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    冬虫夏草制剂治疗慢性阻塞性肺疾病稳定期的网状meta分析

    Network Meta-analysis of Cordyceps Sinensis Preparations for the Treatment of Stable Chronic Obstructive Pulmonary Disease

      摘要
    • 摘要:
      目的 系统评价冬虫夏草制剂治疗慢性阻塞性肺疾病稳定期的临床疗效和安全性。
      方法 计算机检索PubMed、VIP、CNKI、CMB及Wanfang数据库收录的从2015年1月1日至2025年10月1日的文献，收集有关冬虫夏草制剂治疗慢性阻塞性肺疾病稳定期的随机对照试验。按照Cochrane系统评价方法，由2名研究者独立筛选文献、提取资料和评价研究质量，评价员对最后结果进行交叉核对，而后采用Stata MP 18.0软件进行网状meta分析。
      结果 共纳入35个临床随机对照试验，病例3710例，其中试验组1857例，对照组1853例。网状meta分析结果显示：①在提高临床疗效方面，百令片>金水宝胶囊>百令胶囊；②在改善第1秒用力肺活量(forced expiratory volume in the first second，FEV1)方面，百令胶囊>金水宝胶囊；③在改善第1秒用力呼气量占预计值的百分比(FEV1%)方面，金水宝胶囊>百令胶囊>百令片；④在改善用力肺活量(forced vital capacity，FVC)方面，百令片>金水宝胶囊>百令胶囊；⑤在改善FEV1/FVC方面，百令胶囊>百令片>金水宝胶囊；⑥在安全性方面，7篇文献报告了不良反应，主要涉及消化系统、神经系统、皮肤系统、泌尿系统、内分泌系统、心血管系统，所有报道均未发生严重不良反应。
      结论 冬虫夏草制剂联合西医常规治疗慢性阻塞性肺疾病稳定期可提高临床疗效，改善肺功能指标FEV1、FEV1%、FVC及FEV1/FVC。但由于纳入研究的局限性，缺少不同干预措施之间的直接比较，因此仍然需要进行更多高质量、多中心、大样本的临床随机对照研究，以便更客观、全面、正确地评价其疗效。

       

      Abstract:
      OBJECTIVE To systematically evaluate the clinical efficacy and safety of Cordyceps sinensis preparations in the treatment of stable chronic obstructive pulmonary disease.
      METHODS Computerized search was conducted in PubMed, VIP, CNKI, CMB and Wanfang databases from January 1, 2015 to October 1, 2025. Randomized controlled trials on the treatment of stable chronic obstructive pulmonary disease with Cordyceps sinensis preparations were collected. Two researchers independently screened the literature, extracted the data and evaluated the quality of the studies according to the Cochrane systematic review method. The evaluators cross-checked the final results, and then a network meta-analysis was conducted using Stata MP 18.0 software.
      RESULTS A total of 35 clinical randomized controlled trials were included, involving 3710 cases, with 1857 cases in the experimental group and 1853 cases in the control group. The results of the network meta-analysis showed that: ①In terms of improving clinical efficacy, Bailing tablets > Jinshuibao capsules >Bailing capsules; ②In terms of improving forced expiratory volume in the first second(FEV1), Bailing capsules > Jinshuibao capsules; ③In terms of improving the percentage of forced expiratory volume in the first second(FEV1%) of the predicted value, Jinshuibao capsules > Baling capsules > Bailing tablets; ④In terms of improving forced vital capacity(FVC), Bailing tablets > Jinshuibao capsules > Bailing capsules; ⑤In terms of improving FEV1/FVC, Bailing capsules > Bailing tablets > Jinshuibao capsules; ⑥In terms of safety, 7 articles reported adverse reactions, mainly involving the digestive system, nervous system, skin system, urinary system, endocrine system, and cardiovascular system, and no serious adverse reactions occurred.
      CONCLUSION The combination of Cordyceps sinensis preparations and conventional western medicine in the treatment of stable chronic obstructive pulmonary disease can improve clinical efficacy and lung function indicators such as FEV1, FEV1%, FVC and FEV1/FVC. However, due to the limitations of the included studies, there is a lack of direct comparisons between different intervention measures. Therefore, more high-quality, multi-center, large-sample clinical randomized controlled studies are still needed to more objectively, comprehensively and accurately evaluate their efficacy.

       

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