Wang Long, Feng Xianrong, Wang Baojia, Yang Yu, Zhang Tianyao, Zhang Xiaobo
School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610072, China.
Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, China.
Evid Based Complement Alternat Med. 2020 Sep 14;2020:8468219. doi: 10.1155/2020/8468219. eCollection 2020.
XQLF (Xiaoqinglong formula) is the most commonly used prescription of traditional Chinese medicine in the treatment of asthma. XQLF combined with western medicine has been used to treat bronchial asthma in more and more cases, and good results have been achieved. Therefore, this meta-analysis aimed to evaluate the adjuvant treatment of traditional Chinese medicine classic herbal formula XQLF with bronchial asthma in acute attack.
The following electronic databases were systematically searched from inception to April 2019: PubMed, EMBASE database, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang, VIP Database for Chinese Technical Periodicals, and China Biology Medicine (CBM). Two reviewers searched these databases and independently evaluated all the eligible articles for inclusion. Stata 14.0 was used for data synthesis and analysis.
A total of 33 RCTs (randomized controlled trials) including 2176 patients were enrolled. All of the patients in these studies were in the acute attack stage of asthma. We conducted subgroup analysis according to the duration of treatment, which was 14 days, 10 days, and 7 days, respectively. The overall results show that adjuvant treatment with XQLF significantly improve CER (clinical efficacy rate) (RR = 1.17; 95% CI, 1.14 to 1.21; < 0.0001) and promote pulmonary function including FEV1 (WMD = 0.35; 95% CI, 0.27 to 0.43; < 0.0001), PEF (SMD = 1.02; 95% CI, 0.49 to 1.55; < 0.0001), and FVC (WMD = 0.51; 95% CI, 0.35 to 0.66; < 0.0001). The adjuvant treatment of XQLF can also reduce serum IgE concentration (SMD = -1.39; 95% CI, 1.92 to -0.85; < 0.0001) and serum EOS concentration at 14 days (WMD = -39.85; 95% CI, -56.20 to -23.49; < 0.0001).
This study finally showed that XQLF has the auxiliary effect of improving the efficiency, promoting the lung function, and reducing the serum IgE in the treatment of acute attack asthma. This trial is registered with CRD42019133549.
小青龙汤（XQLF）是治疗哮喘最常用的中药方剂。小青龙汤联合西药治疗支气管哮喘的病例越来越多，并取得了良好效果。因此，本荟萃分析旨在评估中药经典方剂小青龙汤对支气管哮喘急性发作的辅助治疗作用。
从数据库建立至2019年4月，系统检索了以下电子数据库：PubMed、EMBASE数据库、Cochrane图书馆、中国知网（CNKI）、万方数据库、维普中文科技期刊数据库和中国生物医学文献数据库（CBM）。两名研究者检索这些数据库，并独立评估所有符合纳入标准的文章。使用Stata 14.0进行数据合成与分析。
共纳入33项随机对照试验（RCT），包括2176例患者。这些研究中的所有患者均处于哮喘急性发作期。我们根据治疗持续时间分别为14天、10天和7天进行了亚组分析。总体结果显示，小青龙汤辅助治疗可显著提高临床有效率（RR = 1.17；95%CI，1.14至1.21；P < 0.0001），并改善肺功能，包括第1秒用力呼气容积（WMD = 0.35；95%CI，0.27至0.43；P < 0.0001）、呼气峰流速（SMD = 1.02；95%CI，0.49至1.55；P < 0.0001）和用力肺活量（WMD = 0.51；95%CI，0.35至0.66；P < 0.0001）。小青龙汤辅助治疗还可降低血清IgE浓度（SMD = -1.39；95%CI，-1.92至-0.85；P < 0.0001）以及14天时的血清嗜酸性粒细胞（EOS）浓度（WMD = -39.85；95%CI，-56.20至-23.49；P < 0.0001）。
本研究最终表明，小青龙汤在治疗哮喘急性发作时具有提高疗效、改善肺功能和降低血清IgE的辅助作用。本试验已在国际系统评价注册库（CRD）注册，注册号为CRD42019133549。
