Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University & National Clinical Research Base of Traditional Chinese Medicine, Ulumuqi 830000, Xinjiang, China.
J Tradit Chin Med. 2013 Feb;33(1):1-8. doi: 10.1016/s0254-6272(13)60092-8.
To evaluate the efficacy of Jianpi therapy in Traditional Chinese Medicine (TCM) for treatment of chronic obstructive pulmonary disease (COPD) in stable phase by performing a systematic review and meta-analysis.
The literatures concerning randomized controlled trials (RCTs) and quasi-RCTs comparing TCM treatment plus Western Medicine (WM) treatment with TCM alone, or TCM treatment vs no treatment, placebo for stable phase of COPD were searched in PubMed (1990-December 2010), in English and using Chinese National Knowledge Infrastructure (CNKI, 1990-December 2010), Chinese Biomedical Database (1990-December 2010), Wangfang Database (1990-December 2010), and Weipu (VIP) Database in Chinese. The quality assessment and data extraction for RCTs were conducted by two reviewers independently. Jadad scale and allocation concealment were used to assess the quality of the included studies, and meta-analyses were conducted with the Collaboration's Revman 5.0 software.
Seventeen RCTs or quasi-RCTs involving 1269 patients were included. The methodological quality was poor in all trials except one trial (Jadad score = 4). In the meta-analysis, TCM-WM treatment was significantly superior to WM treatment in cure rate [OR = 3.82, 95% CI (2.45, 5.95)], and the effective rate between TCM treatment and placebo also had significant difference [OR = 4.31, 95% CI (2.35, 7.91)]. Moreover, pulmonary function of the patients in TCM-WM group and TCM group was significantly improved [forced vital capacity (FVC), P = 0.01, quality of life, P < 0.001].
The experience in TCM-WM treatment of COPD in stable phase was encouraging. The current evidence shows that TCM-WM treatment might be more efficient in effective rate, quality of life, and FVC than WM treatment alone. But for forced expiratory volume in one second (FEV1) and FEV1/FVC, no matter TCM-WM treatment compared with WM treatment alone or TCM treatment compared with placebo, there was no significant difference, with no obvious adverse reactions. Due to the low methodological quality of trials included, more RCTs of high quality in large scale are required.
通过系统评价和荟萃分析评估中医健脾疗法治疗慢性阻塞性肺疾病（COPD）稳定期的疗效。
检索英文文献 PubMed（1990 年 12 月至 2010 年），中文文献中国期刊全文数据库（CNKI，1990 年 12 月至 2010 年）、中国生物医学文献数据库（1990 年 12 月至 2010 年）、万方数据库（1990 年 12 月至 2010 年）、维普（VIP）数据库，收集比较中医治疗加西药（WM）治疗与单纯中医治疗或中医治疗与安慰剂治疗 COPD 稳定期的随机对照试验（RCTs）和准 RCTs。两名评审员独立对 RCT 进行质量评估和数据提取。采用 Jadad 量表和分配隐匿法评价纳入研究的质量，并使用协作 Revman 5.0 软件进行荟萃分析。
纳入 17 项 RCTs 或准 RCTs，共 1269 例患者。除 1 项研究（Jadad 评分=4 分）外，所有试验的方法学质量均较差。荟萃分析显示，中医-WM 治疗在治愈率[比值比（OR）=3.82，95%可信区间（CI）（2.45，5.95）]方面明显优于 WM 治疗，中医治疗与安慰剂治疗的有效率也有显著差异[OR=4.31，95%CI（2.35，7.91）]。此外，中医-WM 组和中医组患者的肺功能[用力肺活量（FVC），P=0.01，生活质量，P<0.001]明显改善。
中医-WM 治疗 COPD 稳定期的经验令人鼓舞。目前的证据表明，与 WM 治疗相比，中医-WM 治疗在有效率、生活质量和 FVC 方面可能更有效。但对于一秒用力呼气容积（FEV1）和 FEV1/FVC，无论是中医-WM 治疗与 WM 治疗相比，还是中医治疗与安慰剂相比，均无显著差异，且无明显不良反应。由于纳入试验的方法学质量较低，需要开展更多高质量、大样本的 RCT。
