中药治疗哮喘-慢阻肺重叠的Meta分析＊

目的 系统评价中药治疗哮喘-慢阻肺（ACO）的疗效与安全性。方法 全面检索PubMed、Cochrane Library、Web of Science、中国知网、万方、维普、中国医学文献数据库,纳入有关中医药治疗ACO的随机对照试验（RCT）,运用Cochrane手册对纳入研究的方法学质量进行评估,采用Review Manager 5.3进行Meta分析。结果 共纳入32项RCT,包括2688例ACO患者,其中试验组1361例,对照组1327例。Meta分析结果显示,中医药可以显著改善ACO患者的中医证候疗效［RR=1.19,95% CI（1.13,1.25）,P<0.00001］、CAT评分［MD=-3.62,95% CI（-4.37,-2.87）,P<0.00001］、ACT评分［MD=3.42,95% CI（2.23,4.62）,P<0.00001］,、中医证候总积分［MD=-3.61,95% CI（-4.83,-2.39）,P<0.00001］、FEV₁［MD=0.59,95% CI（0.08,1.10）,P=0.02］、FEV₁%［MD=8.61,95% CI（5.20,12.1）,P<0.00001］、FEV₁/FVC［MD=6.52,95% CI（4.24,8.80）,P<0.00001］、6 min步行实验［MD=41.18,95% CI（22.15,60.21）,P<0.0001］、急性发作次数［MD=-2.46,95% CI（-3.62,-1.13）,P<0.0001］。所有研究均未报道严重不良反应。结论 中药治疗ACO,可以显著提高临床疗效,改善患者的肺功能且具有较好安全性,但是需要更高质量、多样本、多中心的随机对照试验进一步确认。

Meta-analysis on Asthma and COPD Overlap with Traditional Chinese Medicine

Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine in patients with asthma and COPD overlap syndrome (ACO).Methods Randomized controlled trial (RCT) were searched in PubMed, Cochrane Library, CNKI, Web of Science, Wanfang database, VIP, CBM. The methodological quality of RCTs were assessed by Cocharne manual. Meta-analysis was performed by using Review Manager 5.3.Results Totally 32 RCTs with 2688 participants were divided into treatment group (n=1361) and control group (n=1327). Meta-analysis results showed that traditional Chinese medicine was significantly better than the control group in improving the TCM syndrome effect RR=1.19,95%CI(1.13,1.25),P<0.00001] , asthma symptom(ACT)score MD=3.42, 95% CI(2.23,4.62), P<0.00001], FEV1%MD=8.61, 95% CI(5.20,12.1), P<0.00001], FEV₁/FVCMD=6.52, 95% CI(4.24,8.80), P<0.00001], in reducing chronic obstructive pulmonary symptom(CAT) score MD=-3.62, 95% CI(-4.37,-2.87), P < 0.00001], total score of TCM syndromes MD=-3.61, 95% CI(-4.83,-2.39), P<0.00001], 6 minute walk test MD=41.18, 95% CI(22.15,60.21), P<0.0001]the times of acute exacerbations MD=-2.46, 95% CI(-3.62,-1.13), P<0.0001], with statistical significance. All studies did not report adverse reactions.Conclusion Traditional Chinese medicine can improve clinical efficacy and lung function. However, it should be verified by high quality, large sample size and Multicenter clinical trials.