中医药治疗风温肺热病临床文献回顾性分析

目的:对中医药治疗风温肺热病的临床文献进行回顾性分析,阐明中医药治疗风温肺热病的研究现状,为进一步研究风温肺热病提供客观的数据支撑。方法:检索中国知网、万方数据库、维普中文期刊服务平台及中国生物医学文献数据库中2000年1月至2017年6月发表的关于中医药治疗风温肺热病的临床文献,对其中涉及的药物、观察对象、证候类型、观察时间、试验方法、观察指标、疗效评价标准、治疗效果、外治法、临床路径、不良反应、临床理论进行回顾性分析。结果:共纳入文献121篇,样本量9644例,所有观察对象均为按严格标准纳入的风温肺热病患者。试验方法基本采用组间对照法、自身前后对照法;疗效评价包括症状积分改善情况、临床炎性指标及各项生化指标;涉及药物41种、中医证型11种;临床观察或试验时间多为7～10 d;观察指标主要包括临床症状及实验室检查指标;疗效方面,中药内治法的中医证候改善率均不低于70%,外治法能缩短患者病程、改善部分症状;临床路径的实施能提高临床疗效、降低患者诊疗费用;部分经中药治疗的风温肺热病患者出现不良反应;临床理论研究对其病因、病机、用药特点进行总结。结论:中医药治疗风温肺热病的确切疗效已经得到证实,中医药在改善风温肺热病患者临床症状、缩短病程、减少并发症、降低医疗成本等方面具有一定的优势,但需要进一步明确中医药的疗效稳定性和作用机制。

Retrospective Analysis of Clinical Literature on Wind-Warm Disease with Lung Heat Treated by Traditional Chinese Medicine

Objective:To make a retrospective analysis of clinical literature on wind-warm disease with lung heat treated by traditional Chinese medicine(TCM),so as to expound the research status of treatment of wind-warm disease with lung heat by TCM therapy,thus providing data support for further study of wind-warm disease with lung heat. Methods:Related clinical literature on wind-warm disease with lung heat treated by TCM published from January 2001 to June 2017 was searched from Chinese National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Chinese Periodicals Service Platform Database and China Biology Medicine Database to review and analyze the involved drugs,observed objects,syndrome types,observation time,test methods,observation parameters,criterion of curative efficacy,external treatments,clinical pathways,adverse reactions and clinical theories. Results:A total of 121 articles were included and 9644 patients were involved. All the observation objects were patients with wind-warm disease with lung heat chosen by a strict criteria. The general test methods were mutual control and self control. The criterion of curative efficacy included improvements of symptom scores,clinical inflammatory parameters and various biochemical paratemers. There were 41 kinds of drugs and 11 kinds of TCM syndrome types. The clinical observation or test time was 7 to 10 days and the observation parameters mainly included clinical symptoms and laboratory examination parameters. For the curative efficacy,the improvement rate of TCM symptoms and syndromes obtained by TCM internal treatment was not less than 70% and the external treatment was able to shorten the course of disease and improve part of the patients' symptoms. The implementation of clinical pathway could improve clinical efficacy and reduce the costs of diagnosis and treatment. Some patients treated by TCM suffered from adverse reactions. Clinical theoretical studies summarized its etiology,pathogenesis and medication characteristics. Conclusions:The exact efficacy of TCM on the treatment of wind-warm disease with lung heat has been confirmed. TCM has certain advantages in improving clinical symptoms,shortening the course of disease,reducing complications and medical costs,but the stability of efficacy and mechanism of TCM should be further clarified.