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    5种口服中成药联合常规方案治疗稳定期慢性阻塞性肺疾病的网状meta分析

    Network Meta-analysis of Five Oral Proprietary Chinese Medicines Combined with Conventional Regimens in the Treatment of Stable Chronic Obstructive Pulmonary Disease

      摘要
    • 摘要:
      目的 系统评价5种口服中成药用于治疗稳定期慢性阻塞性肺疾病的疗效和安全性。
      方法 计算机检索中国期刊全文数据库、万方、维普数据库、中国生物医学数据库电子数据库、The Cochrane Library、Embase、Pubmed等7个数据库收录的口服中成药用于治疗稳定期慢性阻塞性肺疾病的随机对照试验，检索时间均自建库至 2023 年 10 月 1 日，由2名评价员独立选择试验和评价质量，提取有效数据采用RevMan 5.3、Stata SE 14、 GeMTC 0.14.3 软件进行网状 meta 分析。
      结果 共纳入 34 个临床对照试验研究，病例共 2385 例，其中对照组1228例，试验组1157例。网状 meta分析结果显示：①提高有效率方面，固肾定喘丸>玉屏风胶囊(颗粒)>金水宝胶囊>百令胶囊>苏黄止咳胶囊；②提高第1秒用力呼气容积方面，苏黄止咳胶囊>固肾定喘丸>百令胶囊>玉屏风胶囊(颗粒)>金水宝胶囊；③提高用力肺活量方面，固肾定喘丸>百令胶囊>苏黄止咳胶囊>玉屏风胶囊(颗粒)；④提高第1秒呼吸容积占用力肺活量百分比方面，百令胶囊>苏黄止咳胶囊>玉屏风胶囊(颗粒)>金水宝胶囊>固肾定喘丸；⑤降低急性发作次数方面，百令胶囊优于玉屏风胶囊(颗粒)；⑥安全性方面，5 种口服中成药均未产生严重不良反应。
      结论 5种口服中成药用于治疗稳定期慢性阻塞性肺疾病效果明显、药品安全系数较高、不良反应轻微，但需更多设计严谨的高质量、大样本、多中心的随机对照试验加以验证。

       

      Abstract:
      OBJECTIVE  To systematically evaluate the efficacy and safety of five oral Chinese patent medicines in the treatment of stable chronic obstructive pulmonary disease(COPD).
      METHODS A computer-based search was conducted in 7 databases, including CNKI, Wanfang, VIP, CBM, the Cochrane Library, Embase and Pubmed, to identify randomized controlled trial(RCT) of oral proprietary Chinese medicines in the treatment of stable COPD. Additionally, a self-built database was searched, with all searches covering records up to October 1, 2023. Two reviewers independently selected the trials and evaluated the quality. RevMan 5.3, Stata SE 14 and GeMTC 0.14.3 software were used to extract valid data for network meta-analysis.
      RESULTS A total of 34 controlled clinical trials were included, including 2385 cases, including 1228 cases in the control group and 1157 cases in the experimental group. The network meta-analysis yielded the following results: ① in terms of improving the effective rate, Gushen Dingchuan pill>Yupingfeng capsule(granules)>Jinshuibao capsule>Bailing capsule>Suhuang Zhike capsule; ② in terms of improving forced expiratory volume in one second, Suhuang Zhike capsule>Gushen Dingchuan pill>Bailing capsule>Yupingfeng capsule(granules)>Jinshuibao capsule; ③ in terms of improving forced vital capacity, Gushen Dingchuan pill>Bailing capsule>Suhuang Zhike capsule>Yupingfeng capsule(granules); ④ in terms of improving the percentage of respiratory volume in the first second to forced vital capacity, Baling capsule>Suhuang Zhike capsule>Yupingfeng capsule(granules)>Jinshuibao capsule>Gushen Dingchuan pill; ⑤ Bailing capsule was more effective than Yupingfeng capsule(granules) in reducing the frequency of acute attacks; ⑥ in terms of safety, no serious adverse reactions occurred in the 5 oral proprietary Chinese medicines.
      CONCLUSION The 5 oral Chinese patent medicines have obvious effect in the treatment of stable COPD, with high safety coefficient and mild adverse reactions. However, more high-quality, large-sample, multicenter randomized controlled trials with rigorous design are needed to verify.

       

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