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| Meta analysis and Grade evaluation of therapeutic effect of acupoint application on chronic obstructive pulmonary disease |
| Hits 380 Download times 311 Received:July 15, 2023 |
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| DOI
10.11656/j.issn.1672-1519.2023.10.13 |
| Key Words
acupoint application;chronic obstructive pulmonary diseases;Meta analysis;Grade evaluation |
| Author Name | Affiliation | | WANG Liangmin | Department of Fever and Respiratory disease, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China | | TANG Ling | Department of Nursing, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China | | SHI Mingjie | Department of Fever and Respiratory disease, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China | | JI Kun | Department of Fever and Respiratory disease, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China | | GUO Shujuan | Beijing University of Chinese Medicine, Beijing 100029, China | | XU Jing | Department of Pharmacy, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China | | BAI Mei | Department of Fever and Respiratory disease, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China | | ZHAO Dandan | Department of Fever and Respiratory disease, Dongfang Hospital Beijing University of Chinese Medicine, Beijing 100078, China |
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| Abstract
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| [Objective] To systematically analyze and evaluate Grade on the clinical efficacy and safety of acupoint application therapy in chronic obstructive pulmonary disease（COPD） by using evidence-based medicine. [Methods] A computer search of Chinese and English databases at home and abroad was conducted to retrieve randomized controlled trials（RCTs） on acupoint application in the treatment of COPD published from the establishment of each database to September 31，2022. Screening was performed by two researchers back-to-back according to the inclusion criteria and exclusion criteria. Review Manager 5.3 software was used for bias risk assessment and Meta-analysis，and Grade system was used for evidence quality evaluation. [Results] A total of 16 references with 1 500 patients were included（751 patients in the treatment group and 749 patients in the control group）. The results of Metaanalysis showed that compared with conventional western medicine，acupoint application was more effective in total response efficiency（TE） [OR=4.68，95%CI（3.36，6.53），P＜0.000 01]，with a superior advantage in increasing the forced expiratory volume in the first second as a percentage of the expected value（FEV1%） [MD=3.04，95%CI（1.76，4.33），P＜0.000 01] and the first-second forced expiratory volume/maximum vital capacity ratio（FEV1/FVC） [MD=2.38，95%CI（0.84，3.92），P=0.002]，improving arterial blood oxygen partial pressure（PaO2）[MD=7.27，95%CI（4.60，9.95），P＜0.000 01] and reducing arterial blood carbon dioxide partial pressure（PaCO2）[MD=-8.68，95%CI（-10.28，-7.09），P＜0.000 01]，and decreasing the St. George’s Respiratory Questionnaire（SGRQ），Respiratory correlation scale（the BODE index and the CAT score） [MD=-7.36，95%CI（-13.22，-1.51），P=0.01；MD=-0.74，95%CI（-0.80，-0.69），P＜0.000 01；MD=-1.92，95%CI（-2.73，-1.10），P＜0.000 01]. Acupoint application could also reduce the number of acute exacerbation [MD=-1.85，95%CI（-2.67，-1.03），P＜0.000 01]，but in a degree increase the incidence of adverse effects [OR=2.89，95%CI（1.57，5.33），P=0.000 7]. There was no differentiation between traditional Chinese medicine syndrome integration groups [MD=-0.87，95%CI（-1.84，0.09），P=0.08]. The Grade evidence classification results showed that three outcome indicators of FEV1/FVC，PaCO2 and the incidence of adverse reactions were moderate quality evidence，four outcome measures which were including in clinical total response rate，FEV1%，CAT score and number of acute exacerbation were the low-quality evidence，four outcome indicators including TCM total syndrome score，PaO2，SGQR score，and BODE index were very low quality evidence. [Conclusion] Acupoint application combined with conventional western medicine in the treatment of COPD has obvious advantages over western medicine treatment alone，but the evidence quality of the included studies is not high，and good-quality research is still needed to provide guidance for clinical practice. |
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