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基于中医理论的黄芪治疗放射性肺损伤的疗效：25 项 RCT 的系统评价和荟萃分析。

Efficacy of astragalus in the treatment of radiation-induced lung injury based on traditional Chinese medicine: A systematic review and meta-analysis of 25 RCTs.

机构信息

Shandong University of Traditional Chinese Medicine, Jinan, China.

Jinan Zhangqiu District Traditional Chinese Medicine Hospital, Jinan, China.

出版信息

Medicine (Baltimore). 2022 Sep 9;101(36):e30478. doi: 10.1097/MD.0000000000030478.

DOI:10.1097/MD.0000000000030478
PMID:36086738
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10980465/
Abstract

BACKGROUND

Astragalus (Hedysarum Multijugum Maxim., Huangqi) is a Chinese herbal medicine, and according to the theory of traditional Chinese medicine (TCM), Chinese medicinal preparations containing astragalus can be used clinically to treat radiation-induced lung injury (RILI). To systematically review the efficacy and safety of Chinese medicinal preparations containing astragalus in the prevention and treatment of RILI by means of meta-analysis.

METHODS

A systematic literature on randomized controlled trials (RCTs) of prescriptions containing astragalus in the treatment of RILI by Pubmed, Embase, Web of Science, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, WANFANG Database. The retrieval time is from the establishment of the database to January 18, 2022. Meta-analysis, heterogeneity test and sensitivity analysis were performed on eligible RCTs using Revman 5.4 software and STATA 17.0 software, and a "funnel plot" was used to analyze potential publication bias.

RESULTS

A total of 25 RCTs were included, including 1762 patients, and the most widely used drugs were heat-clearing and detoxifying, yin-nourishing and qi-nourishing. The prescriptions containing astragalus can significantly reduce the total incidence of RILI (P < .01), improve the total effective rate and cure rate of RILI (P < .01), improve the quality of life of patients, alleviate breathing difficulties and reduce the expression of inflammatory factors (P < .01), and no adverse reactions related to TCM treatment were reported.

CONCLUSION

The traditional Chinese medicinal preparation containing astragalus can effectively alleviate the clinical symptoms of RILI, reduce the toxic side effects, and is safe to use in clinic.

摘要

背景

黄芪（Hedysarum Multijugum Maxim.，黄芪）是一种中草药，根据中医理论，含有黄芪的中药制剂可用于临床治疗放射性肺损伤（RILI）。通过荟萃分析系统评价含有黄芪的中药制剂预防和治疗 RILI 的疗效和安全性。

方法

通过 Pubmed、Embase、Web of Science、Cochrane 图书馆、中国生物医学文献数据库、中国国家知识基础设施、中国科技期刊数据库、万方数据库对含有黄芪的治疗 RILI 的处方进行系统的文献检索。检索时间为从数据库建立到 2022 年 1 月 18 日。使用 Revman 5.4 软件和 STATA 17.0 软件对合格的 RCTs 进行荟萃分析、异质性检验和敏感性分析，并使用“漏斗图”分析潜在的发表偏倚。

结果

共纳入 25 项 RCT，包括 1762 例患者，最常用的药物是清热解毒、滋阴益气。含黄芪的方剂能显著降低 RILI 的总发生率（P<0.01），提高 RILI 的总有效率和治愈率（P<0.01），改善患者的生活质量，缓解呼吸困难，降低炎症因子的表达（P<0.01），且未报告与 TCM 治疗相关的不良反应。

结论

含有黄芪的中药制剂能有效缓解 RILI 的临床症状，降低毒性副作用，在临床上安全使用。

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