To Explore The Clinical Effect Of Five Classic Prescription For Clearing Heat And Reducing Phlegm On AECOPD Based On The Network Meta-analysis

Objective:Systematically evaluated the clinical effectiveness of five classic prescription drugs commonly used to clear fever and dissolve sputum to assist western medicine routine treatment on AECOPD,the improvement of secondary outcome indicators such as WBC,CRP,blood gas analysis index,and lung ventilation function index,and sorted the therapeutic effects of various Traditional Chinese medicine prescriptions in the conventional treatment of assisted Western medicine,in order to select dominant interventions and provide reference for clinical treatment.Method:Taking "Sangbaipi decoction","Yuebijiabanxia decoction","Dingchuan decoction","Qingqi Huatan decoction","Qingjin Huatan decoction" as the theme words and free words,combined with the theme words of "Acute Exacerbation of Chronic Obstructive Pulmonary Disease" plus free words,the six major search libraries such as "CNKI","Wanfang","Weipu","CBM","SCIE" and "pubmed" were searched,and the RCT studies of five kinds of heat-clearing phlegm classic Chinese medicine prescriptions for the treatment of AECOPD were comprehensively collected.According to the set ranking criteria,the literature was screened layer by layer,and the basic information and related outcome indicators of the included literature were extracted,and the quality evaluation was further evaluated.General meta-analyses（heterogeneity tests,effect size analyses,sensitivity analyses,bias analyses,etc.）were performed on relevant outcome measures in the literature using stata 16.0 in conjunction with Revman 5.4,and meta-regression and subgroup analyses if necessary.Under the premise of ensuring the homogeneity,similarity and consistency of the literature on the same outcome indicators,a network meta-analysis of the total clinical effective rate and WBC was performed.Using stata 16.0network packets to make reticular evidence graphs,contribution plots,league plots and SUCAR plots,and calculating the cumulative probability and ranking probability,the clinical efficiency of different antipyretic sputum formulas in the adjuvant treatment of AECOPD was predicted,and the sorting possibility of inflammatory cells was reduced.Results:The results of this study comparing the total efficiency with the network meta-analysis are as follows:From the perspective of clinical total effective rate:（1）The auxiliary effects of the five traditional Chinese medicine prescriptions from high to low may be: Dingchuan decoction plus or minus > Qingjin Huatan decoction plus or minus > Qingqi Huatan decoction plus or minus > Sangbaipi decoction plus or minus >Yuebijiabanxia decoction plus minus.（2）The addition and subtraction of five kinds of traditional Chinese medicine formulas,such as Sangbaipi decoction,Yuebijiabanxia decoction,Dingchuan decoction,Qingjin Huatan decoction and Qingqi Huatan decoction,have a significant role in improving the clinical efficacy of AECOPD.（3）The efficacy of the auxiliary Western medicine conventional treatment of Dingchuan decoction plus and minus may be more advantageous than that of Yuebijiabanxia decoction.（4）There was no statistical significance in the comparison between Yuebijiabanxia decoction and Sangbaipi decoction,Qingjin Huatan decoction and Qingqi Huatan decoction.（5）There was no statistical significance between Sangbaipi decoction,Dingchuan decoction,Qingjin Huatan decoction and Qingqi Huatan decoction.Ordinary meta-analysis suggests that the addition and subtraction of traditional Chinese medicine prescriptions for clearing fever and sputum can reduce the patient’s WBC,CRP and other auxiliary indicators to a certain extent,improve blood gas analysis indicators,improve lung ventilation function,and reduce the harm of acute exacerbations.Conclusion:Compared with the conventional treatment of Western medicine alone,the traditional Chinese medicine prescription for clearing fever and sputum can significantly improve the clinical effectiveness of the auxiliary Western medicine routine treatment AECOPD（sputum fever certificate）,and can improve the patient’s WBC,CRP,blood gas analysis index and lung ventilation function index and other related auxiliary test results to a certain extent,and in terms of improving FVC and FEV1,mulberry white peel soup is of no statistical significance compared with conventional treatment in Western medicine.More high-quality samples are expected in the future to confirm the reliability of the conclusions.