TCM aerosol inhalation treatment in acute exacerbations of chronic bronchitis: a meta-analysis

Abstract

Highlights

This meta-analysis supports the effectiveness of TCM aerosol inhalation treatment in acute exacerbations of chronic bronchitis. TCM aerosol inhalation could improve the total cure rate and improve the symptoms of cough, cough with sputum, cough with dyspnea and lung wet rales. It also could increase the expression of IL-2 while decrease the expression of IL-8 and MDA in sputum and blood.

Abstract

Objectives: To determine whether traditional Chinese medicine (TCM) aerosol inhalation treatment is effective in the treatment of acute exacerbation of chronic bronchitis. Methods: Search double-blind randomised clinical trials (RCT) about the use of TCM aerosol inhalation in patient with acute exacerbation of chronic bronchitis via data base including Chinese biomedicine literature database, Wanfang Data, CNKI, Pubmed, EMBASE and Cochrane Library from the beginning to October 2016. Quality evaluation, data extraction and data analysis of these RCT was carried out with reference to the Cochrane systematic review. Results: 16 studies with 738 patients in TCM aerosol inhalation group and 675 in control group were included. The results of meta-analysis showed, (1) TCM aerosol inhalation group could improve the total cure rate. (2) TCM aerosol inhalation could increase the expression of IL-2 while decrease the expression of IL-8 and MDA in sputum and blood. (3) TCM aerosol inhalation could improve the symptoms of cough, cough with sputum, cough with dyspnea and lung wet rales. It also improve the symptoms of cough, expectorate and lung wet rales. (4) Shorten the time of cough and lung rale. (5) The adverse reactions were light only with 1 occurrence of nausea and vomiting. Conclusions: The use of TCM aerosol inhalation in the treatment of acute exacerbation of chronic bronchitis was effective. However, the inclusion researches quality were not very high, which only provided limited evidence for clinical application. Higher-quality randomized controlled trials were needed for further study.

Translated abstract

目的 运用meta分析技术评价中药雾化吸入治疗慢性支气管炎急性发作的疗效,为临床运用提供参考。 方法 通过中国生物医学文献数据库、万方数据库、中国知网、Pubmed、EMBASE、Cochrane Library等数据库,检索关于中药雾化吸入治疗慢性支气管炎急性发作的随机对照实验（randomized controlled trial,RCT）,检索时间均为建库至2016年10月。参照Cochrane系统评价的要求,对所有中药雾化吸入治疗慢性支气管炎急性发作的随机对照试验进行质量评价、数据提取和数据分析。 结果 一共纳入16篇符合要求的文献,均为国内研究,其中治疗组738例,对照组675例。Meta分析结果显示：①中药雾化组可以提高总有效率,OR = 4.79, 95% CI [3.15,7.28], Z = 7.32 ( P < 0.001);②中药雾化组可以提高痰液和血液中的IL-2的含量,降低痰液和血液中的IL -8、 ET、MDA的水平。③中药雾化组能改善患者咳嗽 、喘息、肺部湿罗音、咳痰、肺部湿罗音的症状体征;④缩短咳嗽和肺部湿啰音消失的时间;⑤中药雾化吸入不良反应少,纳入的研究中仅有1例发生恶心、呕吐。 结论 中药雾化吸入治疗慢性支气管炎急性发作的临床疗效显著,但纳入研究质量不高,使得证据的临床推广应用受到限制,还需更多高质量的随机对照试验进一步验证。