本文選題：慢性阻塞性肺疾病 + 療效��； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的研究N-乙酰半胱氨酸(N-acetylcysteine,NAC)對穩(wěn)定期慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)的療效。方法計算機檢索Pub Med和Medline數(shù)據(jù)庫,查找NAC治療與常規(guī)治療比較治療穩(wěn)定期COPD患者療效的隨機對照試驗(randomized controlled trials,RCTs)。按納入排除標(biāo)準(zhǔn)篩選文獻后、提取資料并進行方法學(xué)質(zhì)量評價,用Meta分析的方法研究NAC對穩(wěn)定期COPD的療效。結(jié)果共納入12個隨機對照研究,共計2691例患者。研究結(jié)果顯示:高劑量(RR=0.90,95%CI=0.82—0.996,p=0.041)及低劑量(RR=0.83,95%CI=0.69—0.99,p=0.043)NAC治療組都減少急性加重總?cè)藬?shù)。在治療療程的亞組分析上,顯示只有NAC治療至少6個月的治療組能減少急性加重總?cè)藬?shù)(RR=0.83,95%CI=0.71—0.96,p=0.015)。結(jié)果顯示,NAC對COPD的急性發(fā)作率(SMD=-0.02,95%CI=-0.29—0.26,p=0.911),FEV1(forced expiratory volume in one second)(SMD=0.15,95%CI=-0.04-0.33,p=0.13),Forced Vital Capacity(FVC)(SMD=0.52,95%CI=-0.21-1.26,p=0.161),及inspiratory capacity(IC)(SMD=-1.38,95%CI=-4.65-1.90,p=0.410)與對照組差異并無統(tǒng)計學(xué)意義。NAC能改善患者自我評價(RR=1.96,95%CI=1.39—2.77,p=0.000),但對患者生活質(zhì)量沒有明顯改善作用(SMD=0.04,95%CI=-0.14-0.22,p=0.684)。此外,結(jié)果顯示,不論藥物的劑量和應(yīng)用療程多少,NAC均不表現(xiàn)出明顯的藥物不良反應(yīng)(RR=1.13,95%CI=0.86-1.48,p=0.384)。結(jié)論高劑量和低劑量組的NAC能減少穩(wěn)定期COPD急性加重次數(shù)及改善COPD病人的自我評價,療程需至少6個月;但對FEV1、FVC、IC及生活質(zhì)量無明顯改善作用。
[Abstract]:Objective to study the effect of N-acetylcysteine (NAC) on stable chronic obstructive pulmonary disease (COPD). Methods the databases of Pub Med and Medline were searched by computer to find out the randomized controlled trial (randomized controlled trialsl RCTs), which was used to compare the efficacy of (randomized controlled therapy with routine therapy in the treatment of stable COPD patients. After the literature was screened according to the exclusion criteria, the data were extracted and the methodological quality was evaluated. The efficacy of NAC in stable COPD was studied by Meta-analysis. Results A total of 2691 patients were enrolled in 12 randomized controlled trials. The results showed that both the high dose (RRX 0.90 ~ 95CI 0.82-0.996p0.041) and the low dose (RRR0.83-95CII 0.69-0.99p0.043) NAC treatment group decreased the total number of patients with acute exacerbation. The subgroup analysis of the course of treatment showed that only NAC treatment for at least 6 months could reduce the total number of acute aggravation (RRR 0.83N 95 CI 0.71-0.96p0.015). 緇撴灉鏄劇ず,NAC瀵笴OPD鐨勬，

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