摘要
[目的]评价六君子汤加减治疗稳定期慢性阻塞性肺疾病肺脾两虚证的有效性及安全性。[方法]检索PubMed、Embase、Cochrane图书馆、中国知网、万方、维普、中国生物医学数据库,搜集六君子汤加减治疗稳定期慢性阻塞性肺疾病合并肺脾两虚证的随机对照试验(RCT),时间限定为建库至2019年3月。使用RevMan 5.3进行Meta分析。[结果]纳入10篇文献,包括870例患者。Meta分析结果显示:六君子汤加减可提高总有效率[OR=3.10,95%CI(2.13,4.51),P<0.00001],改善部分肺功能指标,包括第1秒用力呼气容积(FEV1)[SMD=0.73,95%CI(0.29,1.18),P=0.001]、第1秒用力呼气量占所有呼气量的比例(FEV1/FVC)[SMD=0.75,95%CI(0.41,1.09),P<0.0001];但用力肺活量(FVC)[SMD=0.28,95%CI(-0.24,0.81),P=0.27],差异无统计学意义。改善部分动脉血气分析指标,包括血氧饱合度(SaO2)[SMD=0.94,95%CI(0.21,1.67),P=0.01]、动脉血二氧化碳分压(PaCO2)[SMD=-1.71,95%CI(-2.02,-1.40),P<0.00001];但动脉血氧分压(PaO2)[SMD=2.71,95%CI(-0.44,5.86),P=0.09],差异无统计学意义。改善中医症状积分,包括咳嗽[SMD=-1.16,95%CI(-1.76,-0.55),P=0.0002]、咳痰[SMD=-0.80,95%CI(-1.48,-0.13),P=0.02]、气短[SMD=-0.43,95%CI(-0.71,-0.14),P=0.003]、食少[SMD=-1.00,95%CI(-1.30,-0.70),P<0.00001]、腹胀[SMD=-1.09,95%CI(-1.39,-0.79),P<0.00001],提高运动耐力[SMD=0.94,95%CI(0.10,1.77),P=0.03],改善呼吸困难量表(MMRC)[SMD=-0.58,95%CI(-0.82,-0.34),P<0.00001];在体重指数(BMI)方面,两组差异无统计学意义[SMD=-0.41,95%CI(-1.37,0.55),P=0.41]。[结论]六君子汤加减治疗稳定期慢性阻塞性肺疾病合并肺脾两虚证有疗效优势。
[Objective]To evaluate the efficacy and safety of addition and subtraction of Liujunzi Decoction in the treatment of stable lung and spleen deficiency syndrome in patients with chronic obstructive pulmonary disease.[Methods]Searching with PubMed,EMBASE,Cochrane Library,China knowledge Network,Wanfang,Weipu,China Biomedical Database,to collect the randomized controlled trial of addition and subtraction of Liujunzi Decoction in the treatment of stable lung and spleen deficiency syndrome of chronic obstructive pulmonary disease(COPD).Time was limited to the establishment of the database until March 2019 by RevMan 5.3.[Results]The total of 10 articles were included,including 870 patients.The results of Meta-analysis showed that the addition and subtraction of Liujunzi Decoction can improve the total effective rate[OR=3.10,95%CI(2.13,4.51),P<0.00001],improve some pulmonary function indicators like FEV1[SMD=0.73,95%CI(0.29,1.18),P=0.001],FEV1/FVC[SMD=0.75,95%CI(0.41,1.09),P<0.0001],however,the difference was not statistically significant in FVC[SMD=0.28,95%CI(-0.24,0.81),P=0.27].It can improve some arterial blood gas analysis indicators like SaO_(2)[SMD=0.94,95%CI(0.21,1.67),P=0.01],PaCO_(2)[SMD=-1.71,95%CI(-2.02,-1.40),P<0.00001]),but the difference of PaO2[SMD=2.71,95%CI(-0.44,5.86),P=0.09]had no statistical significance.It can improve TCM syndrome scores(Cough[SMD=-1.16,95%CI(-1.76,-0.55),P=0.0002],expectoration[SMD=-0.80,95%CI(-1.48,-0.13),P=0.02],short breath[SMD=-0.43,95%CI(-0.71,-0.14),P=0.003],eat less[SMD=-1.00,95%CI(-1.30,-0.70),P<0.00001],abdominal distension[SMD=-1.09,95%CI(-1.39,-0.79),P<0.00001]).It can improve exercise endurance[SMD=0.94,95%CI(0.10,1.77),P=0.03],improve MMRC[SMD=-0.58,95%CI(-0.82,-0.34),P<0.00001].There was no significant statistical difference in BMI between the two groups[SMD=-0.41,95%CI(-1.37,0.55),P=0.41].[Conclusion]Addition and subtraction of Liujunzi Decoction has curative and effective advantages in the treatment of stable lung and spleen deficiency syndrome of chronic obstructive pulmonary disease.
作者
李国峰
李祎
LI Guofeng;LI Yi(Department of Respiratory Medicine of Tianjin Beichen Hosptial,Tianjin 300400,China)
出处
《天津中医药》
CAS
2021年第10期1305-1311,共7页
Tianjin Journal of Traditional Chinese Medicine
关键词
六君子汤
慢性阻塞性肺疾病
稳定期
肺脾两虚证
META分析
Liujunzi Decoction
chronic obstructive pulmonary disease
stable period
lung and spleen deficiency syndrome
Meta-analysis
