中成药治疗慢性阻塞性肺疾病稳定期肺肾两虚型临床疗效的Meta分析

Meta-analysis of the clinical efficacy of Chinese patent medicine on chronic obstructive pulmonary disease with lung and kidney deficiency type

目的:系统评价中成药治疗肺肾两虚型稳定期慢性阻塞性肺疾病的临床疗效。方法:计算机检索万方、知网、维普、Cochrane Library、PubMed、EMbase等数据库,查找中成药+常规治疗与常规治疗或安慰剂+常规治疗肺肾两虚型稳定期慢性阻塞性肺疾病患者随机对照试验,检索时间为建库至2020年7月1日。严格按照纳入与排除标准筛选文献、提取资料并进行质量评价后,通过Review Manager 5.3软件进行Meta分析。结果:最终共纳入25项研究,1 833例慢性阻塞性肺疾病病例,均为前瞻性随机对照试验。Meta分析结果显示,应用中成药联合西医疗法治疗肺肾两虚型稳定期慢性阻塞性肺疾病,临床总有效率高于单独西医疗法,在肺功能、6分钟步行距离、中医症状积分、慢性阻塞性肺疾病自我评估、圣乔治呼吸问卷调查表、免疫等指标的改善上优于单独西医疗法,且能减少慢性阻塞性肺疾病急性加重发作,安全性好。结论:当前证据显示,应用中成药联合西医疗法治疗肺肾两虚型稳定期慢性阻塞性肺疾病临床疗效优于单独西医疗法,但本研究存在一定局限性,仍需高质量临床研究加以佐证。

Objective:To systematically evaluate the clinical efficacy of Chinese patent medicine on of stable chronic obstructive pulmonary disease with deficiency of both lung and kidney.Methods:Wanfang,CNKI,VIP,the Cochrane library,PubMed,EMbase and other databases were searched for randomized controlled trials of Chinese patent medicine plus routine treatment of stable COPD patients with deficiency of both lung and kidney.The search time was from July 1,2020 to July 1,2020.The literatures were selected strictly according to the inclusion and exclusion criteria,the data were extracted and the quality was evaluated,and the Meta analysis was carried out by Review Manager 5.3 software.Results:A total of 25 studies were included,including 1 833 COPD cases,all of which were prospective randomized controlled trials.The results of Meta analysis showed that the total effective rate of Chinese patent medicine plus western medicine on of stable COPD,with deficiency of both lung and kidney was higher than that of western medicine alone,and superior to western medicine alone in the improvement of lung function,6-minute walking distance,score of TCM symptoms,chronic obstructive pulmonary disease self-assessment,St.George respiratory questionnaireand immunity.And it can reduce the acute exacerbation of COPD and has good safety.Conclusion:The current evidence shows that the clinical efficacy of Chinese patent medicine plus western medicine on stable COPD of deficiency of both lung and kidney is better than that of Western medicine alone,but this study has some limitations and still needs high-quality clinical research to support it.