目的:系统评价十味龙胆花方剂治疗慢性阻塞性肺疾病的有效性与安全性.方法:检索中国知网、万方数据库、维普网、中国生物医学文献数据库、Web of Science、PubMed、EMbase和Cochrane Library,检索时间为建库至2023年6月,有关十味龙胆花方剂治疗慢性阻塞性肺疾病(Chronic Obstrutive Pulmonary Disease,COPD)的随机对照研究.纳入研究的方法学质量根据Cochrane手册进行评价,所有统计分析采用RevMan 5.4软件进行.结果:共纳入8项符合标准的随机对照研究,共854例患者.Meta分析结果显示,与西医常规治疗相比,西医常规治疗联合十味龙胆花方剂能显著改善临床总有效率[比值比(OR)=3.47,95％置信区间(CI)(2.26,5.33),Z=5.69,P＜0.000 01]和 1 秒用力呼气容积占预计值百分比(Percentage of Predicted Forced Expiratory Volume in One Second,FEV1％)[均数差(MD)=4.92,95％CI(2.73,7.10),Z-4.41,P＜0.000 1],降低 C 反应蛋白(C-Reactive Protein,CRP)[MD=-6.92,95％CI(-9.35,-4.50),Z=5.60,P＜0.000 01]和降钙素原(Procalcitonin,PCT)[MD=-1.41,95％CI(-2.25,-0.57),Z=3.29,P=0.001],同时在治疗周期不超过15 d时,可改善患者1秒率[(Forced Expiratory Volume in One Second,FEV1)/用力肺活量(Forced Vital Capacity,FVC)][MD=5.61,95％CI(1.49,9.74),Z=2.67,P=0.008];而在不良反应[OR=1.16,95％CI(0.53,2.53),Z=0.37,P=0.71]方面,两组并无明显差异.结论:西医常规治疗联合十味龙胆花方剂治疗COPD在提高临床总有效率、改善患者肺功能和抗炎方面优于单纯西医治疗,且安全性良好.受限于纳入研究的数量及质量,上述结论仍需更多高质量的研究验证.
Meta-analysis of efficacy and safety of Shiwei Longdanhua prescription in the treatment of chronic obstructive pulmonary disease
Objective:To systematically evaluate the efficacy and safety of Shiwei Longdanhau prescription(十味龙胆花方剂)in the treatment of chronic obstructive pulmonary disease(COPD).Methods:Chinese National Knowledge Infrastructure(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),China Biology Medicine disc(CBM),Web of Science,PubMed,EMbase and Co-chrane Library were searched for randomized controlled trials(RCT)on the treatment of chronic obstructive pulmonary disease with Shiwei Longdanhau prescription up to June 2023.The Cochrane handbook was used to assess the quality of RCT.RevMan5.4 software was used for statistical analyses.Re-sults:A total of 8 RCT were included,including 854 patients with COPD.The results of Meta-analysis showed that compared with conventional westem medicine,conventional westem medicine combined with Shiwei Longdanhau prescription could significantly improve the clinical total effective rate[OR=3.47,95％CI(2.26,5.33),Z=5.69,P＜0.000 01],percentage of forced expiratory volume in 1 second to the expected value[MD=4.92,95％CI(2.73,7.10),Z=4.41,P＜0.000 1],decreased C-reactive protein[MD=-6.92,95％CI(-9.35,-4.50),Z=5.60,P＜0.000 01],and procalcitonin[MD=-1.41,95％CI(-2.25,-0.57),Z=3.29,P=0.001],and the one-second rate(FEV1/FVC)was improved when the treatment cycle was no more than 15 days[MD=5.61,95％CI(1.49,9.74),Z=2.67,P=0.008].There was no significant difference in adverse reactions/events[OR=1.16,95％CI(0.53,2.53),Z=0.37,P=0.71]between the two groups.Conclusion:The conventional westem medicine combined with Shiwei Longdanhau prescription is superior to simple westem medicine in improving the clinical efficacy,pulmonary function and anti-inflammation in the treatment of chronic obstructive pulmonary disease,and the safety is reliable.Due to limited quality and quantity of included studies,more high-quality studies are required to verity the above conclusion.
万方数据
维普
