Clinical Efficacy And Safety Of Traditional Chinese Medicine In Treating Chronic Obstructive Pulmonary Disease Complicated With CorPulmonale:a Meta-ana Lysis

Objective:The focus is to collect randomized controlled trials of TCM in the treatment of COPD with PHD.A meta-analysis of the literatures on RCTs aims to evaluate the clinical efficacy and safety of TCM,provide evidence-based medicine for clinical use,and point out the deficiencies.Materials and Methods:Extract of effective keywords,using computer retrieval CNKI、WF、VIP and CBM,Cochrane Library for RCTs From 2005 until December,2021.Using the Jadad evaluation to measure the quality,according to the inclusion and exclusion criteria.The data was processed using RevMan 5.4 statistical software.Clinical efficacy,TCM syndrome efficacy score（cough,asthma,palpitation,edema）,lung function（FEV1,FVC）,arterial blood gas analysis（PaO2,PaCO2）,NT-proBNP,LVEF,and PAP were the indicators chosen.Results:1.A total of 25 randomized controlled trials（RCTS）were examined.Metaanalysis was used in 2118 patients,1068 in the observation group and 1050 in the control group.2.Meta-analysis found that Chinese herbal medicine treatment of chronic obstructive pulmonary disease with cor pulmonale clinical efficacy significantly.The effective rate of the observation group was significantly higher than that of the control group[RR=1.19,95%CI（1.15,1.24）,P<0.00001]。increase PaO2[MD=4.19,95%CI（0.99,7.39）,P=0.01]It can improve the prognosis of arterial blood gas analyzer.PaCO2 reduced arterial blood flow[MD=-4.07,95%CI(-6.98,-1.16,P=0.006]]and improved lung function:FEV1[MD=0.75,95%CI（0.24,1.27）,P=0.0001];FVC（MD=0.14,95%confidence interval（0.11,0.17）,P<0.00001）.Decreased NTproBNP levels[MD=-51.43,95%CI（-100.43,-2.44）P=0.04]。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）。Improving TCM Syndrome Complex Cough[MD=-0.35,95%CI(-0.45,-0.25,P<0.0001];Asthma(MD=-0.29,95%Confidence interval（-0.43,-0.15）,P<0.0001;Palpitation(MD=-0.18,95%Confidence interval（-0.26,-0.09）,P<0.0001;Edema[MD=-0.23,95%CI（-0.31,0.14）,P<0.0001]。Conclusion:1.TCM mixed with western has a curative result superior to western alone in the treatment of COPD complicated by PHD,which can greatly increase therapeutic effectiveness.2.TCM combined with western can ameliorate the manifestations in patients with COPD and PHD by boosting TCM syndrome score.3.In patients with COPD and PHD,TCM mixed with Western can enhance PaO2,PaCO2,FEV1,FVC,NT-proBNP,LVEF,PAP,and other markers,as well as,disease management.4.In the treatment of COPD complicated by PHD,TCM mixed western has little side effects and is quite harmless.Appropriate for medical use.