培土生金法联合西药治疗支气管扩张症患者的临床疗效和安全性的系统评价

Clinical Efficacy and Safety of Reinforcing Earth to Generate Metal Combined with Western Medicine in the Treatment of Bronchiectasis:A Systematic Analysis

目的系统评价培土生金法联合西药治疗支气管扩张症临床疗效。方法通过检索中国知网、万方数据库、维普、中国生物医学文献数据库、Web of Science、PubMed、Embase和Cochrane Library等中外数据库,依据纳入排除标准,检索相关培土生金法联合西药治疗支气管扩张症患者随机对照试验,检索时间自建库至2022年10月15日。通过Review Manager 5.3软件对文献数据进行Meta分析。结果共纳入15篇文献,包括1381例患者。Meta分析结果显示,培土生金法联合西药治疗组患者总有效率高于单纯用西药对照组(RR=1.19,P<0.00001);用力肺活量(FVC)(MD=0.43,95%CI=0.33~0.52,P<0.00001)及第1秒用力呼气容积(FEV1)(MD=0.49,95%CI=0.16~0.82,P=0.003)结局指标改善程度优于对照组;咳嗽(MD=-0.48,95%CI=-0.67~-0.29,P<0.00001)、咳痰(MD=-0.54,95%CI=-0.77~-0.31,P<0.00001)和乏力(MD=-0.31,95%CI=-0.47~-0.15,P=0.0002)症状缓解情况优于对照组,描述性分析治疗组不良反应发生率低于对照组(P<0.05),差异均具有统计学意义。但在改善一氧化碳弥散量占预计值百分比(DLCO%)程度方面较对照组,差异无统计学意义(P>0.05)。结论培土生金法联合西药治疗可明显提高支气管扩张症患者的疗效,改善肺功能及缓解临床症状。但本研究纳入文献量少,部分文献质量偏低,仍需高质量临床研究予以证实。

Objective To evaluate the clinical efficacy of reinforcing earth to generate metal combined with west⁃ern medicine in the treatment of bronchiectasis by systematic analysis.Methods CNKI,Wanfang Data,VIP,China Bio⁃medical Literature Database,Web of Science,PubMed,Embase,Cochrane Library and other Chinese and foreign databases were searched for randomized controlled trials of treating bronchiectasis patients with reinforcing earth to generate metal combined with western medicine according to the inclusion and exclusion criteria.The retrieval time was from the establish⁃ment of the database to October 15,2022.Meta analysis of the literature data was conducted through Review Manager 5.3.Results A total of 15 articles were included,including 1381 patients.Meta analysis showed that the total efficacy of pa⁃tients in the treatment group with reinforcing earth to generate metal combined with western medicine was higher than that in the control group with western medicine alone(RR=1.19,P<0.00001),and the improvement in the forced vital ca⁃pacity(MD=0.43,95%CI=0.33~0.52,P<0.00001)and the forced expiratory volume in one second(MD=0.49,95%CI=0.16~0.82,P=0.003)was better than that in the control group.The remission of cough(MD=-0.48,95%CI=-0.67~-0.29,P<0.00001),expectoration(MD=-0.54,95%CI=-0.77~-0.31,P<0.00001)and fa⁃tigue(MD=-0.31,95%CI=-0.47~-0.15,P=0.0002)in the treatment was superior to the conditions in the con⁃trol group.Descriptive analysis demonstrated that the incidence of adverse reactions in the treatment group was lower than that in the control group(P<0.05).However,there was no significant difference in improving the percent predicted diffu⁃sing capacity of the lung for carbon monoxide(DLCO%)between the two groups.Conclusion Reinforcing earth to gener⁃ate metal combined with western medicine can significantly enhance the curative effect of patients with bronchiectasis,im⁃prove pulmonary function and relieve clinical symptoms.However,due to the small amount of literature included in this study and low quality of some literature,high-quality clinical studies are needed for confirmation.