Meta Analysis Of The Clinical Efficacy Of Traditional Chinese Medicine In The Treatment Of Chronic Obstructive Pulmonary With Pulmonary Heart Disease

Purpose:By collecting the literatures about the treatment of chronic obstructive pulmonary disease(COPD)with cor pulmonale(CHD)at home and abroad,the efficacy of TCM in treating COPD with cor pulmonale was evaluated by Meta-analysis method.Materials and Methods: The key words of COPD complicated with cor pulmonale were identified.The original RCT literatures of COPD combined with cor pulmonale were searched by computer in Pub Med,Cochrane Library,CNKI,Chinese scientific and Technological Journal Full-text Database(Weipu),Wanfang Digital Journal Full-text Database and CBM.The time limit of searching was from the database establishment.to 2018 Mar.According to the inclusion criteria and exclusion criteria formulated by 2,independent workers into the literature,using Jadad evaluation to assess the quality.Rev Man 5.3 statistical software was used for data processing.The selected indicators were: clinical efficacy,TCM syndrome efficacy score(cough,asthma,palpitation,edema),lung function(FEV1,FVC),arterial blood gas analysis(Pa O2,Pa CO2),NT-pro BNP,LVEF,PAP.Result:1.A total of 24 RCT literatures were retrieved,all of which were in Chinese.Meta-analysis was carried out with 2110 samples,including 1065 in the observation group and 1045 in the control group.2.Meta analysis showed that TCM had obvious clinical efficacy in treating COPD with cor pulmonale.Compared with the control group,the observation group can significantly improve the treatment efficiency [RR=1.24,95%CI(1.19,1.29),P < 0.00001].Improving the results of arterial blood gas analysis: increasing Pa O2 [MD=4.19,95% CI(0.99,7.39),P=0.01];decreasing Pa CO2 [MD=-4.07,95% CI(-6.98,-1.16),P=0.006].Improving lung function:Increasing FEV1 [MD = 0.18,95% CI(0.08,0.27),P = 0.0003;Increasing FVC [MD = 0.16,95% CI(0.12,0.20),P < 0.00001].Decrease NT-pro BNP [MD =-51.43,95%CI(-100.43,-2.44),P=0.04].Improve LVEF[MD =3.16,95%CI(1.76,4.57),P<0.00001].Improve PAP[MD =-2.08,95%CI(-3.84,-0.33),P=0.02].Improve TCM syndrome integral cough [MD =-0.35,95% CI(-0.45,-0.25),P < 0.0001];asthma [MD =-0.29,95% CI(-0.43,-0.15),P < 0.0001];palpitation [MD =-0.18,95% CI(-0.26,-0.09),P < 0.0001];edema [MD =-0.23,95% CI(-0.31,-0.14),P < 0.0001].Conclusion:1.Traditional Chinese medicine treatment of chronic obstructive pulmonary disease with cor pulmonale has obvious curative effect compared with conventional western medicine treatment alone,which can significantly improve the clinical efficiency.2.TCM can relieve clinical symptoms by improving TCM syndrome scores of COPD patients with cor pulmonale.3.Traditional Chinese medicine can improve the blood gas analysis,lung function,NT-pro BNP,LVEF,PAP indicators of COPD patients with cor pulmonale,thus playing a role in the treatment of this disease.4.Traditional Chinese medicine treatment of COPD with cor pulmonale has fewer adverse reactions and high safety,which is worthy of clinical application.