膏方治疗慢性阻塞性肺疾病的系统评价和Meta分析

A Systematic Review and Meta-Analysis of Ointment for the Treatment of Chronic Obstructive Pulmonary Disease

摘要: 目的：系统全面探讨膏方辅助治疗慢性阻塞性肺疾病(COPD)的临床及其相关Meta分析。方法：检索国内外中英文数据库近五年关于膏方治疗COPD的随机试验(RCT)，利用Revman 5.3软件开展偏倚风险评价和Meta分析。结果：共纳入22篇文献、研究对象1745例，包括治疗组876例，对照组869例，Meta分析结果表明：与单一西药疗法比较，膏方增强总有效率(TE) [OR = 3.64, 95% CI (2.36, 5.59), P < 0.00001]，提高第1秒用力呼气量占预计值的百分比(FEV1%) [MD = 4.91, 95% CI (3.39, 6.43), P < 0.00001]，减少急性加重次数[MD = −0.34, 95% CI (−0.39, −0.28), P < 0.00001]，不良反应轻且少。结论：加用膏剂治疗COPD能显著提升患者整体生理指标，包括缓解呼吸道症状、增强患者运动能力和免疫力，且无明显副作用，因此，建议将膏剂作为COPD辅助药物，并通过大范围、高精度、多点监测的实验来确保其药物的安全和有效。

Abstract: Objective: To systematically and comprehensively investigate the clinical and related Meta-analyses of the adjuvant treatment of chronic obstructive pulmonary disease (COPD) with plaster formula. Methods: Randomized trials (RCTs) of plaster prescriptions for the treatment of COPD in the past five years were searched in Chinese and English databases at home and abroad, and risk of bias assessment and Meta-analysis were carried out using Revman 5.3 software. Result: A total of 22 articles and 1745 study subjects were included, including 876 cases in the treatment group and 869 cases in the control group, and the results of Meta-analysis showed that compared with a single Western drug therapy, the total effective rate (TE) was enhanced by the plaster formula [OR = 3.64, 95% CI (2.36, 5.59), P < 0.00001], increased the percentage of forced expiratory volume in 1 second to predicted value (FEV1%) [MD = 4.91, 95% CI (3.39, 6.43), P < 0.00001], reduced the number of acute exacerbations [MD = −0.34, 95% CI (−0.39, −0.28), P < 0.00001], and the adverse effects were mild and few. Conclusion: The addition of ointment in the treatment of COPD can significantly improve the overall physiological indexes of patients, including alleviating respiratory symptoms, and enhancing patients’ exercise ability and immunity, and has no obvious side effects, therefore, it is recommended to use ointment as an adjuvant drug for COPD, and ensure the safety and effectiveness of the drug through large-scale, high-precision, and multi-point monitoring experiments.