二陈汤合三子养亲汤治疗慢性阻塞性肺病急性加重期疗效的Meta分析＊

目的 系统评价二陈汤合三子养亲汤治疗慢性阻塞性肺疾病急性加重期（acute exacerbation of chronic obstructive pulmonary disease,AECOPD）的临床疗效及安全性。方法 计算机检索维普全文数据库（VIP）、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方数据知识服务平台（WanFang Data）和Embase、PubMed、Web of science、Cochrane Library,收集建库至2020年5月15日国内外公开发表的关于二陈汤合三子养亲汤治疗AECOPD的随机对照试验（RCTs）。2名研究人员根据制定的纳入、排除标准,独立进行文献筛选和相关资料的提取,描述纳入文献基本特征,并独立进行质量评价。Meta分析工具采用RevMan 5.3软件。结果 12项RCTs纳入研究,共1174例患者,其中试验组590例,对照组584例。Meta分析结果显示：二陈汤合三子养亲汤能显著提高AECOPD临床有效率：RR = 1.20,95%CI［1.14,1.26］;显著提高FEV1（1秒用力呼气量）（randomized controlled trial ）占预计值百分比：MD=5.80,95%CI［1.35,10.26］;明显提高每分钟最大通气量（MVV）值：MD = 14.86,95%CI［13.07,16.65］;显著提高血氧分压（PaO₂）：MD = 2.86,95%CI［1.27,4.44］;显著降低白细胞计数（WBC）：MD = -2.24,95%CI［-2.72,-1.76］;显著降低中性粒细胞百分比（N%）：MD = -6.93,95%CI［-7.92,-5.94］;显著降低C反应蛋白（CRP）：MD = -3.72,95%CI［-5.04,-2.402］,且差异均具有统计学意义（P < 0.05）。二陈汤合三子养亲汤治疗能降低二氧化碳分压（PaCO₂）：MD = -2.63,95%CI［-6.49,1.22］,但结果不具有统计学意义（P > 0.05）。结论 二陈汤合三子养亲汤治疗AECOPD在提高临床有效率、改善肺功能、提高血氧含量、降低炎症因子方面明显优于常规治疗。

Meta-analysis of the Efficacy of Erchen Decoction Combined with Sanzi Yangqin Decoction in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Objective To systematically review the clinical efficacy and safety of Erchen Decoction combined with Sanzi Yangqin Decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods We searched the VIP full-text database (VIP), China Knowledge Network (CNKI), China Biomedical Literature Database (CBM), WanFang Data Knowledge Service Platform (WanFang Data) and Embase, PubMed, Web of science, Cochrane Library, and collected the database built up to May 15, 2020 The randomized controlled trials (RCTs) of Er Chen Tang combined with San Zi Yang Yin Tang for the treatment of AECOPD were published at home and abroad. 2 researchers independently performed literature screening and extraction of relevant information according to the established inclusion and exclusion criteria, described the basic characteristics of the included literature, and independently performed quality evaluation. the Meta-analysis tool was RevMan 5.3 software.Results Twelve RCTs were included in the study, with a total of 1174 patients, including 590 in the trial group and 584 in the control group. Meta-analysis showed that Erchen Decoction combined with Sanzi Yangqin Decoction significantly improved the clinical efficiency of AECOPD: RR = 1.20, 95%CI1.14,1.26]; significantly improved FEV1 (exertional expiratory volume in 1 second) (randomized controlled trial) as a percentage of the expected value: MD = 5.80, 95%CI1.35,10.26]; significantly increased maximum ventilation per minute (MVV)value MD = 14.86, 95%CI13.07,16.65]; significantly increased partial pressure of oxygen (PaO2): MD = 2.86, 95%CI 1.27,4.44]; significantly lowered white blood cell count (WBC): MD = -2.24, 95%CI-2.72,-1.76]; significantly lowered neutrophil percentage (N%): MD = -6.93, 95%CI-7.92,-5.94]; significantly lowered C-reactive protein (CRP): MD = -3.72, 95%CI-5.04,-2.402], and all differences were statistically significant (P < 0.05). Treatment with E Erchen Decoction combined with Sanzi Yangqin Decoction reduced partial pressure of carbon dioxide (PaCO₂): MD = -2.63, 95%CI-6.49,1.22], but the results were not statistically significant (P > 0.05).Conclusion The treatment of AECOPD by erchen decoction and sanziyangqin decoction is obviously superior to conventional treatment in improving clinical efficiency, improving lung function, increasing blood oxygen content and reducing inflammatory factors.