吸入性糖皮质激素对稳定期慢性阻塞性肺疾病治疗效果Meta分析.docVIP

吸入性糖皮质激素对稳定期慢性阻塞性肺疾病治疗效果Meta分析 　　[摘要] 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院次数减少。 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。 　　[关键词] 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 　　[中图分类号] R563 [文献标识码] A [文章编号] 1673-7210（2015）08（a）-0144-06 　　Meta-analysis on the effect of inhaled corticosteroids on COPD in stabilization period 　　YANG Qiaoyu NIE Hanxiang▲ HE Qing 　　Department of Respiratory， Renmin Hospital of Wuhan University， Hubei Province， Wuhan 430060， China 　　[Abstract] 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 inc