黄芪对慢性阻塞性肺疾病疗效的Meta分析

摘要

Objective To assess the efficacy of Astragalus on chronic obstructive pulmonary disease ( COPD ) . Methods The randomized or semi - randomized controlled studies involving treatment of COPD with Astragalus were searched and i-dentified from PubMed, China Academic Journals Full - text database, Chinese Biomedical Literature Database, WanFang Resource Database, Chongqing VIP and Chinese Journal Full - text database. The qualities of literature were evaluated and then the valid data were extracted for Meta - analysis. Results Eventually 6 articles, all in Chinese, including 437 cases of patients ( 220 in experimental group and 217 in control group ) were included, with baseline comparability between groups. Systematic review showed that Astragalus could help COPD patients to improve their lung functions ( FEV,/FVC ) [ WMD =4. 32, 95% CI (2.10, 6.55), P = 0. 0001 ], however, there was no significant improvement in clinical efficacy comparing to the control group [ RR = 1. 18, 95% CI ( 0. 95, 1. 46 ), P =0. 14 ]. Conclusion The Meta - analysis shows that astragalus could improve lung function in COPD patients, but it failed to improve the clinical efficacy. Therefore it needs more forward - looking, large - scale randomized controlled clinical trials to verify.%目的 评价黄芪对慢性阻塞性肺疾病的疗效.方法 计算机检索PubMed、中国学术期刊全文数据库、中国生物医学文献数据库、万方资源数据库、重庆维普网和中国重要会议论文全文数据库并手工检索相关期刊,全面收集黄芪治疗慢性阻塞性肺疾病的随机或半随机对照研究,对选入文献进行质量评价,并提取有效数据进行Meta分析.结果 最终纳入6篇文献,均为中文文献,包括437例患者(试验组220例,对照组217例),各组间具有基线可比性.系统评价结果显示:黄芪能改善慢性阻塞性肺疾病患者肺功能(1 s用力呼气容积/用力肺活量,FEV1/FVC)[WMD=4.32,95%CI(2.10,6.55),P=0.0001],但临床疗效无明显改善[RR=1.18,95%CI(0.95,1.46),P=0.14].结论 Meta分析提示,黄芪能改善慢性阻塞性肺疾病患者的肺功能,未能改善临床疗效.因此,还需要更多前瞻性、大规模的临床随机对照研究加以验证.