黄芪注射液联合抗结核药治疗肺结核的疗效及安全性的Meta分析
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摘要
目的 评价黄芪注射液联合抗结核药物治疗肺结核的有效性及安全性。方法 通过检索PubMed、中国知网(CNKI)、维普(VIP)及万方数据库中2010—2018年发表的黄芪注射液联合抗结核药物治疗肺结核的相关文献,并提取相关数据,采用Review Manager 5.3软件和Stata 11.0对纳入研究对象进行Meta分析。结果 最终入选13篇研究,结果表明黄芪注射液联合抗结核药物与单独使用抗结核药物化疗相比差异具有统计学意义,联合用药组在痰菌转阴[OR=4.38,95%CI(3.05,6.31),P<0.00001]、病灶吸收[OR=3.34,95%CI(2.32,4.81),P<0.00001]、空洞闭合[OR=3.30,95%CI(2.47,4.42),P<0.00001]方面均优于对照组。两组在不良反应上差异有统计学意义[OR=0.29,95%CI(0.19,0.43),P<0.00001]。结论 黄芪注射液联合抗结核药物治疗肺结核的效果优于单独使用抗结核药物,且安全性良好。
Objective To evaluate the efficacy and safety of astragalus membranaceus injection combined with anti-tuberculosis drugs in the treatment of pulmonary tuberculosis. Methods Relevant literatures of astragalus membranaceus injection combined with anti-tuberculosis drugs for the treatment of pulmonary tuberculosis published from 2010 to 2018 in PubMed, CNKI, VIP and Wanfang database were searched, and relevant data were extracted. Meta-analysis of the included studies was performed using the Review Manager 5.3 software and Stata 11.0. Results Thirteen literatures were included in this study. The results showed that there was statistically significant difference in chemotherapy between astragalus membranaceus injection combined with anti-tuberculosis drugs group and anti-tuberculosis drugs alone group(control group). The combined drug group was superior to the control group in sputum turning negative [OR=4.38,95%CI(3.05,6.31),P<0.00001], lesion absorption [OR=3.34,95%CI(2.32,4.81),P<0.00001], cavity closure [OR=3.30,95%CI(2.47,4.42),P<0.00001]. There were statistically significant differences in adverse reactions between the two groups[OR=0.29,95%CI(0.19,0.43),P<0.00001]. Conclusion This study shows that the efficacy of astragalus membranaceus injection combined with anti-tuberculosis drugsin the treatment of pulmonary tuberculosis is better than the use of anti-tuberculosis drugs alone, and the safety is good.
Objective To evaluate the efficacy and safety of astragalus membranaceus injection combined with anti-tuberculosis drugs in the treatment of pulmonary tuberculosis. Methods Relevant literatures of astragalus membranaceus injection combined with anti-tuberculosis drugs for the treatment of pulmonary tuberculosis published from 2010 to 2018 in PubMed, CNKI, VIP and Wanfang database were searched, and relevant data were extracted. Meta-analysis of the included studies was performed using the Review Manager 5.3 software and Stata 11.0. Results Thirteen literatures were included in this study. The results showed that there was statistically significant difference in chemotherapy between astragalus membranaceus injection combined with anti-tuberculosis drugs group and anti-tuberculosis drugs alone group(control group). The combined drug group was superior to the control group in sputum turning negative [OR=4.38,95%CI(3.05,6.31),P<0.00001], lesion absorption [OR=3.34,95%CI(2.32,4.81),P<0.00001], cavity closure [OR=3.30,95%CI(2.47,4.42),P<0.00001]. There were statistically significant differences in adverse reactions between the two groups[OR=0.29,95%CI(0.19,0.43),P<0.00001]. Conclusion This study shows that the efficacy of astragalus membranaceus injection combined with anti-tuberculosis drugsin the treatment of pulmonary tuberculosis is better than the use of anti-tuberculosis drugs alone, and the safety is good.
引文
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[14] 陈芳,黄德昌.黄芪注射液联合抗结核药对肺结核的治疗作用研究[J].中国当代医药,2017,24(32):145-147.
[15] 王桂荣.黄芪注射液联合抗结核药对肺结核的治疗作用研究[J].中医临床研究,2016,8(26):86-87.
[16] 鱼宁彬,梁桂英.黄芪注射液联合抗结核药在肺结核中的应用研究[J].湖南师范大学学报(医学版),2017,14(4):97-99.
[17] 温切木·吐尔,艾克拜尔·阿布来提.黄芪注射液联合抗结核药治疗肺结核疗效分析[J].世界最新医学信息文摘,2015,15(55):93.
[18] 陈艳丽,张婷婷.黄芪注射液联合抗结核药治疗肺结核疗效观察[J].世界中西医结合杂志,2013,8(10):1044-1046.
[19] 张金怀.黄芪注射液联合抗结核药治疗肺结核临床观察[J].亚太传统医药,2015,11(4):136-137.
[20] 徐建芳.黄芪注射液佐治老年活动期肺结核50例[J].中国中医药科技,2010,17(3):268-269.
[21] 朱士玉,王中林,舒奇,等.2011—2015年上海市金山区肺结核流行特征分析[J].现代预防医学,2016,43(17):3080-3084.
