中西医结合治疗初治肺结核的荟萃分析

发布时间：2018-01-22 03:52

本文关键词： 初治肺结核荟萃分析中西医结合　出处：《浙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的评价中西医结合治疗初治肺结核的疗效方法以"初治肺结核"、"中医"、"中西医"、"汤"、"方"为检索词,计算机检索相关期刊论文(CNKI)、万方数据知识平台、中文科技期刊全文数据库-维普资讯、PubMed中有关中西医结合治疗初治肺结核的文献,依据Cochrane评价手册评价文献质量,并提交数据进行荟萃分析,利用RevMan5.3统计软件进行荟萃分析,分类变量计算比值比(OR)以及95%可信区间(CI)。结果共检出相关文献974篇,含论文题目、作者姓名、出处以及摘要,查重排除文献剩余文献325篇,阅读题目及摘要排除不相关文献,剩余文献40篇,进一步阅读全文后,剔除数据不完整、观察指标不同及非随机对照(RCT)的文献,最后有16篇文献3100例患者纳入分析,其中中西医结合组1589例,单纯西医治疗组1521例,两组基线数据一致。荟萃分析结果显示:(一)治疗2月末痰菌转阴:有10篇文献入选,对照组976例治疗组930例,与单纯西医治疗对照组相比,OR=3.41,95%CI2.71～4.38,OR1且95%CI不包含1,总效应检测Z=10.09,P0.01,差异有统计学意义,提示治疗2月中西医结合治疗组2月末痰菌转阴率高于单纯西医治疗组。(二)治疗2月末空洞闭合:有6篇文献入选:对照组210例治疗组232例,与单纯西医治疗对照组相比OR=3.87,95%CI 1.91～7.83,OR1且95%CI不包含1,总效应检测Z=5.62,P0.01,差异有统计学意义,提示治疗2月中西医结合治疗空洞闭合率高于单纯西医治疗组。(三)治疗2月末病灶吸收:有7篇文献入选:对照组526例治疗组560例,与单纯西医治疗对照组相比OR=2.52,95%CI1.64～3.87,OR1且95%CI不包含1,总效应检测Z=4.23,P0.01,差异有统计学意义,提示治疗2月中西医结合组病灶吸收率高于单纯西医治疗组。(四)治疗6月末痰菌转阴:有10篇文献入选:对照组847例治疗组872例,与单纯西医治疗对照组相比OR=4.3,95%CI 2.78～6.65,OR1且95%CI不包含1,总效应检测Z=6.54,P0.01,差异有统计学意义,提示治疗6月中西医结合治疗组痰菌转阴率高于单纯西医治疗组。(五)治疗6月末空洞闭合:有8篇文献入选:对照组295例治疗组322例,与单纯西医治疗对照组相比OR=2.24,95%CI 1.46～3.44,OR1且95%CI不包含1,总效应检测Z=3.68,P0.01,差异有统计学意义,提示治疗6月中西医结合治疗组空洞闭合率高于单纯西医治疗组。(六)治疗6月末X线病灶吸收:有10篇文献入选:对照组641例治疗组696例,与单纯西医治疗相比OR=3.49,95%CI 2.47～4.94,Z=7.08,P0.01,差异有统计学意义,提示治疗6月中西医结合治疗组X线病灶吸收率高于单纯西医治疗组。(七)临床疗效:有7篇文献入选:对照组567例治疗组604例,与单纯西医治疗相比OR=3.32,95%CI 2.15～5.14,OR1且95%CI不包含1,合并效应量的检验Z=5.41,P0.01,差异有统计学意义,提示中西医结合治疗组临床疗效高于单纯西医治疗组。结论中西医结合治疗初治肺结核,治疗2月末及6月末,在痰菌转阴、空洞闭合及X线病灶吸收均高于单纯西医治疗,临床疗效中西医结合治疗优于单纯西医治疗。
[Abstract]:Objective to evaluate the curative effect of combination of traditional Chinese and Western medicine treatment of pulmonary tuberculosis with pulmonary tuberculosis "," Chinese medicine "and" western medicine "," soup "," party "as the key words, the computer retrieval Chinese Journal Full-text Database (CNKI), Wanfang Data knowledge platform, Chinese PSTP - VIP information, treatment of primary pulmonary tuberculosis in literature about the combination of traditional Chinese and Western medicine in PubMed, according to the Cochrane evaluation manual evaluation, and submit data for meta-analysis, meta-analysis was performed using RevMan5.3 statistical software, classification variables to calculate the odds ratio (OR) and 95% confidence interval (CI). Results there were 974 literatures, including the title, author's name, and the source, check out the remaining 325 articles, reading the title and abstract excluding the related literature, the remaining 40 references for further reading the whole text, excluding incomplete data, different observation index and non random Machine control (RCT) literature, finally 16 articles were included in the analysis of 3100 cases of patients, 1589 cases of combination of traditional Chinese and Western medicine group, western medicine treatment group 1521 cases, two groups of baseline data. The meta-analysis showed that: (a) treatment at the end of 2 negative sputum: 10 literatures were selected, the control group 976 patients in the treatment group 930 cases, control group compared with the pure western medicine treatment, OR=3.41,95%CI2.71 ~ 4.38, OR1 and 95%CI do not contain 1, the total effect of detection of Z=10.09, P0.01, the difference was statistically significant, indicating that the treatment of combining traditional Chinese and Western medicine treatment group in February 2 at the end of the sputum negative conversion rate is higher than the western medicine treatment group (two) of 2 at the end of treatment. Cavity closure: 6 articles were included: 210 cases in the control group and 232 cases in the treatment group, the control group from 1.91 to 7.83 OR=3.87,95%CI compared with the pure western medicine treatment, OR1 and 95%CI do not contain 1, the total effect of detection of Z=5.62, P0.01, the difference was statistically significant, indicating that the treatment of February combined treatment of TCM and Western Medicine The cavity closure rate is higher than the pure western medicine treatment group (three). 