Oral Chinese herbal medicine combined with pharmacotherapy for stable COPD: a systematic review of effect on BODE index and six minute walk test.
Oral Chinese herbal medicine combined with pharmacotherapy for stable COPD: a systematic review of effect on BODE index and six minute walk test.
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DOI：
10.1371/journal.pone.0091830
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Lin L
中科院分区：
文献类型：
--
作者：
Chen X;May B;Di YM;Zhang AL;Lu C;Xue CC;Lin L
本系统评价评估了中草药 (CHM) 联合常规药物治疗 (RP) 对慢性阻塞性肺疾病 (COPD) 稳定期患者客观结果指标 BODE 指数、6 分钟步行测试 (6MWT) 和 6 分钟步行距离 (6MWD) 的影响。检索了六个中英文数据库（PubMed、EMBASE、CENTRAL、CINAHL、CNKI 和 CQVIP）从建库到 2013 年 11 月 18 日止的随机对照试验，涉及口服 CHM 加 RP 与相同 RP 的比较，以 BODE 指数和/或 6MWT/D 作为结果。确定了二十五项研究。 9 项研究使用了 BODE 指数，22 项研究使用了 6MWT/D。使用 Cochrane 偏倚风险工具评估方法学质量。大多数研究都发现了弱点。六项研究被判定为随机序列生成的偏倚风险“低”。荟萃分析中纳入了涉及 1,834 名参与者的 22 项研究。主要荟萃分析结果显示，9 项研究中的 BODE 指数（平均差 [MD] -0.71，95% 置信区间 [CI] -0.94，-0.47）和 17 项研究中的 6MWT/D（MD 54.61 米，95% CI 33.30，75.92）有利于 CHM 加 RP 组。使用的主要植物是黄芪、人参和冬虫夏草。在 16 项研究的 18 种配方中，黄芪与其他草药联合使用。进行了详细的亚组和敏感性分析。多项研究发现 BODE 指数和 6MWT 具有临床意义的益处。这些治疗效果是有希望的，但由于所使用的 CHM 和 RP 的变化以及研究中方法学上的弱点，需要谨慎解释。这些问题应该在未来的试验中得到解决。
This systematic review evaluated the effects of Chinese herbal medicine (CHM) plus routine pharmacotherapy (RP) on the objective outcome measures BODE index, 6-minute walk test (6MWT), and 6-minute walk distance (6MWD) in individuals with stable chronic obstructive pulmonary disease (COPD). Searches were conducted of six English and Chinese databases (PubMed, EMBASE, CENTRAL, CINAHL, CNKI and CQVIP) from their inceptions until 18th November 2013 for randomized controlled trials involving oral administration of CHM plus RP compared to the same RP, with BODE Index and/or 6MWT/D as outcomes. Twenty-five studies were identified. BODE Index was used in nine studies and 6MWT/D was used in 22 studies. Methodological quality was assessed using the Cochrane Risk of Bias tool. Weaknesses were identified in most studies. Six studies were judged as ‘low’ risk of bias for randomisation sequence generation. Twenty-two studies involving 1,834 participants were included in the meta-analyses. The main meta-analysis results showed relative benefits for BODE Index in nine studies (mean difference [MD] −0.71, 95% confidence interval [CI] −0.94, −0.47) and 6MWT/D in 17 studies (MD 54.61 meters, 95%CI 33.30, 75.92) in favour of the CHM plus RP groups. The principal plants used were Astragalus membranaceus, Panax ginseng and Cordyceps sinensis. A. membranaceus was used in combination with other herbs in 18 formulae in 16 studies. Detailed sub-group and sensitivity analyses were conducted. Clinically meaningful benefits for BODE Index and 6MWT were found in multiple studies. These therapeutic effects were promising but need to be interpreted with caution due to variations in the CHMs and RPs used and methodological weakness in the studies. These issues should be addressed in future trials.
DOI：
10.3736/jcim20090202
发表时间：
2009-02-01
期刊：
Zhong xi yi jie he xue bao = Journal of Chinese integrative medicine
影响因子：
--
作者：
Chen, Ning;Li, Hui;Hao, Xiao-Mei
通讯作者：
Hao, Xiao-Mei
影响因子：
158.5
作者：
Celli, BR;Cote, CG;Cabral, HJ
通讯作者：
Cabral, HJ