Gao Zhen, Liu Yingying, Xu Yizhe, Dong Jingcheng
Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
National Clinical Research Base of Traditional Chinese Medicine, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi 830000, China.
J Tradit Chin Med. 2020 Apr;40(2):188-196.
To evaluate the efficacy and safety of tonifying kidney therapy (Bushen, TK) for stable chronic obstructive pulmonary disease (COPD).
Randomized controlled trials (RCTs) of TK use for treatment of stable COPD were searched in four databases including PubMed, the Cochrane Library, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure Database from inception to December 2017. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. RevMan 5.3 software was used for the Meta-analysis.
Eight RCTs involving 809 patients with stable COPD were included. Compared with the conventional Western Medicine (CWM) group, the TK group (TK combined with CWM) showed significant improvements in the effectiveness rates (RR = 1.37, 95% CI 1.22 to 1.53, P < 0.000 01) and 6-min walk distance in meters (MD 11.92, 95% CI 3.52 to 20.32, P = 0.005), this study also showed that the TK group can decrease The Traditional Chinese Medicine Syndrome Score (MD -8.01, 95% CI －12.89 to －3.13, P = 0.001). The lung function [forced expiratory volume in one second% (FEV1%), FEV1/forced vital capacity] showed no difference between the TK and control groups.
For patients with stable COPD, TK can improve the clinical effectiveness and exercise capacity but fail to improve the patient's symptoms. Because of the low methodological quality of the included trials, additional high-quality and large-scale RCTs are required.
评估补肾疗法（补肾，TK）治疗稳定期慢性阻塞性肺疾病（COPD）的疗效和安全性。
检索PubMed、Cochrane图书馆、中国生物医学文献数据库和中国知网数据库中从建库至2017年12月使用补肾疗法治疗稳定期COPD的随机对照试验（RCT）。两名研究者独立筛选文献、提取数据并评估纳入研究的偏倚风险。采用RevMan 5.3软件进行Meta分析。
纳入8项RCT，共809例稳定期COPD患者。与单纯西医（CWM）组相比，补肾组（补肾联合CWM）的有效率（RR = 1.37，95%CI 1.22至1.53，P < 0.000 01）和6分钟步行距离（MD 11.92，95%CI 3.52至20.32，P = 0.005）显著改善，本研究还表明补肾组可降低中医证候积分（MD -8.01，95%CI -12.89至-3.13，P = 0.001）。补肾组与对照组的肺功能[一秒用力呼气容积百分比（FEV1%）、FEV1/用力肺活量]无差异。
对于稳定期COPD患者，补肾疗法可提高临床疗效和运动能力，但不能改善患者症状。由于纳入试验的方法学质量较低，需要更多高质量、大规模的RCT。
