温肾中药复方治疗慢性阻塞性肺疾病急性加重期疗效的系统评价

Syst ematic Evaluation of Warming Kidney Yang for Acute Exacerbations of Chronic Obstructive Pulmonary Disease

目的评价温肾中药复方治疗慢性阻塞性肺疾病急性加重期(AECOPD)疗效。方法检索从数据库2000年至2014年4月温肾类中药复方治疗AECOPD的随机对照试验。采用Rev Man软件对纳入研究的方法学质量进行系统分析。结果 11个随机对照试验最终纳入研究,均为中文,质量评分均为C级。极少文献涉及对远期疗效的评价。与对照组比较,温肾中药复方结合西医治疗AECOPD患者的显效率、肺功能、血气分析情况差异有统计学意义(P<0.05)。结论温肾中药复方在短期内可能有助于改善AECOPD患者的临床症状、CO2潴留、增加动脉血气中PO2,但对肺功能短期内改善作用、远期生存质量改善作者用尚不明确,尚需大规模、高质量、随访时间足够的随机对照试验研究提供证据。

Objective: To evaluate the efficacy of compound Traditional Chinese Medicine with warming kidney yang for acute exacerbations of Chronic Obstructive Pulmonary Disease(AECOPD). Methods: Literatures were reviewed from the full text of the CNKI database,Wanfang data base and full-text database of Chinese scientific and technical journals,Chinese Biomedical Literature Database,Core journals of TCM regarding randomized controlled trials of compound TCM with warming kidney yang for AECOPD. All searches ended in 2014. Related literatures were selected and analyzed according to different treatment strategies of the trials. The methodological quality of the trials was assessed by the Jadad scale and evaluation was performed with software Rev Man 4.2.10.Results: Eleven randomized controlled trials meting the inclusion criteria were selected and reviewed. All selected trials were in Chinese with the quality scale of C. Most trials were not assessed with long-term effect. In comparison with the contrast group,there were significant differences in efficiency,lung function and blood gas analysis(P < 0.05). Conclusion: In the short term,warming kidney yang may be beneficial to improve the clinical symptoms in patients with AECOPD,CO2 retention,and increase the oxygen partial pressure in the arterial blood gas,but it may not improve lung function in the short term. The quality of the patients with long-term survival is not clear. The further high quality trials are needed.