宽胸理肺汤联合西医治疗AECOPD疗效的meta分析

doi:10.3760/cma.j.cn441417-20240923-11013

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (11): 1826-1834.DOI: 10.3760/cma.j.cn441417-20240923-11013

宽胸理肺汤联合西医治疗AECOPD疗效的meta分析

寇育乐¹ 李向文² 谭曦舒¹ 吕长锐³

¹陕西中医药大学附属医院呼吸与危重症科，咸阳 712000；²陕西中医药大学公共卫生学院，咸阳 712024；³长武县人民医院重症医学科，咸阳 713600

收稿日期:2024-09-23 出版日期:2025-06-01 发布日期:2025-06-14
通讯作者: 吕长锐，Email：12132232@163.com
基金资助:
陕西省自然科学基础研究计划面上项目（2021JM-473）；陕西省中医药管理局中医药基础研究项目（2021-GJ-JC012）

Meta-analysis of the efficacy of Kuanxiong Lifei decoction with western medicine in AECOPD

Kou Yule¹, Li Xiangwen², Tan Xishu¹, Lyu Changrui³

¹Department of Respiratory and Critical Care, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000, China; ²College of Public Health,Shaanxi University of Chinese Medicine, Xianyang 712024, China; ³ICU, Changwu County People's Hospital, Xianyang 713600, China

Received:2024-09-23 Online:2025-06-01 Published:2025-06-14
Contact: Lyu Changrui, Email: 12132232@163.com
Supported by:
Basic Research Project of Natural Science in Shaanxi Province (2021JM-473); Basic Research Project of Traditional Chinese Medicine of Shaanxi Provincial Administration of Traditional Chinese Medicine (2021-GJ-JC012)

摘要/Abstract

摘要：

目的　采用meta分析系统评价宽胸理肺汤联合西医常规疗法治疗慢性阻塞性肺疾病急性加重期（AECOPD）的临床疗效和安全性，为AECOPD的中医临床治疗提供循证医学证据。方法　检索中国知网、维普中文科技期刊数据库、万方数据库、中国生物医学文献数据库、PubMed、The Cochrane Library、Web of Science等数据库中，关于宽胸理肺汤联合西医治疗AECOPD的随机对照试验，检索时间限定为自建库起至2024年7月23日。使用Review Manager 5.4和Stata 18.0对提取数据进行meta分析。结果　本研究共纳入14篇文献，纳入研究对象共计1 217例，其中观察组611例，对照组606例。meta分析结果显示：观察组治疗后的临床有效率［相对危险度（RR）=1.18，95%置信区间（CI）1.08～1.29］、第一秒用力呼气量（FEV1）/用力肺活量（FVC）［均数差（MD）=5.64，95%CI 3.84～7.44］、FEV1占预计值百分比（FEV1/Pred%）（MD=5.14，95%CI 3.96～6.31）、FEV1（MD=0.26，95%CI 0.16～0.36）、动脉氧分压（PO2）（MD=6.25，95%CI 4.94～7.55）、生活质量评分（MD=7.12，95%CI 4.76～9.48）均高于对照组，差异均有统计学意义（均P<0.05）；不良反应发生率略高于对照组（RR=1.50，95%CI 0.27～8.34），但差异无统计学意义（P>0.05）；中医证候评分（MD=-2.44，95%CI -2.81～-2.07）、动脉二氧化碳分压（PCO2）（MD=-6.09，95%CI -7.89～-4.28）、C反应蛋白（MD=-2.21，95%CI -2.48～-1.94）、白细胞计数（MD=-1.40，95%CI -2.24～-0.56）、白细胞介素-6（MD=-1.21，95%CI -2.31～-0.11）、肿瘤坏死因子-α（MD=-1.87，95%CI -3.29～-0.45）均低于对照组（均P<0.05）；中性粒细胞百分比略低于对照组（MD=-2.01，95%CI -5.30～1.27），但差异无统计学意义（P>0.05）。亚组分析结果显示：痰浊壅肺证和痰热郁肺证AECOPD患者接受治疗后，观察组和对照组的临床有效率、中医证候评分、FEV1/FVC等差异均无统计学意义（均P>0.05）。结论　宽胸理肺汤联合西医常规治疗对AECOPD更有效，能更好地改善患者的肺功能、炎症指标和生活质量，且可适用于痰浊壅肺证和痰热郁肺证。

