Chen Yan, Guo Jeff J, Healy Daniel P, Zhan Siyan
Division of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, OH ( USA ).
Pharmacoepidemiology and Pharmacoeconoomics, Division of Pharmacy Practice and Administrative Sciences, College of Pharmacy, University of Cincinnati Medical Center, Cincinnati, OH ( USA ).
Pharm Pract (Granada). 2007 Jan;5(1):1-9. doi: 10.4321/s1886-36552007000100001.
Data regarding the treatment efficacy of integrative treatment of Traditional Chinese Medicine (TCM) and Western Medicine (WM) in treating patients with (SARS) are conflicting. The effects of integrative TCM/WM treatment have not been fully quantified.
To systematically asses the treatment effects of integrated TCM with WM versus WM alone in patients with SARS, incorporating data from recently published studies.
A meta-analysis was conducted, using published randomized and nonrandomized controlled clinical studies that compared the treatment effects of integrative TCM/WM with WM alone from 2002 to 2006. The outcome measurements included mortality rate, cure rate, resolution of pulmonary infiltrate, use of corticosteroid, and time to defervescence. The effect sizes were presented as risk ratio (RR), rate difference (RD), and weighted mean difference (WMD). The pooled effect sizes were calculated by both fixed-effects and random-effects models.
A total of 1,678 patients with a diagnosis of SARS were identified, including 866 patients from 16 randomized controlled studies and 812 patients from 8 nonrandomized controlled studies. There were no differences detected in mortality rate or cure rate between treatments. Compared with patients receiving WM treatment alone, patients receiving integrative treatment were more likely to have complete or partial resolution of pulmonary infiltrate (RD=0.18, 95%CI; 0.07 to 0.30), lower average daily dosage (mg) of corticosteroid (WMD=-60.27, 95% CI; -70.58 to -49.96), higher CD4+ counts (cells/uL) (WMD=167.96, 95% CI; 109.68 to 226.24), and shorter time to defervescence (days) (WMD= -1.06, 95%CI;-1.60 to -0.53).
The experience of integrative TCM/WM in the treatment of SARS is encouraging. The use of TCM as an adjunctive therapy in the treatment of SARS should be further investigated.
关于中西医结合治疗严重急性呼吸综合征(SARS)患者的疗效数据存在冲突。中西医结合治疗的效果尚未完全量化。
结合近期发表研究的数据,系统评估中西医结合治疗与单纯西医治疗对SARS患者的治疗效果。
进行一项荟萃分析,使用2002年至2006年发表的比较中西医结合治疗与单纯西医治疗效果的随机和非随机对照临床研究。结局指标包括死亡率、治愈率、肺部浸润消散情况、皮质类固醇的使用以及退热时间。效应量以风险比(RR)、率差(RD)和加权均数差(WMD)表示。采用固定效应模型和随机效应模型计算合并效应量。
共纳入1678例确诊为SARS的患者,其中16项随机对照研究中的866例患者和8项非随机对照研究中的812例患者。两种治疗方法在死亡率或治愈率方面未发现差异。与单纯接受西医治疗的患者相比,接受中西医结合治疗的患者肺部浸润更有可能完全或部分消散(RD = 0.18,95%CI:0.07至0.30),皮质类固醇的平均每日剂量(mg)更低(WMD = -60.27,95%CI:-70.58至-49.96),CD4 +细胞计数(细胞/μL)更高(WMD = 167.96,95%CI:109.68至226.24),退热时间(天)更短(WMD = -1.06,95%CI:-1.60至-0.53)。
中西医结合治疗SARS的经验令人鼓舞。应进一步研究将中医作为SARS辅助治疗方法的应用。