中国医药导报
中國醫藥導報
중국의약도보
CHINA MEDICAL HERALD
2015年
22期
144-148,152
,共6页
慢性阻塞性肺疾病%吸入性糖皮质激素%随机对照试验%Meta分析
慢性阻塞性肺疾病%吸入性糖皮質激素%隨機對照試驗%Meta分析
만성조새성폐질병%흡입성당피질격소%수궤대조시험%Meta분석
Chronic obstructive pulmonary disease%Inhaled corticosteroid%Randomized controlled trial%Meta-analysis
目的：系统性评价吸入性糖皮质激素对稳定期慢性阻塞性肺疾病(COPD)患者生命质量及肺功能一秒用力呼气容积(FEV1)改善情况。方法计算机检索The Cochrane Library、中国知网、万方及维普等数据库中关于吸入性糖皮质激素治疗稳定期COPD患者的随机对照研究(RCT)，检索时限均为从建库至2014年10月1日。同时手工检索纳入研究的参考文献。由两名研究者按照纳入与排除标准独立筛选文献，提取资料和评价纳入研究的方法学质量后，采用RevMan 5.2软件进行Meta分析。结果共纳入8项研究，844例患者。 Meta分析结果显示：与对照组比较，吸入性糖皮质激素使稳定期COPD患者肺功能第1秒用力呼气量(FEV1)显著改善[SMD=0.83，95%CI：0.49~1.16，P<0.00001]、呼吸困难减轻[SMD=-2.34，95%CI：-3.15~-1.53，P<0.0001]、6 min步行距离增加[SMD=0.33，95%CI：0.17~0.49，P<0.0001]、生命质量提高[SMD=-1.89，95%CI：-2.3~-1.48，P<0.0001]，急性加重患者的门诊和住：次数减少。结论吸入性糖皮质激素的应用可改善稳定期COPD患者FEV1，增加6 min步行距离，改善生命质量、减轻呼吸困难，减少急性加重次数。
目的：繫統性評價吸入性糖皮質激素對穩定期慢性阻塞性肺疾病(COPD)患者生命質量及肺功能一秒用力呼氣容積(FEV1)改善情況。方法計算機檢索The Cochrane Library、中國知網、萬方及維普等數據庫中關于吸入性糖皮質激素治療穩定期COPD患者的隨機對照研究(RCT)，檢索時限均為從建庫至2014年10月1日。同時手工檢索納入研究的參攷文獻。由兩名研究者按照納入與排除標準獨立篩選文獻，提取資料和評價納入研究的方法學質量後，採用RevMan 5.2軟件進行Meta分析。結果共納入8項研究，844例患者。 Meta分析結果顯示：與對照組比較，吸入性糖皮質激素使穩定期COPD患者肺功能第1秒用力呼氣量(FEV1)顯著改善[SMD=0.83，95%CI：0.49~1.16，P<0.00001]、呼吸睏難減輕[SMD=-2.34，95%CI：-3.15~-1.53，P<0.0001]、6 min步行距離增加[SMD=0.33，95%CI：0.17~0.49，P<0.0001]、生命質量提高[SMD=-1.89，95%CI：-2.3~-1.48，P<0.0001]，急性加重患者的門診和住：次數減少。結論吸入性糖皮質激素的應用可改善穩定期COPD患者FEV1，增加6 min步行距離，改善生命質量、減輕呼吸睏難，減少急性加重次數。
목적：계통성평개흡입성당피질격소대은정기만성조새성폐질병(COPD)환자생명질량급폐공능일초용력호기용적(FEV1)개선정황。방법계산궤검색The Cochrane Library、중국지망、만방급유보등수거고중관우흡입성당피질격소치료은정기COPD환자적수궤대조연구(RCT)，검색시한균위종건고지2014년10월1일。동시수공검색납입연구적삼고문헌。유량명연구자안조납입여배제표준독립사선문헌，제취자료화평개납입연구적방법학질량후，채용RevMan 5.2연건진행Meta분석。결과공납입8항연구，844례환자。 Meta분석결과현시：여대조조비교，흡입성당피질격소사은정기COPD환자폐공능제1초용력호기량(FEV1)현저개선[SMD=0.83，95%CI：0.49~1.16，P<0.00001]、호흡곤난감경[SMD=-2.34，95%CI：-3.15~-1.53，P<0.0001]、6 min보행거리증가[SMD=0.33，95%CI：0.17~0.49，P<0.0001]、생명질량제고[SMD=-1.89，95%CI：-2.3~-1.48，P<0.0001]，급성가중환자적문진화주：차수감소。결론흡입성당피질격소적응용가개선은정기COPD환자FEV1，증가6 min보행거리，개선생명질량、감경호흡곤난，감소급성가중차수。
Objective To comprehensively analyze the life quality and FEV1 of inhaled corticosteroids (ICS) on chronic obstructive pulmonary disease (COPD) in stabilization period. Methods Randomized controlled trials (RCT) about ICS for COPD in stabilization period were searched in the Cochrane Library, CNKI, Wanfang and VIP database from the date of their establishment to October 1st 2014. Other relevant journals and references of included studies were also searched manually. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted date and assessed methodological quality of included studies.Meta-analysis was then conducted using RevMan 5.2. Results A total of 8 RCTs involving in 844 patients were included. The results of Meta-analysis indicated that, the patients treated with inhaled corticosteroids were significantly improved. FEV1 was improved (SMD=0.83, 95%CI:0.49-1.16, P< 0.00001). Levels of dyspnea was relieved (SMD=-2.34, 95%CI: -3.15 - -1.53, P< 0.0001), 6-WMN was increased (SMD=0.33, 95%CI: 0.17-0.49, P < 0.0001), life quality was improved (SMD=-1.89, 95%CI: -2.3 --1.48, P< 0.0001), and the frequency of exacerbations was induced. Conclusion Current evidence indicates that the Inhaled corticosteroid can effectively improve the lung function FEV1, increase 6-WMN, decrease levels of dyspnea and improve life quality as well as reduce the frequency of exacerbation of COPD patients in stabilization period.
