【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)作期的隨機對照試驗并對其進行系統(tǒng)評價,探討其臨床療效和安全性,對研究質(zhì)量的總體水平作出評估,以對將來的臨床決策提供循證醫(yī)學(xué)參考依據(jù)。 方法： 計算機檢索1991年至2011年間中國生物醫(yī)學(xué)文獻數(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算機數(shù)據(jù)庫的相關(guān)期刊、會議論文及各大專院校校報等。再對符合納入標(biāo)準(zhǔn)的研究文獻進行資料提取和質(zhì)量評價,并用Reman5.0軟件對主要結(jié)局指標(biāo)臨床有效率及次要結(jié)局指標(biāo)血漿比黏度、紅細胞壓積、氧分壓、二氧化碳分壓等相關(guān)數(shù)據(jù)進行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55篇,共計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)合對降低血漿比黏度、紅細胞壓積、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研究驗證。由于本研究納入的文獻質(zhì)量較低,各個試驗存在的偏倚較大,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)論受原始文獻研究數(shù)據(jù)的影響較大,在臨床實踐和科研中應(yīng)該正確認(rèn)識和合理利用系統(tǒng)評價與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)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R541.5

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