Gao Zhen, Jing Jing, Liu Yingying
Department of Integrative Medicine, Huashan Hospital, Fudan University, Shanghai.
Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University & National Clinical Research Base of Traditional Chinese Medicine, Urumqi, China.
Medicine (Baltimore). 2020 Apr;99(14):e19571. doi: 10.1097/MD.0000000000019571.
A traditional Chinese medicine classic herbal formula named Xiaoqinglong decoction (XQLD) is widely used in China for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The efficacy and safety of XQLD for AECOPD was evaluated in this systematic review.
Five databases, including the Cochrane Library, PubMed, China National Knowledge Infrastructure, Wanfang database, and Chinese Science and Technology Periodical Database were searched up to October 5, 2018 for randomized control trials in treating AECOPD with XQLD.
Thirty-eight trials were identified. Compared with conventional therapy (CT), XQLD plus CT significantly improve the total clinical efficacy rate (Risk Ratio [RR] = 1.22, 95% confidence interval [CI] = 1.18-1.26, P < .00001). Forced expiratory volume in the first second (FEV1) (mean difference [MD] = 0.37, 95% CI = 0.27-0.46; P < .00001), FEV1%pre (MD = 4.52, 95% CI = 2.42-6.62; P < .00001), FEV1/forced vital capacity (MD = 5.11, 95% CI = 4.21-6.00; P < .00001), PaO2 (MD = 7.17, 95% CI = 4.80-9.54; P < .00001); lowered cough symptom score (MD = -0.65; 95% CI = -0.70 to -0.59; P < .00001), sputum symptom score (MD = -0.41; 95% CI = -0.45 to -0.37; P < .00001), wheezing symptom score (MD = -0.49; 95% CI = -0.60 to -0.38; P < .00001); reduce cough relief time (MD = -1.28; 95% CI = -1.53 to -1.02; P < .00001), sputum relief time (MD = -1.19; 95% CI = -1.42 to -0.96; P < .00001), wheezing relief time (MD = -1.65; 95% CI = -2.63 to -0.68; P = .0009), lassitude relief time (MD = -2.16; 95% CI = -3.44 to -0.89; P = .0009), and PaCO2 (MD = -7.63, 95% CI = -9.62 to -5.63; P < .00001). Benefit for interleukin (IL)-4 (MD = -9.20, 95% CI = -13.59 to -4.81; P < .00001), IL-6 (MD = -5.07, 95% CI = -8.14 to -2.01; P = .001), IL-8 (MD = -5.59, 95% CI = -6.09 to -5.08; P < .00001), tumor necrosis factor (TNF)-α (MD = -5.93, 95% CI = -6.97 to -4.89; P < .00001), Interferon (INF)-γ (MD = 18.03, 95% CI = 13.22-22.84; P < .00001), and C-reactive protein (MD = -3.93, 95% CI = -5.97 to -1.89; P = .0002). For adverse events, there were no difference between XILD plus CT and CT.
XQLD plus CT was more effective than CT alone for treating chronic obstructive pulmonary disease. Further higher quality trials are needed. The safety of XQLD remained uncertain.
一种名为小青龙汤（XQLD）的传统中药经典方剂在中国被广泛用于慢性阻塞性肺疾病急性加重期（AECOPD）的治疗。本系统评价对XQLD治疗AECOPD的疗效和安全性进行了评估。
检索了包括Cochrane图书馆、PubMed、中国知网、万方数据库和中国科技期刊数据库在内的五个数据库，检索截至2018年10月5日的关于用XQLD治疗AECOPD的随机对照试验。
共纳入38项试验。与传统疗法（CT）相比，XQLD联合CT显著提高了总临床有效率（风险比[RR]=1.22，95%置信区间[CI]=1.18-1.26，P<.00001）。第一秒用力呼气容积（FEV1）（平均差[MD]=0.37，95%CI=0.27-0.46；P<.00001）、FEV1%预计值（MD=4.52，95%CI=2.42-6.62；P<.00001）、FEV1/用力肺活量（MD=5.11，95%CI=4.21-6.00；P<.00001）、动脉血氧分压（PaO2）（MD=7.17，95%CI=4.80-9.54；P<.00001）；降低咳嗽症状评分（MD=-0.65；95%CI=-0.70至-0.59；P<.00001）、咳痰症状评分（MD=-0.41；95%CI=-0.45至-0.37；P<.00001）、喘息症状评分（MD=-0.49；95%CI=-0.60至-0.38；P<.00001）；缩短咳嗽缓解时间（MD=-1.28；95%CI=-1.53至-1.02；P<.00001）、咳痰缓解时间（MD=-1.19；95%CI=-1.42至-0.
