二陈汤联合西药治疗支气管哮喘随机对照试验的Meta分析

Meta-analysis on the Randomized Controlled Trials in Treating Bronchial Asthma with Erchen Decoction Combined with Western Medicine

目的系统评价二陈汤联合西药治疗支气管哮喘的疗效和不良反应,为临床使用二陈汤治疗支气管哮喘提供循证医学支持。方法计算机检索中国知网、万方数据知识服务平台、维普中文科技期刊数据库、中国生物医学文献数据库、Embase、PubMed、Cochrane Library数据库,提取符合纳入标准的二陈汤治疗哮喘的随机对照试验(RCT),用Cochrane5.1.0手册的偏倚风险评估工具进行纳入文献的质量评价,使用Stata15.0软件进行Meta分析。结果共计12篇RCT文献符合纳入标准,Meta分析结果表明,二陈汤联合西药治疗支气管哮喘能提高疗效[OR=4.13,95%CI(2.83,6.58),P=0.00],降低中医咳嗽证候积分[SMD=-2.16,95%CI(-3.17,-1.15),P=0.00],提高ACT评分水平[SMD=2.66,95%CI(0.77,4.55),P=0.006],提高FEV1水平[SMD=1.38,95%CI(0.58,2.18),P=0.001],提高PEF水平[SMD=0.75,95%CI(0.26,1.24),P=0.003],提高FEV1%水平[SMD=0.85,95%CI(0.56,1.14),P=0.000]。所有纳入RCT均未报告有严重的不良反应。结论现有研究表明二陈汤在提高哮喘患者治疗效果、改善肺功能、降低咳嗽证候积分中有一定作用。

Objective:To systematically evaluate the efficacy and adverse reactions of Erchen Decoction combined with Western medicine in the treatment of bronchial asthma,and to provide evidence-based medical support for the clinical use of Erchen Decoction in the treatment of bronchial asthma.Methods:Computer was used to retrieve the Chinese National Knowledge Infrastructure(CNKI),Wanfang Databases,VIP,CBM,PubMed,Cochrane Library.The randomized controlled trials(RCTs)of Erchen Decoction for asthma treatment that met the inclusion criteria were extracted.Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of included literatures,and Stata14.0 was used for meta-analysis.Results:A total of 12 RCT studies were included.Meta-analysis showed that Erchen Decoction combined with western medicine could improve the curative effect of bronchial asthma[OR=4.13,95%CI(2.83,6.58),P=0.00],decrease the cough scores[SMD=-2.16,95%CI(-3.17,-1.15),P=0.00],improve the levels of ACT[SMD=2.66,95%CI(0.77,4.55),P=0.006],the levels of FEV1[SMD=1.38,95%CI(0.58,2.18),P=0.001],the levels of PEF[SMD=0.75,95%CI(0.26,1.24),P=0.003],and the levels of FEV1%[SMD=0.85,95%CI(0.56,1.14),P=0.000].Serious adverse reactions were not reported in all include studies.Conclusion:Existing studies have shown that Erchen Decoction is effective in improving the therapeutic effect of asthma,improving lung function,and reducing the scores of cough.