关键词: 慢性阻塞性肺疾病急性加重期, 宽胸理肺汤, 痰浊雍肺, 痰热郁肺, meta分析

Abstract:

Objective　To perform a meta-analysis to systematically evaluate the clinical efficacy and safety of Kuanxiong Lifei decoction combined with conventional western medicine in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), providing evidence-based medical support for traditional Chinese medicine (TCM) treatment of AECOPD. Methods　Randomized controlled trials on the treatment of AECOPD with Kuanxiong Lifei decoction combined with western medicine were retrieved from databases including CNKI, VIP Chinese Science and Technology Journal Database, Wanfang Database, China Biomedical Literature Database, PubMed, The Cochrane Library, and Web of Science, with the search period limited from database inception to July 23, 2024. Meta-analysis was conducted using Review Manager 5.4 and Stata 18.0. Results　A total of 14 studies involving 1,217 participants were included, with 611 in the observation group and 606 in the control group. The meta-analysis results showed that the clinical effective rate in the observation group was higher than that in the control group [relative risk (RR)=1.18 (1.08, 1.29)], as were FEV1/FVC [mean difference (MD)=5.64 (3.84, 7.44)], FEV1/Pred% [MD=5.14 (3.96, 6.31)], FEV1 [MD=0.26 (0.16, 0.36)], PO₂ [MD=6.25 (4.94, 7.55)], and quality of life scores [MD=7.12 (4.76, 9.48)], all showing statistically significant differences (all P<0.05). The incidence of adverse reactions in the observation group was higher than that in the control group [RR=1.50 (0.27, 8.34)], but the difference was not statistically significant (P>0.05). The TCM syndrome scores after treatment in the observation group [MD=-2.44 (-2.81 ,-2.07)], PCO₂ [MD=-6.09 (-7.89, -4.28)], CRP [MD=-2.21 (-2.48, -1.94)], WBC [MD=-1.40 (-2.24, -0.56)], IL-6 [MD=-1.21 (-2.31, -0.11)], and TNF-α [MD=-1.87 (-3.29, -0.45)] were all lower than those in the control group, with statistically significant differences (all P<0.05). The N% after treatment in the observation group was lower than in the control group [MD=-2.01 (-5.30, 1.27)], but the difference was not statistically significant (P>0.05). The results of subgroup analysis showed that there was no significant difference in clinical effective rate, TCM syndrome score and FEV1/FVC between AECOPD patients with phlegm turbidity obstructing lung syndrome and phlegm heat obstructing lung syndrome after treatment (all P>0.05). Conclusion　The combination of Kuanxiong Lifei decoction and conventional western therapy is more effective for AECOPD, improving lung function, inflammatory markers, and quality of life, and is applicable to patients with phlegm obstructing lung syndrome and phlegm heat obstructing lung syndrome.

Key words: Acute exacerbation of chronic obstructive pulmonary disease;Kuanxiong Lifei decoction, Phlegm obstructing lung syndrome, Phlegm heat obstructing lung syndrome, Meta-analysis

寇育乐李向文谭曦舒吕长锐. 宽胸理肺汤联合西医治疗AECOPD疗效的meta分析 [J]. 国际医药卫生导报, 2025, 31(11): 1826-1834.

Kou Yule, Li Xiangwen, Tan Xishu, Lyu Changrui.

Meta-analysis of the efficacy of Kuanxiong Lifei decoction with western medicine in AECOPD [J]. International Medicine and Health Guidance News, 2025, 31(11): 1826-1834.

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宽胸理肺汤联合西医治疗AECOPD疗效的meta分析

Meta-analysis of the efficacy of Kuanxiong Lifei decoction with western medicine in AECOPD

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