七种补气中药注射剂治疗慢性阻塞性肺疾病急性加重期患者的疗效及安全性比较：一项系统评价与网状Meta分析
Comparative Effectiveness and Safety of Seven Qi-Tonifying Chinese Medicine Injections for AECOPD Patients: A Systematic Review and Network Meta-Analysis.
作者信息
Deng Xueyi, Kang Fuqin, Chen Xueyin, Lai Jiaqi, Guan Xuanchen, Guo Xinfeng, Liu Shaonan
机构信息
The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
The Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China.
出版信息
Evid Based Complement Alternat Med. 2021 Nov 15;2021:6517515. doi: 10.1155/2021/6517515. eCollection 2021.
INTRODUCTION
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) imposes a large burden on economy and society worldwide. In addition to western medicine, multiple kinds of qi-tonifying Chinese medicine injections have been widely used in China as adjunctive treatments. Previous small-sample clinical trials have proven their efficacy in the treatment of AECOPD. However, data on comparative effectiveness and safety of qi-tonifying injections are limited. We conducted this network meta-analysis to compare the efficacy and safety of 7 commonly used qi-tonifying injections in patients with AECOPD.
METHODS
Literature search was conducted through electronic databases, including PubMed, the Cochrane Library, EMBASE, CINAHL, AMED, CBM, CNKI, Wanfang database, and VIP database. Randomized clinical trials (RCTs) exploring the efficacy of any of these 7 qi-tonifying injections were included. The primary outcome was lung function (FEV1 and FVC). R 4.0.0 and STATA 12.0 were adopted to perform the network meta-analysis using Bayesian statistics.
RESULTS
A total of 36 RCTs involving 2657 participants were included. The results of network meta-analyses indicated that Chuankezhi injection (CKZ) combined with routine treatment (RT) was superior to other qi-tonifying injections combined with RT in terms of FEV1 improvement (MD = 0.63, 95% CI: 0.22, 1.04). For improving FVC, Shengmai injection (SGM) combined with RT showed the greatest therapeutic effect (MD = 0.38, 95% CI: 0.13, 0.61). Moreover, SGM combined with RT revealed the best estimates for response rate (MD = 4.00, 95% CI: 1.34, 13.63). The main adverse events in this study were gastrointestinal reactions and injection site reactions. No serious adverse events were reported.
CONCLUSION
In this network meta-analysis, SGM and CKZ were potential best adjunctive therapies in the treatment of AECOPD.
引言
慢性阻塞性肺疾病急性加重（AECOPD）给全球经济和社会带来了沉重负担。除了西医治疗外，多种补气类中药注射剂在中国已被广泛用作辅助治疗。以往的小样本临床试验已证实其在治疗AECOPD方面的疗效。然而，关于补气注射剂的比较有效性和安全性的数据有限。我们进行了这项网状Meta分析，以比较7种常用补气注射剂对AECOPD患者的疗效和安全性。
方法
通过电子数据库进行文献检索，包括PubMed、Cochrane图书馆、EMBASE、CINAHL、AMED、CBM、CNKI、万方数据库和维普数据库。纳入探索这7种补气注射剂中任何一种疗效的随机临床试验（RCT）。主要结局指标为肺功能（FEV1和FVC）。采用R 4.0.0和STATA 12.0软件，使用贝叶斯统计进行网状Meta分析。
结果
共纳入36项RCT，涉及2657名参与者。网状Meta分析结果表明，在改善FEV1方面，喘可治注射液（CKZ）联合常规治疗（RT）优于其他补气注射剂联合RT（MD = 0.63，95%CI：0.22，1.04）。在改善FVC方面，参麦注射液（SGM）联合RT显示出最大的治疗效果（MD = 0.38，95%CI：0.13，0.61）。此外，SGM联合RT在缓解率方面显示出最佳估计值（MD = 4.00，95%CI：1.34，13.63）。本研究中的主要不良事件为胃肠道反应和注射部位反应。未报告严重不良事件。
结论
在这项网状Meta分析中，SGM和CKZ是治疗AECOPD潜在的最佳辅助疗法。
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