[1]林文璇,陈燕虹,张 军,等.宣白承气汤单独用药及联合用药治疗肺炎痰热壅肺证Meta分析*[J].陕西中医,2020,(6):831-837.[doi:DOI:10.3969/j.issn.10007369.2020.06.037]
 LIN Wenxuan,CHEN Yanhong,ZHANG Jun,et al.Single administration of Xuanbai Chengqi decoction and combined administration for pneumonia with syndrome of phlegm-heat obstructing lung:a Meta-analysis of randomized clinical trials[J].,2020,(6):831-837.[doi:DOI:10.3969/j.issn.10007369.2020.06.037]
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宣白承气汤单独用药及联合用药治疗肺炎痰热壅肺证Meta分析*
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2020年6期
页码:
831-837
栏目:
Meta分析
出版日期:
2020-06-01

文章信息/Info

Title:
Single administration of Xuanbai Chengqi decoction and combined administration for pneumonia with syndrome of phlegm-heat obstructing lung:a Meta-analysis of randomized clinical trials
作者:
林文璇1陈燕虹1张 军2陈伯钧2李 健2△
1.广州中医药大学第二临床医学院(广州 510405); 2.广东省中医院(广州 510120)
Author(s):
LIN WenxuanCHEN YanhongZHANG Junet al.
The Second Clinical College,Guangzhou University of Chinese Medicine(Guangzhou 510405)
关键词:
宣白承气汤 肺肠同治 肺炎 痰热壅肺 随机对照研究 系统评价
Keywords:
Xuanbai Chengqi decoction Simultaneous treatment of lung and intestine Pneumonia Syndrome of phlegm-heat obstructing lung Randomized control System evaluation
分类号:
R563.1
DOI:
DOI:10.3969/j.issn.10007369.2020.06.037
文献标志码:
A
摘要:
目的:系统评价宣白承气汤单用及联合用药治疗肺炎痰热壅肺证的临床疗效。方法:检索CNKI、万方、CBM、PubMed等数据库,筛选宣白承气汤治疗肺炎的随机对照试验(RCT),运用Cochrane协作网偏倚风险评价工具进行文献质量评价,使用Revman 5.3 软件进行Meta分析。结果:最终纳入16项研究,共1393例患者,纳入文献质量不高。Meta分析结果表明,与单纯西医治疗相比,使用宣白承气汤可明显提高肺炎痰热壅肺证的临床总有效率[RR=1.29,95%,CI(1.22,1.36),P<0.00001],且亚组分析显示单用或联用宣白承气汤的组间差异无统计学意义; 可明显改善APACHE II评分、CPIS评分,明显降低炎症因子水平,改善中医证候积分。结论:宣白承气汤可有效治疗肺炎痰热壅肺证,但鉴于纳入临床研究在质量上存在一定局限性,得出的阳性结果仅作为临床诊疗的提示与参考,急需开展更多的高质量大规模的RCT来进一步验证。
Abstract:
Objective:To systematically evaluate the efficacy of single administration of Xuanbai Chengqi decoction and combined administration in treatment of pneumonia with syndrome of phlegm-heat obstructing lung.Methods:CNKI、Wanfang、CBM、PubMed were searched for randomized controlled trials of Xuanbai Chengqi decoction in treatment of pneumonia.Cochrane collaboration network was used to evaluate the quality of included studies and RevMan 5.3 to Meta-analysis.Results:A total of 16 studies involving 1393 patients were eventually included and the quality of these literature was generally low.Meta-analysis results showed that compared with western routine treatment,Xuanbai Chengqi decoction can significantly improve total clinic efficacy of pneumonia(phlegm-heat obstructing lung syndrome)[RR=1.29,95%,CI(1.22,1.36),P<0.00001],as well as the subgroup analysis showed there have little difference about the efficacy between single administration and combined administration of it; decrease APACHE II scores、CPIS score; reduce the levels of inflammatory factors and make TCM syndrome score lower.Conclusion:Xuanbai Chengqi decoction can effectively treat pneumonia(obstruction of phlegm and heat with lung obstruction),however,due to some limitations in the quality of the included clinical studies,the positive results obtained are only used as a hint and reference for clinical diagnosis and treatment.Therefore,it is urgent to carry out more high-quality large-scale RCT to further verify.

参考文献/References:

