摘要
目的系统评价宣白承气汤治疗痰热壅肺型重症肺炎的有效性及安全性。方法系统检索CNKI、WANGFANG DATA、VIP、SinoMed、EMbase、PubMed、The Cochrane Library等数据库,按照预先设定的纳入与排除标准筛选临床随机对照试验研究文献,采用风险评估工具进行研究质量评价,提取数据并运用RevMan 5.3和R 3.6.1软件进行Meta分析。结果共计纳入11篇文献,涉及882例患者。Meta分析结果显示:与单纯西医常规治疗相比,加用宣白承气汤加减治疗痰热壅肺型重症肺炎可以提高总有效率[OR=5.19,95%CI(3.33,8.07),P<0.00001],减少外周动脉血乳酸含量[WMD=-2.04,95%CI(-2.30,-1.79),P<0.00001]、有创机械通气时间[WMD=-125.33,95%CI(-132.21,-118.44),P<0.00001]、临床肺部感染评分[WMD=-1.93,95%CI(-2.29,-1.57),P<0.00001]、急性生理与慢性健康Ⅱ评分[WMD=-7.94,95%CI(-8.47,-7.41),P<0.00001]。仅有2篇文献报道了不良反应,结果显示在西医常规疗法基础上加用宣白承气汤加减治疗痰热壅肺型重症肺炎未出现明显不良反应。结论在西医常规疗法基础上联用宣白承气汤加减治疗痰热壅肺型重症肺炎,较单纯应用西医常规疗法能够提高临床疗效、改善患者的生活质量;但纳入的文献数量、质量有限,相关结论有待进一步验证。
Objective To systematically evaluate the clinical efficacy and safety of Xuanbai Chengqi decoction(XBCQD)in the treatment of severe pneumonia of phlegm-heat obstructing lung pattern.Methods CNKI,Wanfang Data Knowledge Service Platform,VIP,SinoMed,EMbase,PubMed,the Cochrane Library and other databases were searched systematically.According to the pre-set inclusion and exclusion criteria,the clinical randomized controlled trials(RCTs)research literatures were screened,the research quality was evaluated by risk assessment tools,and the data were extracted and meta-analyzed by RevMan 5.3 and R 3.6.1 software.Results A total of 11 papers involving 882 patients were included.Meta-analysis results showed that compared with the routine treatment of western medicine alone,the modified XBCQD can improve the total effective rate[OR=5.19,95%CI(3.33,8.07),P<0.00001],reduce the lactic acid content in peripheral arterial blood[WMD=-2.04,95%CI(-2.30,-1.79),P<0.00001],invasive mechanical ventilation time[WMD=-125.33,95%CI(-132.21,-118.44),P<0.00001],clinical pulmonary infection score[WMD=-1.93,95%CI(-2.29,-1.57),P<0.00001],acute physiological and chronic health II score[WMD=-7.94,95%CI(-8.47,-7.41),P<0.00001].Only 2 papers reported adverse reactions.The results showed that there was no obvious adverse reaction in the treatment of severe pneumonia of phlegm-heat obstructing lung pattern with modified XBCQD on the basis of conventional western medicine therapy.Conclusion The application of XBCQD on the basis of conventional western medicine therapy to treat severe pneumonia of phlegm-heat obstructing lung pattern can improve clinical efficacy andlife quality of patients compared with conventional western medicine therapy alone.However,as the quantity and quality of literatures included were limited,the relevant conclusions need further verification.
作者
霍金林
温昊天
胡静
朱海燕
HUO Jinlin;WEN Haotian;HU Jing;ZHU Haiyan(Basic Medical College,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;School of Pharmacy,Fudan University,Shanghai 201203,China)
出处
《上海中医药杂志》
2020年第4期40-45,共6页
Shanghai Journal of Traditional Chinese Medicine
基金
国家自然科学基金项目(81001491,81673713)
国家中医药管理局全国中医药创新骨干人才项目(2019.8-2022.7)
