{"title":"中药对哮喘患者肺功能的疗效:随机对照试验的系统回顾和荟萃分析。","authors":"Alireza Derakhshan, Masoumeh Sadeghi, Amir-Mohammad-Hashem Asnaashari, Mohsen Dehghani, Roshanak Salari, Majid Khadem-Rezaiyan, Majid Mirsadraee, Shahin Saeidinejat, Shima Jalali, Shabnam Jalali","doi":"10.3831/KPI.2023.26.2.124","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The present study was designed to conduct a comprehensive systematic review and meta-analysis to assess the efficacy of herbal medicines as add-on therapy on lung function in asthmatic patients.</p><p><strong>Methods: </strong>A comprehensive search of online databases was performed up to December 2021 to identify randomized controlled trials that used orally herbal preparations for asthma as add-on therapy. Studies were assessed for methodological quality using the Cochrane Collaboration's Risk of Bias tool. The main outcome was percent predicted value of forced expiratory volume (% predicted FEV1). Pooled weighted mean difference (WMD) estimate with corresponding 95% confidence interval (CI) was calculated using inverse-variance weights method while random effects meta-analysis was used, taking into account clinical and conceptual heterogeneity.</p><p><strong>Results: </strong>As a result, 1,525 studies were identified. 169 studies were reviewed in-depth and 23 studies met our systematic review inclusion criteria. Finally, nine randomized controlled trials were included in the meta-analysis. Findings indicated that use of herbal medicines in patients with asthma significantly improved % predicted FEV1 (WMD 3.73, 95% CI 1.76-5.70), with no evidence for significant heterogeneity (p = 0.56 [Q statistic], I<sup>2</sup> = 0.0%). In subgroup analysis by age, improvement in % predicted FEV1 was higher and significant in adults (WMD 5.16; 95% CI 2.68-7.63) compared to children (WMD = 1.27; 95% CI -1.98-4.51). Sensitivity analysis showed the significant effect of herbal medicine consumption on improving FEV1 was consistently (range of summary WMDs 3.27-4.59), indicating that the meta-analysis model was robust. There was no evidence of publication bias both visually and statistically.</p><p><strong>Conclusion: </strong>Findings support, the complementary use of herbal medicines resulted in significant improvement in the lung function compared to standard treatment in asthmatic patients with no considerable adverse events. 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引用次数: 0
摘要
目的:本研究旨在进行一项全面的系统评价和荟萃分析，以评估草药作为辅助治疗对哮喘患者肺功能的疗效。方法:对截至2021年12月的在线数据库进行全面检索，以确定使用口服草药制剂作为哮喘附加治疗的随机对照试验。使用Cochrane协作的偏倚风险工具评估研究的方法学质量。主要终点为用力呼气量预测值百分比(预测FEV1百分比)。考虑到临床和概念上的异质性，采用反方差权重法计算具有相应95%置信区间(CI)的合并加权平均差(WMD)估计值，同时采用随机效应荟萃分析。结果:1525项研究被确认。169项研究被深入审查，23项研究符合我们的系统审查纳入标准。最后，meta分析纳入了9个随机对照试验。结果显示，哮喘患者使用中草药可显著改善预测FEV1的% (WMD 3.73, 95% CI 1.76 ~ 5.70)，无显著异质性(p = 0.56 [Q统计值]，I2 = 0.0%)。在按年龄分组的亚组分析中，成人预测FEV1的改善率更高且显著(WMD为5.16;95% CI 2.68-7.63)与儿童相比(WMD = 1.27;95% ci -1.98-4.51)。敏感性分析显示，草药消费对改善FEV1的显著作用是一致的(总wmd范围为3.27-4.59)，表明meta分析模型是稳健的。在视觉上和统计上都没有发表偏倚的证据。结论:研究结果支持，与标准治疗相比，补充使用草药可显著改善哮喘患者的肺功能，无明显不良事件。这种改善在成年人中更容易观察到。
Efficacy of Herbal Medicines on Lung Function in Asthma: a systematic review and meta-analysis of randomized controlled trials.
Objectives: The present study was designed to conduct a comprehensive systematic review and meta-analysis to assess the efficacy of herbal medicines as add-on therapy on lung function in asthmatic patients.
Methods: A comprehensive search of online databases was performed up to December 2021 to identify randomized controlled trials that used orally herbal preparations for asthma as add-on therapy. Studies were assessed for methodological quality using the Cochrane Collaboration's Risk of Bias tool. The main outcome was percent predicted value of forced expiratory volume (% predicted FEV1). Pooled weighted mean difference (WMD) estimate with corresponding 95% confidence interval (CI) was calculated using inverse-variance weights method while random effects meta-analysis was used, taking into account clinical and conceptual heterogeneity.
Results: As a result, 1,525 studies were identified. 169 studies were reviewed in-depth and 23 studies met our systematic review inclusion criteria. Finally, nine randomized controlled trials were included in the meta-analysis. Findings indicated that use of herbal medicines in patients with asthma significantly improved % predicted FEV1 (WMD 3.73, 95% CI 1.76-5.70), with no evidence for significant heterogeneity (p = 0.56 [Q statistic], I2 = 0.0%). In subgroup analysis by age, improvement in % predicted FEV1 was higher and significant in adults (WMD 5.16; 95% CI 2.68-7.63) compared to children (WMD = 1.27; 95% CI -1.98-4.51). Sensitivity analysis showed the significant effect of herbal medicine consumption on improving FEV1 was consistently (range of summary WMDs 3.27-4.59), indicating that the meta-analysis model was robust. There was no evidence of publication bias both visually and statistically.
Conclusion: Findings support, the complementary use of herbal medicines resulted in significant improvement in the lung function compared to standard treatment in asthmatic patients with no considerable adverse events. This improvement is more likely to be observed amongst adults.
期刊介绍：
The Journal of Pharmacopuncture covers a wide range of basic and clinical science research relevant to all aspects of the biotechnology of integrated approaches using both pharmacology and acupuncture therapeutics, including research involving pharmacology, acupuncture studies and pharmacopuncture studies. The subjects are mainly divided into three categories: pharmacology (applied phytomedicine, plant sciences, pharmacology, toxicology, medicinal plants, traditional medicines, herbal medicine, Sasang constitutional medicine, herbal formulae, foods, agricultural technologies, naturopathy, etc.), acupuncture (acupressure, electroacupuncture, laser acupuncture, moxibustion, cupping, etc.), and pharmacopuncture (aqua-acupuncture, meridian pharmacopuncture, eight-principles pharmacopuncture, animal-based pharmacopuncture, mountain ginseng pharmacopuncture, bee venom therapy, needle embedding therapy, implant therapy, etc.). Other categories include chuna treatment, veterinary acupuncture and related animal studies, alternative medicines for treating cancer and cancer-related symptoms, etc. Broader topical coverage on the effects of acupuncture, the medical plants used in traditional and alternative medicine, pharmacological action and other related modalities, such as anthroposophy, homeopathy, ayurveda, bioelectromagnetic therapy, chiropractic, neural therapy and meditation, can be considered to be within the journal’s scope if based on acupoints and meridians. Submissions of original articles, review articles, systematic reviews, case reports, brief reports, opinions, commentaries, medical lectures, letters to the editor, photo-essays, technical notes, and book reviews are encouraged. Providing free access to the full text of all current and archived articles on its website (www.journal.ac), also searchable through a Google Scholar search.
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