[1] 官旭华,Benjamin JS,Aaron TF,等.中国大陆肺炎发病率与死亡率:1985-2008年中英文文献的系统分析[J].公共卫生与预防医学,2011,22(1):14-19.
[2] 赵春江,张菲菲,王占伟,等.2012年中国成人社区获得性呼吸道感染主要致病菌耐药性的多中心研究[J].中国结核和呼吸杂志,2015,38(1):18-22.
[3] 李晓明,汪丽珠,龚国富.成人社区获得性肺炎中肺炎支原体的耐药性探讨[J].临床内科杂志,2014,31(2):113-115.
[4] 刘又宁,陈民钧,赵铁梅,等.中国城市成人社区获得性肺炎665例病原学多中心调查[J].中华结核和呼吸杂志,2006,29(1):7-12.
[5] 徐红日,王 兰,张立山,等.老年耐药菌肺炎的中医证型演变规律研究[J].中国中医急症,2011,20(10):38-41.
[6] 陈海襄,朱维娜,隆红艳.重症肺炎患者病原菌与证型关系的回顾性研究[J].中国中医急症,2015,24(11):84-85,89.
[7] 吴孟珊,谭勇文,黄东晖.肺肠同治法治疗慢性阻塞性肺疾病急性加重期临床随机试验的Meta分析[J].中国中医急症,2019,28(8):1335-1338.
[8] 牛逸群,王珏云,李得民,等.宣白承气汤联合西医常规治疗慢性阻塞性肺疾病急性加重期系统评价[J].中国中医药信息杂志,2019,26(10):85-90.
[9] 刘德智,周 霞,高尚兰.清肺承气汤辅助治疗重症肺炎痰热壅肺证临床分析[J].中国实验方剂学杂志,2016,22(8):199-203.
[10] 陈 颖.宣白承气汤加减对痰热壅肺型重症肺炎的效果观察[J].现代养生,2017,10(5):96.
[11] 游 芳.宣白承气汤加减治疗痰热壅肺型重症肺炎的临床疗效及肺部感染率评价[J].养生保健指南,2018(34):358.
[12] 肖 平.宣白承气汤治疗老年肺炎痰热壅肺证效果评价[J].饮食保健,2018,45(5):99-100.
[13] 李 剑,薛城敬.宣白承气汤加减治疗痰热壅肺型重症肺炎的临床观察[J].光明中医,2018,33(4):80-82.
[14] 仝 倩.中西医结合治疗重症肺炎痰热壅肺型临床观察[J].实用中医药杂志,2018,34(2):66-67.
[15] 张 琼,钱义明.宣白承气汤治疗老年社区获得性肺炎痰热壅肺型的临床观察[J].河北中医,2018,40(9):1316-1325.
[16] 赵兴峰.宣白承气汤加减联合西医常规治疗痰热壅肺型重症肺炎的 临床疗效及对炎症因子白细胞介素 6、超敏 C 反应蛋白、 肿瘤坏死因子 α 水平的影响[J].河北中医,2018,40(4):79-82.
[17] 周国栋.宣白承气汤加减治疗痰热壅肺型重症肺炎的临床效果分析[J].系统医学,2018,3(12):24-26.
[18] 刘 爽.宣白承气汤加减治疗痰热壅肺型重症肺炎的效果分析[J].中国医药指南,2019,17(9):175-176.
[19] 谢 磊.宣白承气汤治疗痰热壅肺型肺炎的疗效探究[J].当代医药论丛,2018,17(11):209-210.
[20] 佟旭光.宣白承气汤加减联合西医对痰热壅肺型重症肺炎的临床疗效[J].名医,2019(1):236.
[21] 卢文韬.宣白承气汤加减治疗痰热壅肺型重症肺炎的临床疗效观察[J].数理医药学杂志,2019,20(4):106-107.
[22] 郑伟旭.宣白承气汤加减治疗痰热壅肺型重症肺炎的临床效果分析[J].名医,2019(6):224.
[23] 邓声财,陈小安,郭贵州.中西医结合治疗痰热壅肺型重症肺炎的效果[J].中国当代医药,2019,26(23):146-148.
[24] 王艳军.中西医联合治疗老年肺炎痰热壅肺证的临床效果及对肺功能的影响[J].临床医学研究与实践,2019(26):152-153.
[25] 海东虎.大黄的研究进展[J].世界最新医学信息文摘,2019,19(5):196-197.
[26] 朱起之,赵树进.知母皂甙对糖皮质激素副作用的影响[J].实用医学杂志,2001,20(7):583-584.
[27] Lu WQ,Qiu Y,Li TJ,et al.Timosaponin B-II inhibits proinflammatory cytokine induction by lipopolysaccharide in BV2 cells[J].Arch Pharm Res,2009,32(9):1301-1308.
[28] Kim JY,Shin JS,Ryu JH,et al.Anti-inflammatory effect of anemarsaponin B isolated from the rhizomes of anemarrhena asphodeloides in LPS-induced RAW 264.7 macrophages is mediated by negative regulation of the nuclear factor-κB and p38 pathways[J].Food Chem Toxicol,2009,47(7):1610-1617.
[29] 杨国辉,魏丽娟,王德功,等.中药苦杏仁的药理研究进展[J].中兽医学杂志,2017,30(4):75-76.
[30] 卢鹏飞,施伟丽,王志国,等.瓜蒌皮的临床应用及作用机制[J].中医杂志,2013,54(16):1428-1431.
[31] 皮秀国.大承气汤通腑泄浊治肺炎[J].北方药学,2012,9(4):11.
[32] 宋治荣,赵 珺.大承气汤的药理机制探讨[J].航空航天医学杂志,2013,24(2):218-219.
[33] 苏中昊,杨爱东,王利霞,等.宣白承气汤对急性肺损伤大鼠肺组织CD14和NF-κB mRNA表达的影响[J].中国实验方剂学杂志,2012,18(5):131-134.
[34] 全贞雪,钟相根,李宇航,等.“通利大肠”对COPD大鼠气道重构的影响[J].中国实验方剂学杂志,2012,38(19):167-171.
[35] Yang H,Qu W,Fang F,et al. Gut-lung axis:the microbial contributions and clinical implications[J].Critical Reviews in Microbiology,2017,43(1):102-106.
[36] 马 敬,张 涛,马 珂.头孢哌酮舒巴坦联合替加环素治疗多重耐药/泛耐药鲍曼不动杆菌肺炎的Meta分析[J].西北国防医学杂志,2019,40(6):371-377.
[37] 李国英,陈 良,刘 军.抗生素联合热毒宁治疗儿童社区获得性肺炎的系统评价和Meta分析[J].新疆医科大学学报,2020,43(3):349-353,359.
[38] 董艳彬,张希龙,茆丽娜.大剂量氨溴索联合纤维支气管镜灌洗吸痰治疗老年重症肺炎疗效的Meta分析[J].江苏医药,2019,45(5):444-449.

备注/Memo

备注/Memo:
*广东省科技计划项目(2017B030314176);广东省中医药局科技项目(20181117);广东省中医院中医药科学技术研究专项(YN2014PJR203)
更新日期/Last Update: 2020-06-09