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纸质出版日期:2020,
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明春玉, 许光兰, 赵媚, 等. 吸入激素联合噻托溴铵对比单用吸入激素治疗哮喘-慢阻肺重叠综合征有效性的Meta分析[J]. 中国药房, 2020,31(11).
MING Chunyu, XU Guanglan, ZHAO Mei, et al. Meta-analysis of the Effectiveness of Inhaled Corticosteroids Combined with Tiotropium Bromide versus Inhaled Corticosteroids Alone in the Treatment of Asthmatic-COPD Overlap Syndrome[J]. China Pharmacy, 2020,31(11).
明春玉, 许光兰, 赵媚, 等. 吸入激素联合噻托溴铵对比单用吸入激素治疗哮喘-慢阻肺重叠综合征有效性的Meta分析[J]. 中国药房, 2020,31(11). DOI:
MING Chunyu, XU Guanglan, ZHAO Mei, et al. Meta-analysis of the Effectiveness of Inhaled Corticosteroids Combined with Tiotropium Bromide versus Inhaled Corticosteroids Alone in the Treatment of Asthmatic-COPD Overlap Syndrome[J]. China Pharmacy, 2020,31(11). DOI:
目的:系统评价吸入激素联合噻托溴铵对比单用吸入激素治疗哮喘-慢阻肺重叠综合征的有效性,为临床应用提供循证依据。方法:计算机检索PubMed、WebofScience、Embase、CochraneLibrary、中国生物医学文献数据库、中国知网、维普网、万方数据库,检索时限为建库至2019年11月,收集吸入激素联合噻托溴铵(试验组)对比单用吸入激素(对照组)治疗哮喘-慢阻肺重叠综合征的随机对照试验(RCT)。对符合纳入标准的文献进行资料提取,并采用改良Jadad量表进行质量评价后,采用RevMan5.3.0统计软件对有效率、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、吸气分数(IC/TLC)、残总比(RV/TLC)、哮喘症状(ACT)评分、慢阻肺症状(CAT)评分、急性加重次数进行Meta分析。结果:共纳入25项RCT,合计2828例患者。Meta分析结果显示,试验组患者有效率[RR=1.16,95%CI(1.10,1.22),P<0.001]、FEV1[MD=0.44,95%CI(0.35,0.54),P<0.001]、FVC[MD=0.70,95%CI(0.46,0.95),P<0.001]、FEV1/FVC[MD=8.79,95%CI(6.22,11.37),P<0.001]、IC/TLC[MD=4.93,95%CI(3.01,6.85),P<0.001]、RV/TLC[MD=-9.22,95%CI(-9.79,-8.66),P<0.001]、ACT评分[MD=5.38,95%CI(4.30,6.47),P<0.001]、CAT评分[MD=-3.67,95%CI(-4.89,-2.45),P<0.001]、急性加重次数[MD=-1.49,95%CI(-2.82,-0.17),P=0.03]均显著高于对照组,差异均有统计学意义。结论:与单用吸入激素比较,吸入激素联合噻托溴铵治疗可提高哮喘-慢阻肺重叠综合征患者的有效率,改善其肺功能,但会增加急性加重次数。
OBJECTIVE:To systematically e valuate the effectiveness of inhaled corticosteroids combined with tiotropium bromide versus inhaled corticosteroids alone in the treatment of asthmatic-COPD overlap syndrome ,and to provide evidence-based reference for clinical use. METHODS :Retrieved from PubMed ,Web of Science ,Embase,Cochrane Library ,CBM,CNKI, VIP,Wanfang database ,during the establishment of the database to Nov. 2019,randomized controlled trials (RCT)about inhaled corticosteroids combined with tiotropium bromide (trial group )versus inhaled corticosteroids alone (control group )in the treatment of asthmatic-COPD overlap syndrome were collected. After data extraction of included literatures met inclusion criteria ,quality evaluation with modified Jadad scale ,Meta-analysis was performed for response rate ,forced expiratory volume in the first second (FEV1),forced vital capacity (FVC),FEV1/FVC,inspiratory fraction (IC/TLC),residual to total ratio (RV/TLC),asthma symptom(ACT)score,chronic obstructive pulmonary symptom (CAT)score,the times of acute exacerbations by Rev Man 5.3.0 software. RESULTS :A total of 25 RCTs were included ,involving 2 828 patients. The results of Meta-analysis showed that the response rate [RR =1.16,95%CI(1.10,1.22),P<0.001],FEV1[MD=0.44,95%CI(0.35,0.54),P<0.001],FVC [MD =0.70, 95%CI(0.46,0.95),P<0.001],FEV1/FVC [MD= 8.79,95%CI(6.22,11.37),P<0.001],IC/TLC [MD =4.93,95%CI(3.01, 6.85),P<0.001],RV/TLC [MD =-9.22,95%CI(-9.79,-8.66),P<0.001],ACT score [MD =5.38,95%CI(4.30,6.47), P<0.001],CAT score [MD =-3.67,95%CI(-4.89,-2.45),P<0.001] and the times of acute exacerbations [MD =-1.49, 95%CI(-2.82,-0.17),P=0.03] in trial group were significantly higher than control group ,with statistical significance. CONCLUSIONS:Compared with inhaled corticosteroids alone ,inhaled hormone combined with tiotropium bromide can improve the response rate and pulmonary function ,but increase the times of acute exacerbation of patients with asthmatic-COPD overlap syndrome.
吸入激素噻托溴铵哮喘-慢阻肺重叠综合征有效性Meta分析
Inhaled corticosteroidsTiotropium bromideAsthmatic-COPD overlap syndromeEffectivenessMeta-analysis
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