N-乙酰半胱氨酸对稳定期慢性阻塞性肺疾病的疗效：Meta分析

发布时间：2018-07-05 12:19

  本文选题：慢性阻塞性肺疾病 + 疗效　； 参考：《广西医科大学》2017年硕士论文

【摘要】：目的研究N-乙酰半胱氨酸(N-acetylcysteine,NAC)对稳定期慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)的疗效。方法计算机检索Pub Med和Medline数据库,查找NAC治疗与常规治疗比较治疗稳定期COPD患者疗效的随机对照试验(randomized controlled trials,RCTs)。按纳入排除标准筛选文献后、提取资料并进行方法学质量评价,用Meta分析的方法研究NAC对稳定期COPD的疗效。结果共纳入12个随机对照研究,共计2691例患者。研究结果显示:高剂量(RR=0.90,95%CI=0.82—0.996,p=0.041)及低剂量(RR=0.83,95%CI=0.69—0.99,p=0.043)NAC治疗组都减少急性加重总人数。在治疗疗程的亚组分析上,显示只有NAC治疗至少6个月的治疗组能减少急性加重总人数(RR=0.83,95%CI=0.71—0.96,p=0.015)。结果显示,NAC对COPD的急性发作率(SMD=-0.02,95%CI=-0.29—0.26,p=0.911),FEV1(forced expiratory volume in one second)(SMD=0.15,95%CI=-0.04-0.33,p=0.13),Forced Vital Capacity(FVC)(SMD=0.52,95%CI=-0.21-1.26,p=0.161),及inspiratory capacity(IC)(SMD=-1.38,95%CI=-4.65-1.90,p=0.410)与对照组差异并无统计学意义。NAC能改善患者自我评价(RR=1.96,95%CI=1.39—2.77,p=0.000),但对患者生活质量没有明显改善作用(SMD=0.04,95%CI=-0.14-0.22,p=0.684)。此外,结果显示,不论药物的剂量和应用疗程多少,NAC均不表现出明显的药物不良反应(RR=1.13,95%CI=0.86-1.48,p=0.384)。结论高剂量和低剂量组的NAC能减少稳定期COPD急性加重次数及改善COPD病人的自我评价,疗程需至少6个月;但对FEV1、FVC、IC及生活质量无明显改善作用。
[Abstract]:Objective to study the effect of N-acetylcysteine (NAC) on stable chronic obstructive pulmonary disease (COPD). Methods the databases of Pub Med and Medline were searched by computer to find out the randomized controlled trial (randomized controlled trialsl RCTs), which was used to compare the efficacy of (randomized controlled therapy with routine therapy in the treatment of stable COPD patients. After the literature was screened according to the exclusion criteria, the data were extracted and the methodological quality was evaluated. The efficacy of NAC in stable COPD was studied by Meta-analysis. Results A total of 2691 patients were enrolled in 12 randomized controlled trials. The results showed that both the high dose (RRX 0.90 ~ 95CI 0.82-0.996p0.041) and the low dose (RRR0.83-95CII 0.69-0.99p0.043) NAC treatment group decreased the total number of patients with acute exacerbation. The subgroup analysis of the course of treatment showed that only NAC treatment for at least 6 months could reduce the total number of acute aggravation (RRR 0.83N 95 CI 0.71-0.96p0.015). 缁撴灉鏄剧ず,NAC瀵笴OPD鐨勬，

本文编号：2100182