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[口服中成药治疗慢性阻塞性肺疾病急性加重的网络荟萃分析]

[Network Meta-analysis of oral Chinese patent medicines in treatment of acute exacerbation of chronic obstructive pulmonary disease].

作者信息

Ding Meng-Yao, Yang Shu-Guang, Yu Ning-Xia, Hong Yun-Zhe, Ye Zi-Chun, Yu Xue-Qing

机构信息

Henan University of Chinese Medicine Zhengzhou 450046, China.

the First Affiliated Hospital of Henan University of Chinese Medicine Zhengzhou 450000, China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2023 Jun;48(12):3373-3385. doi: 10.19540/j.cnki.cjcmm.20230226.501.

Abstract

This study aimed to evaluate the effectiveness and safety of eight oral Chinese patent medicines in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) by network Meta-analysis. Randomized controlled trial(RCT) on the treatment of AECOPD with eight oral Chinese patent medicines was retrieved from databases including CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase, and Cochrane Library from database inception to August 6, 2022. The information was extracted from the included literature and the quality of the included studies was evaluated using the Cochrane risk of bias assessment tool. The data were analyzed using Stata SE 15.1 and ADDIS 1.16.8 software. Finally, 53 RCTs were included, with 5 289 patients involved, including 2 652 patients in the experimental group and 2 637 patients in the control group. Network Meta-analysis showed that Lianhua Qingwen Capsules+conventional western medicine were optimal in improving clinical effective rate, Shufeng Jiedu Capsules+conventional western medicine in improving FEV1/FVC, Qingqi Huatan Pills+conventional western medicine in improving FEV1%pred, Feilike Mixture(Capsules)+conventional western medicine in improving PaO_2, Lianhua Qingwen Capsules+conventional western medicine in reducing PaCO_2, and Qingqi Huatan Pills+conventional western medicine in reducing C-reactive protein(CRP). In terms of safety, most of them were gastrointestinal symptoms, and no serious adverse reactions were reported. When the clinical effective rate was taken as the comprehensive index of efficacy evaluation, Lianhua Qingwen Capsules+conventional western medicine were the most likely to be the best treatment for AECOPD. There are some limitations in the conclusion of this study. It only provides references for clinical medication.

摘要

本研究旨在通过网状Meta分析评价8种口服中成药治疗慢性阻塞性肺疾病急性加重期(AECOPD)的有效性和安全性。从中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science、EMbase和Cochrane图书馆等数据库中检索自建库至2022年8月6日期间关于8种口服中成药治疗AECOPD的随机对照试验(RCT)。从纳入文献中提取信息,并使用Cochrane偏倚风险评估工具对纳入研究的质量进行评价。采用Stata SE 15.1和ADDIS 1.16.8软件进行数据分析。最终纳入53项RCT,涉及5289例患者,其中试验组2652例,对照组2637例。网状Meta分析显示,连花清瘟胶囊+常规西药在提高临床有效率方面最优,疏风解毒胶囊+常规西药在提高FEV1/FVC方面最优,清气化痰丸+常规西药在提高FEV1%pred方面最优,肺力咳合剂(胶囊)+常规西药在提高PaO₂方面最优,连花清瘟胶囊+常规西药在降低PaCO₂方面最优,清气化痰丸+常规西药在降低C反应蛋白(CRP)方面最优。在安全性方面,大多数为胃肠道症状,未报告严重不良反应。以临床有效率作为疗效评价的综合指标时,连花清瘟胶囊+常规西药最有可能是治疗AECOPD的最佳方案。本研究结论存在一定局限性,仅为临床用药提供参考。

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