[22] 尤爱国,杨建华,聂轶飞,等.河南省2004—2011年肺结核流行特征分析[J].中华疾病控制杂志,2013,17(9):778-780.
[23] 丁松宁,李晨,孙照平,等.南京市2005—2015年学校肺结核流行特征与时间趋势分析[J].中华疾病控制杂志,2017,21(3):315-317.
[24] 李晓蓉,李敬新,江丽娜,等.天津市2005—2015年学校肺结核流行病学特征分析[J].中国学校卫生,2016,37(9):1361-1363.
[25] 韩惠明.耐多药结核病的预防和综合治疗探讨[J].现代预防医学,2011,38(4):745-746,750.
[26] 郭雪红.黄芪注射液的药理作用及临床应用研究进展[J].中国药房,2015,26(21):3018-3021.
[27] Seki K,Chisaka M,Eriguchi M,et al.An attempt to integrate Western and Chinese medicine:rationale for applying Chinese medicine as chronotherapy against cancer[J].Biomed Pharmacother,2005,59 Suppl 1:S132-S140.
[2] 殷春阳,冷东雷,何仲贵.抗结核药物的研究进展[J].沈阳药科大学学报,2015,32(1):77-84.
[3] 陆城华,张惠勇.中医药治疗肺结核病研究现状[J].山西中医,2014,30(04):56-57.
[4] 毛强.2004—2015年全国肺结核流行趋势时空特征及预测研究[D].兰州:兰州大学,2018.
[5] 中华医学会结核病学分会.中国结核病分类法[J].中华结核和呼吸杂志,1998,21(12):716-717.
[6] 王树明.黄芪注射液辅助抗结核药治疗肺结核的临床疗效[J].现代医药卫生,2014,30(24):3772-3773.
[7] 章期生,徐金田,郑德明.黄芪注射液辅助抗结核药治疗复治肺结核疗效观察[J].药物流行病学杂志,2015,24(6):354-355,363.
[8] 中华医学会结核病学分会.肺结核诊断和治疗指南[J].中华结核和呼吸杂志,2001,24(2):5-9.
[9] van Enst WA,Ochodo E,Scholten RJ,et al.Investigation of publication bias in meta-analyses of diagnostic test accuracy:a meta-epidemiological study[J].BMC Medical Research Methodology,2014,14:70.
[10] 杨永勇.90例黄芪注射液联合抗结核药物治疗肺结核的不良反应[J].中国保健营养,2017,27(21):260.
[11] 祁海萍.肺结核应用黄芪注射液联合抗结核药治疗的效果评定及报道[J].世界最新医学信息文摘,2016,16(22):127.
[12] 吴杰,褚国锋.黄芪注射液辅助抗结核药治疗肺结核的临床疗效分析[J].内蒙古中医药,2016,35(17):88.
[13] 徐红艳.黄芪注射液辅助治疗肺结核并糖尿病患者的临床效果[J].中国医药导报,2017,14(11):140-143.
[14] 陈芳,黄德昌.黄芪注射液联合抗结核药对肺结核的治疗作用研究[J].中国当代医药,2017,24(32):145-147.
[15] 王桂荣.黄芪注射液联合抗结核药对肺结核的治疗作用研究[J].中医临床研究,2016,8(26):86-87.
[16] 鱼宁彬,梁桂英.黄芪注射液联合抗结核药在肺结核中的应用研究[J].湖南师范大学学报(医学版),2017,14(4):97-99.
[17] 温切木·吐尔,艾克拜尔·阿布来提.黄芪注射液联合抗结核药治疗肺结核疗效分析[J].世界最新医学信息文摘,2015,15(55):93.
[18] 陈艳丽,张婷婷.黄芪注射液联合抗结核药治疗肺结核疗效观察[J].世界中西医结合杂志,2013,8(10):1044-1046.
[19] 张金怀.黄芪注射液联合抗结核药治疗肺结核临床观察[J].亚太传统医药,2015,11(4):136-137.
[20] 徐建芳.黄芪注射液佐治老年活动期肺结核50例[J].中国中医药科技,2010,17(3):268-269.
[21] 朱士玉,王中林,舒奇,等.2011—2015年上海市金山区肺结核流行特征分析[J].现代预防医学,2016,43(17):3080-3084.
[22] 尤爱国,杨建华,聂轶飞,等.河南省2004—2011年肺结核流行特征分析[J].中华疾病控制杂志,2013,17(9):778-780.
[23] 丁松宁,李晨,孙照平,等.南京市2005—2015年学校肺结核流行特征与时间趋势分析[J].中华疾病控制杂志,2017,21(3):315-317.
[24] 李晓蓉,李敬新,江丽娜,等.天津市2005—2015年学校肺结核流行病学特征分析[J].中国学校卫生,2016,37(9):1361-1363.
[25] 韩惠明.耐多药结核病的预防和综合治疗探讨[J].现代预防医学,2011,38(4):745-746,750.
[26] 郭雪红.黄芪注射液的药理作用及临床应用研究进展[J].中国药房,2015,26(21):3018-3021.
[27] Seki K,Chisaka M,Eriguchi M,et al.An attempt to integrate Western and Chinese medicine:rationale for applying Chinese medicine as chronotherapy against cancer[J].Biomed Pharmacother,2005,59 Suppl 1:S132-S140.