过敏性鼻炎中医内治法临床疗效的Meta分析及其安全性评价

发布时间：2018-07-20 13:10

【摘要】：目的:运用循证医学系统评价中医药疗法治疗过敏性鼻炎的有效性,为临床用药提供依据。材料与方法:中文文献检索中国知网数据库(CNKI)、重庆维普中文科技期刊数据库(VIP),万方数据库(Wanfang Data)、外文文献检索Pub Med和Cochrane Library数据库,搜集1989年至2017年2月相关文献,初步获得可能符合本次研究所需的文献。用Note Express筛查并剔除各数据库中重复文献,通过阅读文献标题及摘要剔除与本研究明显不相关的文献得到初步筛选文献。通过阅读全文,根据纳入标准,排除标准对纳入研究进行二次筛选,最终获取符合本次研究纳入标准的中医药治疗过敏性鼻炎RCT试验的研究文献,并对其进行数据提取。采用Cochrance reviews Handhook 5.1.0对纳入文献进行质量评价,采用Rev Man 5.3统计学软件对数据进行Meta分析,运用异质性检验、敏感性分析、漏斗图分析等方法统计相关数据,若临床异质性较大,则只进行定性分析,系统评价中医药疗法治疗变应性鼻炎的疗效。结果:共纳入63项随机对照试验,总样本量5602例,试验组2857例,对照组2745例,纳入文献总体质量不高。Meta分析结果显示:对于过敏性鼻炎患者,在改善患者鼻部症状、总有效率、实验室指标及生活质量方面,中医药治疗过敏性鼻炎的疗效是肯定的,且研究表明中医药治疗过敏性鼻炎发作初期的疗效不及抗组胺药,但对过敏性鼻炎的远期疗效稳定,而且避免了抗组胺药的副作用。中西医结合方面疗效要明显优于单纯西药治疗,差异有明显统计学意义。结论:传统中医药疗法是一种非常重要的“补充和替代疗法”,尤其是对过敏性鼻炎的治疗,可作为治疗过敏性鼻炎安全、有效的治疗手段。但由于所纳入的文献质量不高,大部分研究属于小样本研究,因此需要大量高质量,多中心RCT进一步来证实,为临床研究提供更可靠的依据。
[Abstract]:Objective: to evaluate the efficacy of traditional Chinese medicine (TCM) in the treatment of allergic rhinitis. Materials and methods: Chinese literature retrieval database (CNKI), Chongqing Weipu Chinese scientific and technological journal database (VIP), Wanfang database (Wanfang data), foreign literature retrieval Pub Med and Cochrane Library databases were collected from 1989 to 2017. The preliminary results may meet the needs of this study. Note Express was used to screen and eliminate the repeated literature in each database, and the literature was screened by reading the titles and abstracts of the literature which were not obviously related to this study. Through reading the full text, according to the inclusion criteria, exclusion criteria for the inclusion of the secondary screening of the study, and finally obtained according to the criteria included in the study Chinese medicine treatment of allergic rhinitis RCT research literature, and carry on the data extraction. Cochrance reviews hook 5.1.0 was used to evaluate the quality of the literature included. The data were analyzed by Meta-analysis using Rev Man 5.3 statistical software. The data were analyzed by heterogeneity test, sensitivity analysis, funnel chart analysis and so on. If the clinical heterogeneity was greater, Only qualitative analysis was carried out to evaluate the efficacy of TCM therapy in the treatment of allergic rhinitis. Results: a total of 63 randomized controlled trials were conducted, the total sample size was 5602 cases, the trial group was 2857 cases, and the control group was 2745 cases. The results of meta-analysis showed that the total effective rate in improving the nasal symptoms of allergic rhinitis patients was lower than that in the control group. In terms of laboratory indexes and quality of life, the efficacy of traditional Chinese medicine in the treatment of allergic rhinitis is positive, and studies have shown that the efficacy of Chinese medicine in the treatment of allergic rhinitis at the initial stage is not as good as that of antihistamines, but the long-term effect on allergic rhinitis is stable. Moreover, the side effects of antihistamines were avoided. The curative effect of integration of traditional Chinese and western medicine is better than that of western medicine alone, and the difference is statistically significant. Conclusion: traditional Chinese medicine therapy is a very important "supplement and replacement therapy", especially for allergic rhinitis. It can be used as a safe and effective treatment method for allergic rhinitis. However, because the quality of the literature included is not high, most of the studies belong to small samples, so it needs a large number of high-quality, multi-center RCT to further confirm, to provide a more reliable basis for clinical research.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R276.1

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