【摘要】：目的： 本研究收集已有的中西醫(yī)結(jié)合治療慢性肺源性心臟病急性發(fā)作期的隨機(jī)對(duì)照試驗(yàn)并對(duì)其進(jìn)行系統(tǒng)評(píng)價(jià),探討其臨床療效和安全性,對(duì)研究質(zhì)量的總體水平作出評(píng)估,以對(duì)將來的臨床決策提供循證醫(yī)學(xué)參考依據(jù)。 方法： 計(jì)算機(jī)檢索1991年至2011年間中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、維普中文科技期刊數(shù)據(jù)庫、中國知網(wǎng)數(shù)據(jù)庫、萬方學(xué)位論文數(shù)據(jù)庫,手工檢索上述數(shù)據(jù)庫中無法下載或者未收錄入計(jì)算機(jī)數(shù)據(jù)庫的相關(guān)期刊、會(huì)議論文及各大專院校校報(bào)等。再對(duì)符合納入標(biāo)準(zhǔn)的研究文獻(xiàn)進(jìn)行資料提取和質(zhì)量評(píng)價(jià),并用Reman5.0軟件對(duì)主要結(jié)局指標(biāo)臨床有效率及次要結(jié)局指標(biāo)血漿比黏度、紅細(xì)胞壓積、氧分壓、二氧化碳分壓等相關(guān)數(shù)據(jù)進(jìn)行Meta分析。 結(jié)果： 依據(jù)納入與排除標(biāo)準(zhǔn),總共納入研究文獻(xiàn)55篇,共計(jì)4863名慢性肺源性心臟病急性發(fā)作期患者。分析結(jié)果顯示：中西醫(yī)結(jié)合治療比用單純西醫(yī)治療有效率更高；中西醫(yī)結(jié)合治療比用單純西醫(yī)治療能更有效的降低血漿比黏度、紅細(xì)胞壓積、二氧化碳分壓,升高氧分壓。 結(jié)論： 中西醫(yī)結(jié)合用藥對(duì)治療慢性肺源性心臟病急性發(fā)作期的有效率高于單純使用西藥；中西醫(yī)結(jié)合對(duì)降低血漿比黏度、紅細(xì)胞壓積、二氧化碳分壓,升高氧分壓的程度優(yōu)于西藥；雖然不存在統(tǒng)計(jì)學(xué)差異,但由于存在異質(zhì)性較大的原因,仍需更多的臨床試驗(yàn)研究驗(yàn)證。由于本研究納入的文獻(xiàn)質(zhì)量較低,各個(gè)試驗(yàn)存在的偏倚較大,而Meta分析作為一種定量性分析,屬于描述性的二次分析,其結(jié)論受原始文獻(xiàn)研究數(shù)據(jù)的影響較大,在臨床實(shí)踐和科研中應(yīng)該正確認(rèn)識(shí)和合理利用系統(tǒng)評(píng)價(jià)與Meta分析,不應(yīng)當(dāng)盲目過分依賴上述的分析結(jié)果。
[Abstract]:Objective: to investigate the clinical efficacy and safety of a randomized controlled trial of integrated traditional Chinese and western medicine in the treatment of acute attack of chronic pulmonary heart disease. The overall level of research quality was evaluated to provide evidence-based medical reference for future clinical decision-making. Methods: Chinese biomedical literature database, Weipu Chinese science and technology journal database, Chinese knowledge network database and Wanfang degree thesis database were searched by computer from 1991 to 2011. Manually search the related journals, conference papers and college newspapers which cannot be downloaded or not included in the computer database. Then the data were extracted and the quality was evaluated according to the inclusion criteria. The clinical efficacy and secondary outcome indexes of the main outcome indicators, namely plasma viscosity, hematocrit, partial pressure of oxygen, were evaluated by Reman5.0 software. Carbon dioxide partial pressure and other related data were analyzed by Meta. Results: according to the inclusion and exclusion criteria, a total of 55 articles were included in the study, with a total of 4863 patients with acute attack of chronic pulmonary heart disease. The results showed that the effective rate of integrated traditional Chinese and western medicine was higher than that of western medicine alone, and the combination of traditional Chinese and western medicine could reduce plasma viscosity, hematocrit, partial pressure of carbon dioxide and increase partial pressure of oxygen more effectively than that of western medicine alone. Conclusion: the effective rate of integrated traditional Chinese and western medicine in the treatment of acute attack of chronic pulmonary heart disease is higher than that of western medicine alone, and it can reduce plasma viscosity, hematocrit and partial pressure of carbon dioxide. The degree of increasing oxygen partial pressure is better than that of western medicine, although there is no statistical difference, but due to the existence of greater heterogeneity, there is still need for more clinical trials to verify. Because of the low quality of the literature included in this study and the bias of each experiment, the Meta analysis, as a quantitative analysis, belongs to the descriptive secondary analysis, and its conclusion is greatly influenced by the original literature research data. In clinical practice and scientific research, the system evaluation and Meta analysis should be correctly recognized and reasonably used, and the above analysis results should not be blindly relied on.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R541.5

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李可建;;補(bǔ)陽還五湯化裁治療慢性肺心病急性發(fā)作期的系統(tǒng)評(píng)價(jià)[J];中醫(yī)藥臨床雜志;2007年02期

2 張海泉;;加味小青龍湯對(duì)慢性肺心病急性發(fā)作期的改善作用[J];中醫(yī)藥臨床雜志;2012年04期

3 蔡建郁;;利水湯治療肺心病水腫30例臨床觀察[J];中醫(yī)藥導(dǎo)報(bào);2011年03期

4 陳保霞;王長祿;;中西醫(yī)結(jié)合治療肺原性心臟病30例[J];河南中醫(yī);2010年09期

5 薛國新;;溫補(bǔ)湯治療慢性肺原性心臟病50例[J];河南中醫(yī);2011年05期

6 任花;;劉文峰教授自擬瀉肺強(qiáng)心湯治療肺心病經(jīng)驗(yàn)拾萃[J];環(huán)球中醫(yī)藥;2010年05期

7 許文忠;張立新;梅建強(qiáng);;中西醫(yī)結(jié)合綜合療法對(duì)肺心病急性發(fā)作期血常規(guī)和血流變的影響[J];河北中醫(yī)藥學(xué)報(bào);2011年02期

8 徐勇;周鐵中;;血府逐瘀湯聯(lián)合肝素霧化吸入治療肺原性心臟病高黏血癥30例[J];河南中醫(yī);2012年10期

9 張勝;;葶藶瀉肺湯應(yīng)用于肺原性心臟病急性加重期28例療效觀察[J];河南中醫(yī);2012年06期

10 王穎;;扶正固本法治療肺心病緩解期臨床觀察[J];遼寧中醫(yī)藥大學(xué)學(xué)報(bào);2012年03期

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