CAJ | 학술논문

目的：系统评价沙美特罗替卡松与噻托溴铵联合吸入治疗稳定期中重度慢性阻塞性肺疾病患者的效果。方法计算机检索Cochrane图书馆、Pubmed、CNKI、万方数据库,检索时限为建库至2014年11月。根据纳入/排除标准选择研究对象为稳定期中重度慢性阻塞性肺疾病患者,以沙美特罗替卡松联合噻托溴铵吸入治疗为观察组,单用沙美特罗替卡松粉吸入剂治疗为对照组,比较两组治疗效果。由2名研究者对文献质量进行评价和资料提取,采用RevMan 5.1进行Meta分析。结果共纳入12个RCT的稳定期中重度慢性阻塞性肺疾病患者878例,其中观察组447例,对照组431例。 Meta分析结果显示：观察组患者第1秒用力呼气量(FEV1)/用力肺活量(FVC)(W MD =8.86,95%CI：6.64~11.08,P <0.00001)、FEV1占预计值的百分比(W MD =7.77,95%CI：5.31~10.24,P<0.00001)、动脉血氧分压(PaO2)(W MD =9.97,95%CI：7.08~12.86,P<0.00001)和二氧化碳分压(Pa-CO2)(W MD=7.69,95%CI：5.67~9.71,P<0.00001)改变较对照组显著,差异均有统计学意义。对临床症状等进行描述性分析,结果显示观察组能明显改善患者的症状与体征,提高患者生活质量。结论沙美特罗替卡松与噻托溴铵联合吸入治疗稳定期中重度慢性阻塞性肺疾病可以更显著地改善患者临床症状、肺功能及动脉血气。但鉴于原始研究的质量均不高,且样本量少,故需要更多方法科学规范的高质量、大样本的RCT进一步论证。
목적：계통평개사미특라체잡송여새탁추안연합흡입치료은정기중중도만성조새성폐질병환자적효과。방법계산궤검색Cochrane도서관、Pubmed、CNKI、만방수거고,검색시한위건고지2014년11월。근거납입/배제표준선택연구대상위은정기중중도만성조새성폐질병환자,이사미특라체잡송연합새탁추안흡입치료위관찰조,단용사미특라체잡송분흡입제치료위대조조,비교량조치료효과。유2명연구자대문헌질량진행평개화자료제취,채용RevMan 5.1진행Meta분석。결과공납입12개RCT적은정기중중도만성조새성폐질병환자878례,기중관찰조447례,대조조431례。 Meta분석결과현시：관찰조환자제1초용력호기량(FEV1)/용력폐활량(FVC)(W MD =8.86,95%CI：6.64~11.08,P <0.00001)、FEV1점예계치적백분비(W MD =7.77,95%CI：5.31~10.24,P<0.00001)、동맥혈양분압(PaO2)(W MD =9.97,95%CI：7.08~12.86,P<0.00001)화이양화탄분압(Pa-CO2)(W MD=7.69,95%CI：5.67~9.71,P<0.00001)개변교대조조현저,차이균유통계학의의。대림상증상등진행묘술성분석,결과현시관찰조능명현개선환자적증상여체정,제고환자생활질량。결론사미특라체잡송여새탁추안연합흡입치료은정기중중도만성조새성폐질병가이경현저지개선환자림상증상、폐공능급동맥혈기。단감우원시연구적질량균불고,차양본량소,고수요경다방법과학규범적고질량、대양본적RCT진일보론증。
Objective To systematically evaluate the efficacy of Salmeterol/Fluticasone Propionate combined with Tiotropium Bromide in the treatment of patients with stable moderate to severe chronic obstructive pulmonary disease (COPD). Methods The Cochrane Library, Pubmed, CNKI and Wanfang Data were searched in English and Chinese from the date of establishment of databases to November 2014. Randomized controlled trials (RCTs) were chosen ac-cording to criteria, in which Salmeterol/Fluticasone Propionate plus Tiotropium Bromide was taken as observation group, while single Salmeterol/Fluticasone Propionate therapy was taken as control group. The effect of the two groups was e-valuated, the data was extracted by two independent researchers. Meta-analysis was performed with RevMan 5.1 soft-ware. Results 12 RCTs of 878 patients with stable moderate to severe COPD were included, Meta-analysis showed that, compared with control group, the observation group could statistically improve the FEV1/FVC (W MD=8.86, 95%CI:6.64-11.08, P<0.000 01), FEV1%predicted (W MD=7.77, 95%CI:5.31-10.24, P<0.000 01), PaO2 (W MD=9.97, 95%CI: 7.08-12.86, P< 0.000 01) and PaCO2 (W MD = 7.69, 95%CI: 5.67-9.71, P< 0.000 01). Descriptive analysis for secondary indexes showed that combined therapy could statistically relieve patients' clinical symptoms than control group, and improve patients' quality of life. Conclusion This meta-analysis suggests that the combined therapy of Sal-meterol/Fluticasone Propionate and Tiotropium Bromide can obviously improve clinical symptoms, lung function and arterial blood gases of patients with stable moderate and severe COPD. However, due to the poor quality of the origi-nal studies and the small sample size of included stud-ies, more high-quality, large-sample studies are re-quired.