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宣白承气汤联合西药治疗痰热壅肺型重症肺炎疗效的 Meta 分析。

Xuanbai Chengqi decoction plus Western Medicine in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung: a Meta-analysis.

机构信息

Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine, Nanjing 210001, China.

Xinglong Community Health Centre, Nanjing 210019, China.

出版信息

J Tradit Chin Med. 2021 Feb;41(1):17-25. doi: 10.19852/j.cnki.jtcm.2021.01.003.

DOI:10.19852/j.cnki.jtcm.2021.01.003
PMID:33522193
Abstract

OBJECTIVE

To evaluate the effectiveness and safety of Xuanbai Chengqi decoction (, XBCQD) plus Western Medicine (WM) in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.

METHODS

Randomized controlled trials (RCTs) investigating the effect of XBCQD on severe pneumonia with symptom pattern of phlegm-heat obstructing lung, were included in this study. Seven electronic databases were searched up to March 2019. Meta-analysis was conducted by Review Manager 5.3 software. Risk ratio (RR) and mean difference (MD) with 95% confidence interval (CI) were used as effect estimation.

RESULTS

Eleven RCTs were included, involving 992 participants. Meta-analysis showed that XBCQD combined with WM achieved better effectiveness than WM alone in terms of total effective rate [RR = 1.23, 95%CI (1.16, 1.30)], clinical pulmonary infection score [CPIS, MD = -2.02, 95%CI (-2.42, -1.63)], acute physiology and chronic health evaluation Ⅱ [APACHEⅡ, MD = -6.81, 95% CI (-8.26, 5.37)], mechanical ventilation time [MD = -101.41, 95%CI (-140.47, -62.34)], and lactic acid content in arterial blood [MD = -2.41, 95%CI (-2.64, -2.18)].

CONCLUSION

XBCQD combined with WM had better benefit than WM alone to the patients of severe pneumonia with the symptom pattern of phlegm-heat obstructing lung. However, due to low quality of the included studies, more rigorously designed studies were required to further evaluate the effectiveness and safety of XBCQD in the treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.

摘要

目的

评价宣白承气汤联合西药治疗痰热壅肺证重症肺炎的有效性和安全性。

方法

计算机检索中国知网、维普、万方、PubMed、EMbase、Cochrane 图书馆、中国生物医学文献数据库,搜集宣白承气汤联合西药治疗痰热壅肺证重症肺炎的随机对照试验(RCT),检索时限均为建库至 2019 年 3 月。由 2 位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用 RevMan 5.3 软件进行 Meta 分析。

结果

共纳入 11 项 RCT,包含 992 例患者。Meta 分析结果显示,与单纯西药治疗相比,宣白承气汤联合西药治疗可提高临床总有效率[RR=1.23,95%CI(1.16,1.30)],降低临床肺部感染评分[CPIS,MD=-2.02,95%CI(-2.42,-1.63)]、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)[MD=-6.81,95%CI(-8.26,5.37)]、机械通气时间[MD=-101.41,95%CI(-140.47,-62.34)],降低动脉血乳酸水平[MD=-2.41,95%CI(-2.64,-2.18)]。

结论

与单纯西药治疗相比,宣白承气汤联合西药治疗可提高痰热壅肺证重症肺炎患者的临床疗效,降低 CPIS、APACHEⅡ评分,缩短机械通气时间,降低动脉血乳酸水平,但由于纳入研究的质量均较低,仍需要更多设计严谨的研究进一步评价宣白承气汤治疗痰热壅肺证重症肺炎的有效性和安全性。

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