|
|
舒利迭联合苏黄止咳胶囊治疗咳嗽变异性哮喘疗效的Meta分析
|
Abstract:
目的：对舒利迭(沙美特罗替卡松)联合苏黄止咳胶囊治疗咳嗽变异性哮喘的临床案例进行分析，从而来评价其临床疗效。方法：利用万方数据库(WanFang Data)、中国知网(CNKI)及PubMed，搜索有关舒利迭联合苏黄止咳胶囊治疗咳嗽变异性哮喘临床疗效的研究。用质量评价工具对选择的文献进行评价及RevMan5.4软件进行Meta分析。结果：总共有13项随机对照试验被纳入，包括993例患者。研究结果显示：舒利迭联合苏黄止咳胶囊治疗咳嗽变异性哮喘的有效率[RR = 1.21, 95%CI (1.12, 1.29), P < 0.00001]、FEV1[MD = 0.27, 95%CI (0.20, 0.34), P < 0.00001]、FEV1/FVC [MD = 9.22, 95%CI (7.71, 10.73), P ≤ 0.00001]均高于对照组，有明显的统计学差异。试验组日间咳嗽症状积分[MD = ？0.08, 95%CI (？0.12, ？0.03), P = 0.0007]、夜间咳嗽症状积分[MD = ？0.05, 95%CI (？0.10, ？0.01), P = 0.02]、诱导痰EOS百分比[MD = ？2.41, 95%CI (？2.58, ？2.25), P < 0.00001]、TNF-a [MD = ？1.68, 95%CI (？2.35, ？1.01), P < 0.00001]、IL-6 [MD = ？6.09, 95%CI (？9.33, ？2.85), P = 0.0002]均低于对照组，具有统计学差异。结论：舒利迭联合苏黄止咳胶囊治疗咳嗽变异性哮喘，具有肯定的治疗效果。
Objective: The clinical cases of seretide (salmeterol ticasone) combined with Suhuang cough capsule in the treatment of cough variant asthma were analyzed to evaluate its clinical efficacy. Methods: WanFang Data, CNKI and PubMed were used to search for studies on the clinical efficacy of seretide combined with Suhuang cough capsule in the treatment of cough-variant asthma. The selected lit-eratures were evaluated with quality evaluation tools and meta-analysis was conducted with RevMan5.4 software. Results: Ultimately, 13 RCTS met the inclusion criteria, with a total of 993 pa-tients. The results indicated that the effective rates of seretide combined with Suhuang cough cap-sule in the treatment of cough variant asthma [RR = 1.21, 95%CI (1.12, 1.29), P < 0.00001], FEV1 [MD = 0.27, 95%CI (0.20, 0.34), P < 0.00001], FEV1/FVC [MD = 9.22, 95%CI (7.71, 10.73), P ≤ 0.00001] were higher than those of the control group, with significant statistical differences. The scores of daytime cough symptoms [MD = ？0.08, 95%CI (？0.12, ？0.03), P = 0.0007], nighttime cough symptoms [MD = ？0.05, 95%CI (？0.10, ？0.01), P = 0.02], induced sputum EOS percentage [MD = ？2.41, 95%CI (？2.58, ？2.25), P < 0.00001], TNF-a [MD = ？1.68, 95%CI (？2.35, ？1.01), P < 0.00001] and IL-6 [MD = ？6.09, 95%CI (？9.33, ？2.85), P = 0.0002] in the experimental group were all lower than those in the control group, and the differences were statistically significant. Conclu-sion: Seretide combined with Suhuang cough capsule in the treatment of cough variant asthma has a positive therapeutic effect.
| [1] | Corrao, W.M., Braman, S.S. and Irwin, R.S. (1979) Chronic Cough as the Sole Presenting Manifestation of Bronchial Asthma. The New England Journal of Medicine, 300, 633-637. https://doi.org/10.1056/NEJM197903223001201 |
| [2] | Corrao, W.M. (2018) Pearls and Pitfalls in the Diagnosis of Cough Variant Asthma. Allergy & Asthma Proceedings, 39, 466-467. https://doi.org/10.2500/aap.2018.39.4168 |
| [3] | Jiang, G., Huang, X., Li, T. and Xu, D. (2016) Chronic Cough: Clinical Characteristics and Etiologies of 510 Cases. Turkish Journal of Medical Sciences, 46, 1734-1739. https://doi.org/10.3906/sag-1508-133 |
| [4] | Gu, C., Peng, W., Wang, Z., Xu, Y., Han, D. and Zhou, X. (2020) Su-huang Zhike Capsules for the Treatment of Cough Variant Asthma: A Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2020, Article ID: 9485746.
https://doi.org/10.1155/2020/9485746 |
| [5] | Dicpinigaitis, P.V. (2006) Chronic Cough Due to Asthma: ACCP Evi-dence-Based Clinical Practice Guidelines. Chest, 129, 75S-79S. https://doi.org/10.1378/chest.129.1_suppl.75S |
| [6] | Chinese Toracic Society Asthma Consortium (2016) Diagnosis and Treatment Guidelines for Cough (2015). Chinese Journal of Tuberculosis and Respiratory Diseases, 39, 323-354. |
| [7] | 韩佳颖, 王真, 徐凯丽. 苏黄止咳胶囊治疗感冒后咳嗽的Meta分析[J]. 中国现代应用药学, 2016, 33(10): 1328-1333. |
| [8] | 中华医学会呼吸病学分会哮喘学组. 咳嗽的诊断与治疗指南(2015) [J]. 中华结核和呼吸杂志, 2016, 39(5): 323-354. |
| [9] | Saraiva-Romanholo, B.M., Barnabé, V., Carvalho, A.L., Martins, M.A., Saldiva, P.H. and Nunes Mdo, P. (2003) Comparison of Three Methods for Differential Cell Count in Induced Sputum. Chest, 124, 1060-1066.
