世界中医药

作者	单位
陈伦1，祁佳1，张宇锋2，江卫龙2	1 上海交通大学医学院附属新华医院药剂科，上海，200092； 2 南京中医药大学附属江阴市中医院呼吸内科，江阴，214400

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中文摘要:

目的：评价黄芪细辛汤治疗咳嗽变异性哮喘临床疗效和安全性。方法：检索11个数据库从建库至2014年8月15日黄芪细辛汤治疗咳嗽变异性哮喘随机对照试验研究，筛选合格研究。应用Cochrane评价员手册进行偏倚风险评价，Jadad评分法进行质量评价。应用RevMan5.3软件进行Meta分析。结果：符合纳入标准的文献共3篇。Meta分析结果显示，黄芪细辛汤治疗咳嗽变异性哮喘治疗组与对照组相比，临床疗效总有效率比值比(Odds Ratio，OR)为3.88，95%可信区间(Confidence Interval，CI)［1.00，15.01］，差异无统计学意义（P=0.05)；气道反应性总有效率OR为4.26，95% CI［1.31，13.83］，差异有统计学意义（P=0.02)；复发率治疗组低于对照组，差异有统计学意义（P<0.05）；未有不良反应报道。结论：黄芪细辛汤治疗咳嗽变异性哮喘临床疗效与对照组比较差异无统计学意义，但仍有一定临床意义。由于本系统评价纳入研究的总体质量较低，研究的数量和样本量均较小，尚需要更多高质量、多中心、大样本、严格设计的随机对试验来进一步验证其疗效与安全性。

English Summary:

To evaluate the clinical efficacy and safety of Astragalus Asarum Decoction in the treatment of cough variant asthma. Methods:Randomized clinical trials (RCTs) of astragalus asarum decoction for cough variant asthma were included from eleven databases (from the inception of each database up to 15 August 2014). Cochrane was used to assess the risk of bias and Jadad rating scale was used to assess quality. The Cochrane Collaborations RevMan5.3 software was used for meta analysis. Results:Three studies were included and being meta analyzed. The results showed that the differences between the control group and the Astragalus Asarum Decoction treatment group were of statistical difference, with the total efficiency rate of clinical curative effect, odds ratio(OR) was 3.88 and 95% confidence interval (CI) ［1.00，15.01］. The total efficiency rate of airway reaction, OR was 4.26 with 95% CI［1.31，13.83］, and the difference was statistically significant (P=0.02). The recurrence rate in treatment group were lower than that of the control group, and the difference has statistical significance. No adverse reaction was reported. Conclusion:Astragalus Asarum Decoction in the treatment of cough variant asthma has no significant clinical curative effect. However, the number of the study, and the study sample size are limited, and the methodological quality is low. To further evaluate the effect and safety of Astragalus Asarum Decoction for the treatment of cough variant asthma, more rationally designed and strictly executed RCTs with large samples are required.

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