| 引用本文:叶东珂1，李素云2，杨建雅2，李宁1，姚富科1.痰热清注射液治疗慢性阻塞性肺疾病合并呼吸衰竭的系统评价[J].世界中医药,2024,(05):. |
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| 痰热清注射液治疗慢性阻塞性肺疾病合并呼吸衰竭的系统评价 |
| Application of Tanreqing Injection in Treating Chronic Obstructive Pulmonary Disease Combined with Respiratory Failure：A Systematic Review |
| 投稿时间：2022-10-15 |
| DOI：10.3969/j.issn.1673-7202.2024.05.006 |
| 中文关键词: 慢性阻塞性肺疾病急性加重 呼吸衰竭 痰热清注射液 动脉血气 系统评价 Meta分析 |
| English Keywords:Acute exacerbation of chronic obstructive pulmonary disease Respiratory failure Tanreqing Injection Arterial blood gas Systematic review Meta-analysis |
| 基金项目:国家重点研发计划项目（2018YFC1704800）——慢性阻塞性肺疾病（稳定期-急性加重期-慢性呼衰）中医药治疗方案优化及循证评价研究；中医药传承与创新“百千万”人才工程（岐黄学者）项目（国中医药人教函〔2018〕284号）；河南省中医药科学研究专项课题2019JDZX2035）——慢性阻塞性肺疾病稳定期中医临床研究核心结局指标集的建立 |
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| 中文摘要: |
| 目的：对痰热清注射液应用于慢性阻塞性肺疾病伴呼吸衰竭的有效性及安全性做出系统评价和Meta分析。方法：检索国家知识基础设施数据库（CNKI）、中国生物医学文献数据库（CBM）、中国学术期刊数据库（CSPD）及中文科技期刊数据库（CCD）、PubMed、Cochrane Library、Web of Science、Embase医学文献数据库，筛选出痰热清注射液治疗慢性阻塞性肺疾病伴呼吸衰竭的随机对照试验，使用RevMan 5.4软件对纳入研究进行系统评价和Meta分析，并使用GRADE评价系统对结局指标质量进行分级。结果：本研究纳入13项临床研究，共1 007例患者，观察组505例，对照组502例；痰热清注射液联合西医常规-治疗慢阻肺伴呼吸衰竭患者，在临床总有效率（OR=3.52,95%CI为2.35~5.27,P<0.000 01）、动脉血气pH值（MD=0.04,95%CI为0.02~0.05,P<0.000 01）、氧分压（MD=7.86,95%CI为7.24~8.48,P<0.000 01）、二氧化碳分压（MD=-6.85,95%CI为-8.99~-4.77,P<0.000 01）、肿瘤坏死因子（TNF-α）（SMD=-2.56,95%CI为-4.11~-1.01,P<0.01）方面，联合痰热清注射液的观察组与对照组比较，差异有统计学意义（P<0.01）；GRADE证据分级提示，GRADE证据分级结果提示，总有效率、动脉血气pH值、动脉血气氧分压、动脉血气二氧化碳分压为低级质量证据，肿瘤坏死因子-α（TNF-α）为极低质量证据。结论：西医常规结合痰热清注射液治疗慢阻肺合并呼吸衰竭可以提高临床治疗总有效率，改善低氧血症和（或）二氧化碳潴留，减轻炎症状况，安全性较好，值得推广应用。 |
| English Summary: |
| To perform a systematic review and meta-analysis on the efficacy and safety of Tanreqing Injection in treating chronic obstructive pulmonary disease(COPD) combined with respiratory failure.Methods:China National Knowledge Infrastructure，China Biology Medicine，China Science Periodical Database，Chinese Citation Database，PubMed，Cochrane Library，Web of Science，and Embase were searched for the randomized controlled trials(RCTs) of Tanreqing Injection in the treatment of COPD combined with respiratory failure.RevMan 5.4 was used for the systematic review and meta-analysis of the included studies，and the Grading of Recommendations Assessment，Development and Evaluation(GRADE) system was used to estimate the quality of outcome indicators.Results:Thirteen clinical studies were included in this study，involving a total of 1 007 patients(505 in the observation group and 502 in the control group).In the treatment of COPD patients with respiratory failure，Tanreqing Injection combined with conventional Western medicine showed significant differences compared with the control group in terms of the total response rate(OR=3.52，95%CI 2.35 to 5.27，P<0.000 01)，arterial pH(MD=0.04，95%CI 0.02 to 0.05，P<0.000 01)，arterial partial pressure of oxygen(MD=7.86，95%CI 7.24 to 8.48，P<0.000 01)，arterial partial pressure of carbon dioxide(MD=-6.85，95%CI -8.99 to -4.77，P<0.000 01)，and tumor necrosis factor-α(TNF-α)(SMD=-2.56，95%CI -4.11 to -1.01，P<0.01).GRADE evidence indicated that the total response rate，arterial pH，arterial partial pressure of oxygen，and arterial partial pressure of carbon dioxide were low-quality evidence，and TNF-α was the evidence of extremely low quality.Conclusion:Conventional Western medicine combined with Tanreqing Injection improves the total response rate，reduces hypoxemia or/and carbon dioxide retention，and alleviates inflammation in the treatment of COPD combined with respiratory failure，with good safety，being worthy of promotion and application. |
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