摘要
目的系统评价中西医结合治疗新型冠状病毒肺炎的疗效。方法计算机检索中文数据库中有关中西医结合治疗新冠肺炎的研究,检索时间均自2019年12月12日-2020年3月25日。由两位评价员独立检索文献、筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Stata15.1软件进行Meta分析。结果共纳入12项研究,4项RCT,8项非随机对照研究,全部研究对象共912例。Meta分析结果显示:与单纯西药相比,中西医结合治疗新冠肺炎总有效率提高(RR=1.313,95%CI(1.105,1.560),P=0.002),临床症状总积分前后差值增加(SMD=0.818,95%CI(0.03,1.606),P=0.042),发热控制率提高(RR=1.296,95%CI(1.161,1.447),P<0.0001),发热持续时间缩短(WMD=-1.577,95%CI(-1.980,-1.173),P<0.0001),乏力改善率提高(RR=1.553,95%CI(1.213,1.990),P<0.0001),乏力前后积分差值增加(SMD=1.489,95%CI(0.679,2.300),P<0.0001),乏力持续时间缩短(WMD=-1.742,95%CI(-2.006,-1.478),P<0.0001),咳嗽改善率提高(RR=1.653,95%CI(1.341,2.036),P<0.0001),咳嗽前后积分差值增加(SMD=1.951,95%CI(1.127,2.774),P<0.0001),咳嗽持续时间缩短(WMD=-1.711,95%CI(-2.303,-1.119),P<0.0001),CT好转率提高(RR=1.278,95%CI(1.040,1.571),P=0.019),转危重率降低(RR=0.438,95%CI(0.258,0.673),P<0.0001);发热前后积分差值、核酸转阴率差异无统计学意义。结论中西医结合治疗新冠肺炎在治疗总有效率,临床症状总积分,发热控制率、持续时间,乏力改善率、前后积分差值、持续时间,咳嗽改善率、前后积分差值、持续时间,CT好转率,转危重率均优于单纯西医组,提示中西医结合治疗新冠肺炎具有一定价值。但由于纳入研究数量和质量的限制,有待于进一步考证。
Objective:To give a systematic appraisal of the curative effect on treating COVID-19 by Integrated Medicine.Methods:To search the relevant studies on the treatment of COVID-19 with the integration of Chinese and Western Medicine in the Chinese Corpus ranging from December 12th,2019 to March 25th,2020.The Meta-analysis of the data is done by Stata15.1 until two appraiser independently search and select the documents,then extract the informa-tion and evaluate the risk of bias.Results:912 cases among 12 studies are selected and grouped into 4 RCT and 8 non-random research respectively.The result of Meta shows that the overall curative effect of treatment with Chinese and West-ern Medicine significantly rise[RR=1.313,95%CI(1.105,1.560),P=0.002],the difference value of clinical syn-drome score increase[SMD=0.818,95%CI(0.03,1.616),P=0,042],the control rate of fever increases[RR=1.296,95%CI(1.161,1.447),P<0.0001],the duration of fever shortens[WMD=-1.577,95%CI(-1.980,-1.173),P<0.0001],the improvement rate of debilitation increase[RR=1.553,95%CI(1.213,1.990),P<0.0001],the difference value of debilitation increase[SMD=1.489,95%CI(0.679,2.300),P<0.0001],the duration of debilita-tion shortens[WMD=-1.742,95%CI(-2.006,-1.478),P<0.0001],the improvement rate of cough increase[RR=1.653,95%CI(1.341,2.036),P<0.0001],the difference value of cough increase[SMD=1.951,95%CI(1.127,2.774),P<0.0001],the duration of cough shortens[WMD=-1.711,95%CI(-2.303,-1.119),P<0.0001],the im-provement rate of CT increase[RR=1.278,95%CI(1.040,1.571),P=0.019],the rate of transforming to severe de-clines[RR=0.438,95%CI(0.258,0.673),P<0.0001];the difference value before and after fever and the difference value of the negative transformation rate have no statistical significance.Conclusion:The overall curative rate,overall clinical symptom scores,the control rate of fever and its duration,the improvement of debilitation,the difference value and its duration,the improvement rate of cough and the difference value as well as its duration,the improvement rate
作者
杲春阳
宋昌梅
付燕来
张晋
GAO Chun-yang;SONG Chang-mei;FU Yan-lai;ZHANG Jin(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)
出处
《陕西中医药大学学报》
2021年第1期1-9,共9页
Journal of Shaanxi University of Chinese Medicine
基金
第四批全国优秀临床人才项目(国中医药人教发[2017]24号)
国家中医药管理局全国中医学术流派传承工作室第二轮建设项目(国中医人教函[2019]62号)。
