中西药联合治疗痰热壅肺型卒中相关性肺炎的Meta分析

Meta analysis of combined treatment of traditional Chinese medicine and Western medicine on stroke associated pneumonia in phlegm heat obstructing lung type

关键词:  中西药联合  卒中相关性肺炎  Meta 分析

Key words:  combination of Chinese and Western medicine  stroke associated pneumonia  Meta analysis

摘要:

[目的] 系统评价中西药联合治疗痰热壅肺型卒中相关性肺炎的临床疗效。[方法] 计算机检索维普、万方、中国知网、中国医学文献数据库、Cochrane图书馆和PubMed，纳入各数据库从建库至2018年1月治疗痰热壅肺型卒中相关性肺炎的临床对照试验文献，对文献进行筛选、提取数据。使用Cochrane偏倚风险评价工具对符合纳入标准的随机对照研究进行质量评价，并使用软件Revman 5.3进行Meta分析。[结果] 纳入文献10篇，病例755例，其中观察组382例，对照组373例。中西药联合与单纯西药相比，Meta分析结果如下：以总有效率为结局指标，OR=3.84，95%CI（2.37，6.24），Z=5.44，P<0.000 01；以体温恢复至正常范围所需时间为结局指标，MD=-1.37，95%CI（-1.83，-0.90），Z=5.77，P<0.000 01；以白细胞恢复至正常范围所需时间为结局指标，MD=-2.89，95%CI（-4.71，-1.06），Z=3.10（P=0.002）。[结论] 中西药联合治疗痰热壅肺型卒中相关性肺炎具有很好的临床疗效，可增补临床治疗方案。但本次研究仍存在一定的局限性，证据强度有限，仍需进一步的高质量循证研究支持。

Abstract:

[Objective] To systematically evaluate the efficacy of combination of Chinese and Western medicine in the treatment of stroke associated pneumonia due to phlegm heat obstructing the lung. [Methods] The computer retrieved VIP,Wanfang,China knowledge network,CBM,Cochrane library and PubMed,and included the clinical controlled literature on the treatment of phlegm induced pulmonary apoplexy associated pneumonia from database to January 2018. The Cochrane bias risk assessment was used to score the quality of the randomized controlled trials that met the inclusion criteria and Meta analysis was performed using software Revman 5.3. [Results] There were 10 articles and 755 cases,including 382 cases in the observation group and 373 cases in the control group. Compared with western medicine,the results of Meta analysis were as follows:OR=3.84,95%CI (2.37,6.24),Z=5.44,P<0.000 01 with the total effective rate,the time required for the recovery of body temperature to the normal range,MD=-1.37,95%CI (-1.83,-0.90),Z=5.77,P<0.000 01;white blood cells recovered to normal model. The time required was the outcome index,MD=-2.89,95%CI (-4.71,-1.06), Z=3.10 (P=0.002). [Conclusion] The combination of Chinese and Western medicine has significant clinical curative effect in the treatment of stroke associated pneumonia with phlegm heat obstructing lung type,and the clinical treatment plan can be supplemented. However,this study still has some limitations,and the strength of evidence is limited. Further high-quality evidence-based research is still needed.