摘要
目的:评价全肺灌洗术(whole lung lavage,WLL)联合汉防己甲素治疗尘肺的疗效。方法:检索中国知网、万方、中国生物医学文献服务系统(SinoMed)、PubMed、维普共5个数据库中关于WLL联合汉防己甲素治疗尘肺的临床研究,检索时间为建库至2022年3月1日,采用RevMan 5.4.1软件分析数据,合并数据效应量采用平均差(mean deviation,MD)及95%置信区间(95%CI)表示。结果:纳入15项研究,1402例患者。与汉防己甲素治疗组比较,WLL联合汉防己甲素组能明显改善FEV1(第1秒用力呼气量)(MD=0.24,95%CI[0.11,0.38],n=3,I2=54%)、FEV1/FVC(第1秒用力呼气量占肺活量的百分比)(MD=6.83,95%CI[6.83,7.28],n=7,I2=0%)、MVV(每分钟最大通气量)(MD=5.46,95%CI[0.68,10.06],n=2,I2=0%)等肺功能指标及白介素-1(IL-1)含量(MD=-14.77,95%CI[-20.06,-9.47],n=2,I2=0%),差异有统计学意义。与WLL组比较,WLL联合汉防己甲素组能改善患者用力肺活量(FVC)(MD=5.07,95%CI[2.03,8.10],n=2,I2=0%)和MVV(MD=6.07,95%CI[2.56,9.57],n=2,I2=4%),差异有统计学意义;两组改善患者FEV1情况比较,差异无统计学意义(MD=0.18,95%CI[-0.07,0.34],n=3,I2=94%),对治疗时间进行亚组分析,治疗时间为6个月两组FEV1/FVC比较差异有统计学意义(MD=3.06,95%CI[1.55,4.57],n=3,I2=0%),而治疗时间为3个月两组FEV1/FVC比较差异无统计学意义(MD=3.84,95%CI[-17.47,25.16],n=2,I2=99%)。与WLL组比较,WLL联合汉防己甲素组能改善患者二氧化碳分压(PaCO_(2))(MD=-6.07,95%CI[-8.52,-3.62],n=2,I2=33%)、呼吸症状(MD=-5.30,95%CI[-8.18,-2.42],n=2,I2=0%)、圣乔治呼吸问卷(SGRQ)评分总分(MD-5.97,95%CI[-8.43,-3.50],n=2,I2=0%),差异有统计学意义。结论:WLL与汉防己甲素联合使用既能快速改善尘肺患者症状,又能延缓肺纤维化进程。
Objective:To evaluate the efficacy of whole lung lava(WLL)combined with tetrandrine in the treatment of pneumoconiosis.Methods:The clinical studies on the treatment of pneumoconiosis by WLL combined with tetrandrine were retrieved from 5 databases:CNKI,WanFang,SinoMed,PubMed and VIP.The retrieval time was from the establishment of the database to March 1,2022.RevMan 5.4.1 software was used to analyze the data.The effect size of the combined data was ex-pressed as mean deviation(MD)and 95%confidence interval(95%CI).Results:15 studies with 1402 patients were included.Compared with tetrandrine treatment group,WLL combined with tetrandrine treatment group significantly improved pulmonary function indexes,such as FEV 1(forced expiratory volume in the first second)(MD=0.24,95%CI[0.11,0.38],n=3,I2=54%),FEV 1/FVC(percentage of forced expiratory volume in the first second to forced vital capacity)(MD=6.83,95%CI[6.83,7.28],n=7,I2=0%)and MVV(maximum ventilatory volume per minute)(MD=5.46,95%CI[0.68,10.06],n=2,I2=0%)and interleu-kin-1(IL-1)content(MD=-14.77,95%CI[-20.06,-9.47],n=2,I2=0%).Compared with WLL group,WLL combined with tetrandrine could improve FVC and MVV,and the results were(MD=5.07,95%CI[2.03,8.10],n=2,I2=0%)and(MD=6.07,95%CI[2.56,9.57],n=2,I2=4%),respectively.There was no statistical difference in FEV 1 improvement between the two groups(MD=0.18,95%CI[-0.07,0.34],n=3,I2=94%).Subgroup analysis of treatment time showed that there was a statistically signif-icant difference in FEV 1/FVC between the two groups after 6 months of treatment,while after 3 months of treatment,there was no statistical difference in FEV 1/FVC between the two groups,and the results were(MD=3.06,95%CI[1.55,4.57],n=3,I2=0%)and(MD=3.84,95%CI[-17.47,25.16],n=2,I2=99%),respectively.Compared with WLL group,WLL combined with tetrandrine group could improve the partial pressure of carbon dioxide(PaCO 2),respiratory symptoms and the total score of St.George Res-piratory Questionnaire(SGRQ),and the results were(MD=-6.07,95%CI[-8.52,-3.62],n=2,I2=33%),(MD=-5.30,95%CI(8.18,2.42),n=2,I2=0%)and(MD=-5.97,95%CI(8.43,3.50),n=2,I2=0%).Conclusion:The combination of WLL and tetrandrine can not only quickly improve the symptoms of pneumoconiosis patients,but also delay the process of pulmonary fibrosis,which needs to be further confirmed by high-quality studies.
作者
徐佳佳
胡建国
张永学
华华
Xu Jiajia;Hu Jianguo;Zhang Yongxue;Hua Hua(School of Nursing,Anhui Sanlian University,Hefei Anhui 230601)
出处
《山西中医药大学学报》
2023年第1期19-27,51,共10页
Journal of Shanxi University of Chinese Medicine
基金
安徽省教育厅自然科学重点项目(KJ2020A0802)
安徽三联学院校级科研创新平台重点项目(PTZD2021009)。