2 at the end of treatment: the lesions absorption of 7 articles were included: 526 cases in the control group and 560 cases in the treatment group, the control group to 3.87 OR=2.52,95%CI1.64 compared with the pure western medicine treatment, OR1 and 95%CI do not contain 1, the total effect of detection of Z=4.23, P0.01, the difference was statistically significant, suggesting that the combination of TCM and Western medicine treatment in February the focus absorption rate is higher than the pure western medicine treatment group (four). 6 at the end of treatment negative sputum: 10 literatures were included: 847 cases in the control group and 872 cases in the treatment group, the control group from 2.78 to 6.65 OR=4.3,95%CI compared with the pure western medicine treatment, OR1 and 95%CI do not contain 1, the total effect of detection Z=6.54. P0.01, the difference was statistically significant, indicating that the treatment in June, combining traditional Chinese and Western medicine treatment group the sputum negative conversion rate higher than the treatment group western medicine. (five) 6 at the end of treatment: void closure 8 articles included: 295 cases of control group, 322 cases in the treatment group, compared with the pure western medicine treatment Compared with OR=2.24,95%CI 1.46 ~ 3.44, OR1 and 95%CI do not contain 1, the total effect of detection of Z=3.68, P0.01, the difference was statistically significant, indicating that the treatment of combining traditional Chinese and Western medicine treatment group June cavity closure rate higher than the treatment group western medicine. (six) absorption treatment at the end of 6 there are 10 X-ray lesions: Literature: selected 641 cases in the control group the treatment group of 696 cases, compared with the pure western medicine treatment of 2.47 ~ 4.94 OR=3.49,95%CI, Z=7.08, P0.01, the difference was statistically significant, indicating that the treatment of combining traditional Chinese and Western medicine treatment group June X-ray focus absorption rate is higher than the pure western medicine treatment group. (seven) clinical curative effect: 7 articles were included: 567 cases in the control group and the treatment group of 604 cases. The pure western medicine treatment compared to OR=3.32,95%CI from 2.15 to 5.14, OR1 and 95%CI do not contain 1, the combined effect of the amount of the test of Z=5.41, P0.01, the difference was statistically significant, suggesting that combined with the clinical effect of treatment group was higher than that of Western medicine treatment group and Western medicine. Conclusion the traditional Chinese medicine and Western Medicine Combined with the treatment of the initial treatment of tuberculosis, treatment at the end of 2 and the end of 6, sputum smear negative, cavity closure and X-ray lesion absorption were higher than that of Western medicine alone. The clinical efficacy of integrated traditional Chinese and Western medicine is better than that of Western medicine alone.

【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R521

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