantly improved by supplementing qi and promoting blood circulation on the basis of routine treatment[OR=4.31,95%CI(3.10,6.01),P<0.00001].PaO_(2)[MD=7.08,95%CI(5.87,8.30),P<0.00001].PaCO_(2)[MD=-5.06,95%CI(-6.33,-5.06),P<0.00001].FEV1(L)[MD=0.39,95%CI(0.17,0.61),P=0.0004].FEV1%[MD=5.75,95%CI(1.84,9.67),P=0.004].FEV1/FVC%[MD=4.96,95%CI(3.72,6.21),P<0.00001].CRP[MD=-6.02,95%CI(-6.51,-5.53),P<0.00001].IL-8[MD=-7.51,95%CI(-10.60,-4.43)P<0.00001].Compared with the control group,the difference was statistically significant.Conclusion The method of supplementing qi and promoting blood circulation has certain advantages in the treatment of AECOPD.However,due to the limitations and low quality of the included studies,more high-quality randomized controlled studies are needed to confirm.