Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
J Altern Complement Med. 2010 Dec;16(12):1309-19. doi: 10.1089/acm.2009.0686. Epub 2010 Nov 23.
In China, most patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) are usually treated with Tanreqing injection plus conventional Western medicine. However, the value of its use remains uncertain. The objective of this systematic review is to compare the efficacy of Tanreqing injection plus conventional Western medicine with that of conventional Western medicine alone (therapy A versus therapy B, respectively) in the management of acute exacerbations of COPD.
Literature retrieval was conducted using the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE,(®) EMBASE, Chinese Biomedical Database (CBM), and other electronically available databases from respective inception to August 2009. In addition, manual search of some traditional Chinese journals was performed to identify potential studies. Review authors independently extracted the trial data and assessed the quality of each trial. The following outcomes were evaluated: (1) forced expiratory volume in 1 second as a percentage of the predicted value; (2) arterial partial pressure of oxygen (Po(2)); (3) arterial partial pressure of carbon dioxide (Pco(2)); (4) length of hospital stay; (5) marked efficacy rate; (6) interleukin-8; and (7) adverse events.
Based on the search strategy, 14 trials involving 954 patients were finally included. Our results showed that compared with therapy B, therapy A improved Po(2), clinical efficacy, and lung function, reduced Pco(2), shortened the length of hospital stay, and was thus more therapeutically beneficial. No serious adverse events were reported.
Within the limitations of this systematic review, we can conclude that compared with therapy B, therapy A may provide more benefits for patients with acute exacerbations of COPD. Further large-scale high-quality trials are warranted.
在中国，大多数慢性阻塞性肺疾病（COPD）急性加重期患者通常采用痰热清注射液联合常规西药治疗。然而，其应用价值尚不确定。本系统评价的目的是比较痰热清注射液联合常规西药与单纯常规西药（分别为治疗 A 和治疗 B）治疗 COPD 急性加重的疗效。
检索 Cochrane 对照试验中心注册库（CENTRAL）、MEDLINE、(®) EMBASE、中国生物医学文献数据库（CBM）和其他电子数据库，检索时间截至 2009 年 8 月。另外，还手工检索了一些中文期刊以查找潜在的研究。评价者独立提取试验数据并评价每个试验的质量。评价的结局指标包括：（1）第 1 秒用力呼气容积占预计值的百分比；（2）动脉血氧分压（Po(2)）；（3）动脉血二氧化碳分压（Pco(2)）；（4）住院时间；（5）显效率；（6）白细胞介素-8；（7）不良反应。
根据检索策略，最终纳入 14 项试验共 954 例患者。结果显示，与治疗 B 相比，治疗 A 可改善 PaO(2)、临床疗效和肺功能，降低 Pco(2)，缩短住院时间，更有益于患者。未报告严重不良反应。
受本系统评价的限制，我们可以得出结论，与治疗 B 相比，治疗 A 可能为 COPD 急性加重患者带来更多获益。但仍需要开展更多大规模、高质量的临床试验。
