A Meta-analysis Of Integrated Traditional Chinese And Western Medicine In The Treatment Of COPD With Stable Malnutrition

Objective:To systematically evaluate the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of chronic obstructive pulmonary disease combined with malnutrition using the method of meta-analysis,and to summarize the rules and principles of traditional Chinese medicine and common Chinese medicine for treating this disease.Methods:"Chronic obstructive pulmonary disease","malnutrition","traditional Chinese medicine","integrated Chinese and western medicine","chronic obstructive pulmonary disease（COPD）","Dystrophy","Malnutrition"etc.HowNet,Wanfang Database,Chongqing Weipu Database,China Biomedical Literature Service System（CBM）,Pubmed and other databases searched from the establishment of the database until December 2019.Related literature.According to the established inclusion and exclusion criteria,two researchers independently selected the literature and extracted the literature data of the randomized controlled trial（RCT）.Finally,the Revman5.3 software was used for meta-analysis and systematic review.Results:After preliminary screening,the number of relevant documents retrieved was 385,and 183 duplicate documents were excluded.After reading the article title,abstract,text,etc.,159 irrelevant documents were deleted,and the acute phase was excluded based on strict inclusion and exclusion criteria.There were 17 articles,4 articles of other treatment methods such as acupuncture,diet,etc.,1 article could not be obtained from the original text or data,3 were non-randomized clinical studies,and18 research articles were finally included for meta-analysis.The analysis results are as follows:Combined traditional Chinese and western medicine treatment of COPD in the stable period combined with malnutrition has an advantage over the western medicine treatment group in the total effective rate,there is a statistical difference{combined RR=1.25,95%CI is 1.15-1.35,RR and hypothesis test Z=5.54,P<0.00001};Integrated Chinese and Western Medicine,the improvement of serum albumin in the stable period of COPD combined with malnutrition was better than that of the control group,combined with WMD=1.77,95%CI was 1.3-2.15,WMD and hypothesis test Z=9.08,P<0.00001;combined traditional Chinese and western medicine for stable COPD combined period The improvement of serum prealbumin index in malnutrition is better than that in control group,combined with WMD=0.71,95%CI is0.44-0.98,WMD and hypothesis test Z=5.10,P<0.00001;combined traditional Chinese and western medicine for stable COPD combined with malnutrition weight The improvement of the index index was better than that of the control group.The combined WMD=1.17,95%CI was 0.96-1.39,and the WMD hypothesis test was Z=10.08,P<0.00001.The improvement of TSF index of combined traditional Chinese and western medicine for stable COPD combined with malnutrition was better than that of the control group.In the control group,the combined WMD=0.19,95%CI was-0.01-0.38,and the WMD hypothesis test Z=1.89,P=0.06;the improvement of TSF indicators of COPD combined with malnutrition in the treatment of COPD combined with western medicine was better than that of the control group,combined with WMD=0.64,95%CI is 0.27-1.00,WMD and hypothesis test Z=3.44,P=0.006;the improvement of FEV1（%）index of stable COPD combined with malnutrition in the stable period of COPD is better than that of the control group,combined with WMD=4.13,95%CI is 2.86-5.40,WMD and Hypothesis test Z=6.36,P<0.00001;the improvement of the FEV1/FVC（%）index of stable COPD combined with malnutrition in the stable period of COPD was better than that of the control group,combined with WMD=1.96,95%CI was 0.13-3.78,and WMD was Hypothesis test Z=2.10,P=0.04;the improvement of the six-minute walking test index for stable COPD combined with malnutrition in the treatment of COPD during the stable period is better than that of the control group,combined with WMD=65.45,95%CI is 51.28-79.62,WMD and hypothesis test Z=0.05,P<0.00001.Among the 18 selected papers,the following eight Chinese medicines are frequently used:16 Poria,13Atractylodes,11 Chenpi,10 Glycyrrhiza,9 Pinellia,8 Codonopsis,6 Astragalus and 4 Ginseng.In the included 18 studies^[22-39],the word"random"was mentioned;4 of them^{[23,25,28,29]}were assigned according to the random number table method;4 studies^[22,24,36]were assigned according to the prospective random method;1 study^[35]mentioned the blind method and specific implementation schemes;1 study^[30.33.35]described the number of fallouts and described the data analysis method after fallout;Baseline comparability was described in all included studies.Conclusion:Integrated traditional Chinese and western medicine treatment of stable COPD combined with malnutrition can improve patient symptoms,serum albumin,serum prealbumin,BMI,TSF,Mac,FEV1（%）,FEV1/FVC（%）,six-minute walking test,etc.It has certain advantages and is worthy of clinical recommendation.However,the methods included in the literature included random methods,allocation concealment,and case shedding reports were insufficient,suggesting that further research is needed in the future.