https://doi.org/10.1378/chest.124.3.1060 |
| [10] | 刘铭. 系统评价、Meta-分析设计与实施方法[M]. 北京: 人民卫生出版社, 2011: 69-71. |
| [11] | 张玉斗, 袁霞. 复方甲氧那明胶囊治疗呼吸道感染后咳嗽的效果Meta分析[J]. 中国当代医药, 2020, 27(16): 7-10. |
| [12] | 陈慧芬, 谢艳萍, 辅桓钦, 姚伟. 苏黄止咳胶囊联合沙美特罗/丙酸氟替卡松治疗咳嗽变异性哮喘的临床观察[J]. 中国医药导报, 2018(9): 105-108. |
| [13] | 欧阳晓平, 吴峰, 顾扬, 陶玉坚, 黄玉民. 沙美特罗替卡松联合苏黄止咳胶囊治疗咳嗽变异性哮喘疗效观察[J]. 临床肺科杂志, 2013(2): 257-258. |
| [14] | 任先杰, 廖德英, 陈东. 苏黄止咳胶囊辅助治疗咳嗽变异性哮喘的临床疗效[J]. 临床合理用药杂志, 2015, 8(33): 127-128. |
| [15] | 叶锋, 方雨龙. 苏黄止咳胶囊联合沙美特罗/丙酸替卡松治疗咳嗽变异性哮喘的临床观察[J]. 临床医药文献电子杂志, 2018, 5(26): 31-32. |
| [16] | 任程, 李洁, 冉方兰, 卢安静, 王钢. 苏黄止咳胶囊联合舒利迭对咳嗽变异性哮喘患者肺功能、免疫功能及诱导痰炎性介质的影响[J]. 现代生物医学进展, 2020, 20(17): 3363-3366+3353. |
| [17] | 朱迎霞, 李金润. 苏黄止咳胶囊联合西药治疗咳嗽变异型哮喘25例临床观察[J]. 云南中医中药杂志, 2013, 34(3): 23-24+89. |
| [18] | 王宁, 霍晓颖, 陈葆青, 王婷, 杨岚. 苏黄止咳胶囊联合舒利迭对咳嗽变异性哮喘患者血清TNF-α TGF-β_1和IgE水平的影响[J]. 河北医学, 2018, 24(5): 718-722. |
| [19] | 李静杰, 王群, 范伟杰. 西药联合苏黄止咳胶囊治疗成人咳嗽变异性哮喘临床研究[J]. 新中医, 2019, 51(1): 125-128. |
| [20] | 郑兰芝, 蒋旭宏, 丁黎敏, 陆如凤. 苏黄止咳胶囊联合舒利迭治疗咳嗽变异性哮喘临床观察[J]. 中国中医急症, 2014, 23(8): 1548-1549. |
| [21] | 郑伟伟. 苏黄止咳胶囊辅助治疗咳嗽变异性哮喘的疗效研究[J]. 中国社区医师, 2019(3): 120. |
| [22] | 郑玉晶, 冯洁. 苏黄止咳胶囊配合治疗咳嗽变异性哮喘的临床效果分析[J]. 健康必读, 2019(15): 83. |
| [23] | 周洋, 张家洪. 苏黄止咳胶囊联合沙美特罗/丙酸氟替卡松对咳嗽变异性哮喘患者气道炎症的影响[J]. 实用医学杂志, 2016, 32(2): 298-299. |
| [24] | 车玲艳, 刘建红, 樊延平. 苏黄止咳胶囊联合沙美特罗替卡松对咳嗽变异性哮喘患者疗效及对肺功能指标的影响[J]. 山西医药杂志, 2020(23): 3303-3305. |
| [25] | Tagaya, E., Kondo, M., Kirishi, S., Kawagoe, M., Kubota, N. and Tamaoki, J. (2015) Effects of Regu-lar Treatment with Combination of Salmeterol/Fluticasone Propionate and Salmeterol Alone in Cough Variant Asthma. Journal of Asthma, 52, 512-518. https://doi.org/10.3109/02770903.2014.975358 |
| [26] | Mansfield, L., Yiu, G., Sa-kov, A., et al. (2017) A 6-Month Safety and Efficacy Study of Fluticasone Propionate and Fluticasone Propio-nate/Salmeterol Multidose Dry Powder Inhalers in Persistent Asthma. Allergy and Asthma Proceeding, 38, 264-276. https://doi.org/10.2500/aap.2017.38.4061 |
| [27] | Yoshihara, S., Tsubaki, T., Ikeda, M., et al. (2019) The Efficacy and Safety of Fluticasone/Salmeterol Compared to Fluticasone in Children Younger than Four Years of Age. Pediatric Aller-gy and Immunology, 30, 195-203.
https://doi.org/10.1111/pai.13010 |
| [28] | Hatziagorou, E., Kouroukli, E., Galogavrou, M., et al. (2019) Efficacy and Safety of the Combination Fluticasone Propionate plus Salmeterol in Asthmatic Preschoolers: An Observational Study. Journal of Asthma, 56, 573-580.
https://doi.org/10.1080/02770903.2018.1474923 |
| [29] | 熊宁, 彭志群, 吴金飞, 王强, 陈传琳, 吴珊燕. 苏黄止咳胶囊治疗咳嗽变异性哮喘的有效性研究[J]. 中国医药, 2013, 8(8): 1071-1072. |
| [30] | 陈利玲, 唐燕, 黎晓莉. 苏黄止咳胶囊治疗咳嗽变异性哮喘的疗效及对患者诱导痰中炎性介质的影响[J]. 河北医学, 2015, 21(10): 1602-1605. |
