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·循证药学·
灯盏花素注射液联合常规治疗用于AECOPD有效性和安全性的
Meta分析 Δ
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程 莎 ,何海艳 ,肖 创 ,翁稚颖 ,陈 晨 ,曾德优 ,杨为民 (1.昆明医科大学药学院暨云南省天然药物药
理重点实验室,昆明 650500;2.昭通市天麻研究院,云南 昭通 657000)
中图分类号 R563 文献标志码 A 文章编号 1001-0408(2020)08-0997-06
DOI 10.6039/j.issn.1001-0408.2020.08.18
摘 要 目的:系统评价灯盏花素注射液联合常规治疗用于慢性阻塞性肺疾病急性加重期(AECOPD)的疗效和安全性,为临床用
药提供循证参考。方法:计算机检索Cochrane图书馆、PubMed、Embase、中国生物医学文献数据库、中国知网、维普数据库和万方
数字化期刊全文数据库,收集灯盏花素注射液联合常规治疗(试验组)对比常规治疗(对照组)用于 AECOPD 的随机对照试验
(RCT)。筛选文献、提取资料并按改良Jadad量表评价文献质量后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入19项
RCT,合计1 930例患者。Meta分析结果显示,试验组患者总有效率[OR=2.80,95%CI(1.96,4.01),P<0.000 01]、第1秒用力呼气
容积(FEV1)[MD=0.65,95%CI(0.57,0.72),P<0.000 01]、FEV1占预计值百分比[MD=5.33,95%CI(0.31,10.35),P=0.04]、用力
肺活量(FVC)[MD=0.69,95%CI(0.23,1.16),P=0.004]、FEV1/FVC 比值[MD=4.83,95%CI(0.98,8.67),P=0.01]、呼气峰流
+
速[MD=0.95,95%CI(0.57,1.33),P<0.001]、氧分压[MD=4.70,95%CI(2.02,7.37),P<0.001]、CD3 水平[MD=5.11,95%CI
(3.04,7.18),P<0.001]、CD4 水平[MD=2.62,95%CI(1.78,3.47),P<0.001]均显著高于对照组,二氧化碳分压[MD=-3.33,
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95%CI(- 5.02,- 1.65),P<0.001]、CD8 水 平 [MD=- 2.55,95% CI(- 4.28,- 0.82),P<0.004]、咳 嗽 缓 解 时 间 [MD=
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- 1.93,95% CI(-2.24,-1.63),P<0.001]、咳痰缓解时间[MD=-2.19,95%CI(-2.48,-1.89),P<0.001]、哮鸣音缓解时
间[MD=-1.59,95%CI(-1.86,-1.32),P<0.001]、住院时间[MD=-1.73,95%CI(-2.06,-1.39),P<0.001]均显著低于或
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短于对照组,两组患者 CD4 /CD8 比值比较,差异无统计学意义[MD=-0.11,95%CI(-0.23,0.01),P=0.06]。安全性方面,有3
项研究报告了不良反应发生情况,均未见严重不良反应发生。结论:灯盏花素注射液可提高AECOPD患者疗效、改善肺功能、增
强免疫力,且安全性较高。
关键词 灯盏花素注射液;慢性阻塞性肺疾病;急性加重;Meta分析;肺功能;免疫力;疗效;安全性
Efficacy and Safety of Breviscapine Injection Combined with Routine Treatment of AECOPD: A
Meta-analysis
CHENG Sha ,HE Haiyan ,XIAO Chuang ,WENG Zhiying ,CHEN Chen ,ZENG Deyou ,YANG Weimin(1.
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School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products,Kunming
Medical University,Kunming 650500,China;2. Zhaotong Institute of Gastrodia Elata,Yunnan Zhaotong
657000,China)
ABSTRACT OBJECTIVE:To systematically evaluate therapeutic efficacy and safety of Breviscapine injection combined with
routine treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to provide evidence-based
reference for clinical drug use. METHODS:Retrieved from Cochrane Library,PubMed,Embase,CBMdisc,CNKI,VIP and
Wanfang database,randomized controlled trials(RCTs)about Breviscapine injection combined with routine treatment(trial group)
versus routine treatment(control group)in the treatment of AECOPD were collected. After literature screening and data extraction,
the qualities of literatures were evaluated with modified Jadad scale;Meta-analysis was performed by using Rev Man 5.2 statistical
software. RESULTS:A total of 19 RCTs were included,involving 1 930 patients. Results of Meta-analysis showed that total
response rate [OR=2.80,95% CI (1.96,4.01),P<0.000 01],FEV1[MD=0.65,95% CI(0.57,0.72),P<0.000 01],
FEV1%[MD=5.33,95%CI(0.31,10.35), P=0.04],FVC[MD=0.69,95%CI(0.23,1.16),P=0.004], FEV1/FVC [MD=
4.83,95%CI(0.98,8.67),P=0.01],PEF [MD=0.95,95%CI
Δ 基 金 项 目 :国 家 自 然 科 学 基 金 资 助 项 目(No.81870037,
(0.57,1.33),P<0.001],PaO2 [MD=4.70,95% CI(2.02,
No.81402991)
7.37),P<0.001],CD3 + level [MD=5.11,95% CI(3.04,
*硕士研究生。研究方向:呼吸系统药理学。E-mail:1589894559@
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7.18),P<0.001] and CD4 level [MD=2.62,95%CI(1.78,
qq.com
# 通信作者:研究员,博士,博士生导师。研究方向:慢性阻塞性 3.47),P<0.001] of trial group were significantly higher than
肺疾病药物研发。电话:0871-6532746。E-mail:ywmbessie@yeah.net those of control group;PaCO 2 [MD=-3.33,95%CI(-5.02,
中国药房 2020年第31卷第8期 China Pharmacy 2020 Vol. 31 No. 8 ·997 ·