Meta Analysis For Treatment Of Idiopathic Pulmonary Fibrosis With Chinese And Western Medicine

Objectives: Idiopathic pulmonary fibrosis(IPF)is a common disease,which is a chronic inflammatory interstitial lung disease as a pathological change of common type of interstitial pneumonia.It is currently classified as a refractory disease by WHO with hidden incidence.The cause is not clear yet,and the prognosis is poor.After diagnosed,the median survival is only 2-4 years.Most patients showed slowly,gradually and predictably decline in lung function,with clinical manifestations of fatigue,breath shortness and breathing difficulties.At present,Western medicine treatment of IPF usually use a large ofglucocorticoids combined with immunosuppressive agents,anti-fibrosis,anti-oxidation and other treatments,but there is no evidence-based medical evidence of a definite therapeutic effect.And the long course of treatment and side effects significantly increased physical discomfort and anxiety of the patients.In recent years,Chinese medicine treatment has been applied in the clinical research.Chinese medicine treatment of IPF has certain effect.However,the treatment of traditional Chinese medicine is not widely used in clinical.Integrated traditional and Western medicine has become the main promising treatment.But the clinical research evidence of systematic evaluation is lack.In this study,the clinical efficacy and safety of IPF treated with integrated traditional and Western medicine was systematically evaluated by Meta-analysis,which provided a more effective method and clinical basis for the treatment of IPF.Methods: The data was collected from Chinese National Knowledge Infrastructure databases(CNKI),Chinese Biomedical Database(CBM),the Chinese Full-text Database of Chinese Science and Technology Journals,Pub Med,EMBASE,Cochrane Library.The randomized controlled trials(RCTs)of integrated Chinese and Western medicine for treatment of IPF in these databases were screened systematically from until June 30 th,2016.Two reviewers were selected from the literatures and extracted the data by the inclusive and exclusive criteria independently and the quality of the included studies was evaluated according to the revised Jadad scale.The randomized controlled trials were included in the Meta-analysis performed with Revman Manager 5.2 software.Results: A total of 17 randomized controlled trials were included in this study.The total number of cases was 1337,of which 675 treatment groups and 662 control groups.The treatment groups were treated with integrated traditional and western medicine and the control groups were treated with western medicine only.The Meta analysis results showed that:1.The clinical efficacy of IPF treated with integrated traditional and western medicine was statistically significant better than that of western medicine group.2.Compared with western medicine,the integrated traditional and western medicine could improve the patients' DLCO,FVC,VC,FEV1/ FVC,FEV1 and PEF.The efficacy of integrated traditional and western medicine was similar as to TLC.3.Compared with western medicine,the integrated traditional and western medicine could effectively improve the Pa O2.4.Compared with western medicine,the integrated traditional and western medicine could reduce the score of dyspnea and cough,and relieve the symptoms of dyspnea and cough.5.Adverse reactions:Five studies reported the incidence of adverse reactions,and there were no adverse drug reactions in the treatment group of integrated traditional and western medicine.Conclusions: Compared with Western medicine,the integrated traditional and western medicine has certain advantages,e.g.it can improve clinical efficacy,improve lung function and clinical symptoms,improve the quality of life of patients,and reduce the adverse reaction of western medicine,increase the tolerance of western medicine.However,since adverse reaction report rate in included studies is low,it is hard to give the conclusion that integrated traditional and western medicine treatment of IPF is safe.Future studies needed to be explored with larger samples,higher quality,and multi-centerrandomized controlled study.