Meta-analysis And Clinical Observation Of Promoting Blood Circulation By Removing Blood Stasis In Acute Exacerbation Of Chronic Obstructive Pulmonary Disease

This study includes the following components:First part of the literature review include:modern medicine on the treatment of AECOPD,Traditional knowledge on AECOPD,Blood circulation of drugs in AECOPD.The second part is about Meta-analysis of AECOPD treated with Activating Blood Circulation to Dissipate Blood Stasis Methods:all the Papers of clinical studys that used Activating Blood Circulation to Dissipate Blood Stasis as the main intervention to treat AECOPD were retrived and collected, Meta-analysis was performded by using the statistical soft ware RevMan 4.3.2 on the basis of strict quality evalution. Sensitivity analysis were carried out between warious inclusion criteria.Funnel-plot was used to identify the publication bias. Resultes:26 papers were selected according with criteria,In these articles, Research objective of 23 articles is total effective,heterogeneity test results were significant, so use the random effect model.Meta-analysis suggest:synthesized efficacy(Risk ration,RR)of efficent probability between groups was 1.24,95%CI[1.15,1.33],Z=5.55 P<0.0001, As a result of blood gas analysis,14 articles were analyzed, heterogeneity test results were significant, so use the random effect model, Meta-analysis shows:synthesized efficacy (Weighted mean difference,WMD)of COPD between groups was 7.55,95%CI[5.09,10.01], Z=6.02 P<0.0001.Combined effect of PCO2 valuesWMD=5.07,95%CI [2.65,7.48], Z=4.11, P<0.0001. Take FEV1 as an object of study.51 literatures met the inclusion criteria, heterogeneity test results are not statistically significant, so using fixed effect model, combined effect size WMD=0.17,95%CI [0.12,0.22], Z=6.22, P<0.00001. Funnel-plot showed the possible existence of publication bias.Thus,come to the conclusion:It initially proves that effect of therapy of promoting the blood circulation and relieving the stasis may be superior to western medicine treatment, It suggests that AECOPD can be treated by promoting blood circulation therapy.The third part of clinical research:There are 51 patients meeting the inclusion criteria of "guiding principles for new drug clinical research of Chinese medicine" from Chinese Medicine Hospital of Jiangsu Province and Jiangsu Provincial People's Hospital.On this basis,patients were divided into two groups, the use of western medicine are set to the control group alone, in this based,Traditional Therapy for the treatment group are set. The project has the following observation:generalconditions,Comparison of symptoms and laboratory indicators of change.The results are as follows:the total control rate of treatment group was 44%, significantly higher than control group (7.7%). The symptoms cough, sputum production, appetite has improved, the treatment group improved breathing and rales significantly better than the control group.heart rate, breathing, CRP, blood rheology indicators of Two groups have improved, the treatment group ESR, fibrinogen, blood gases improve significantly better than the control group.