A Meta-analysis Of The Clinical Efficacy Of Traditional Chinese Medicine In The Treatment Of Chronic Obstructive Pulmonary With Pulmonary Hypertension

Purpose:To evaluate the efficacy and safety of TCM for chronic obstructive pulmonary disease(COPD)with pulmonary hypertension.Material and method:Extract of effective keywords,using computer retrieval CNKI?WF?VIP and CBM for RCTs until December 31,2017.The study contained 20 RCTs,included in 1636 patients,including 826 in experimental group and 810 in control group.RevMan 5.3 software was used to analyze the data.The quality evaluation tool provided by the Cochrane collaboration network.The main outcomes including the clinical efficiency,pulmonary artery pressure,PASP,PADP,MPAP,MSAP,blood gas analysis(PaO2,PaCO2,SaO2),pulmonary function(FEV1(%),FEV1/FVC(%)),syndrome score of TCM,six minutes walking distance.The calculated data use the Odds Ratio(OR),the measurement data are expressed by Standardized Mean Difference(SMD)and their 95% confidence intervals(CI).Results:Traditional Chinese medicine has effect in chronic obstructive pulmonary disease with pulmonary hypertension.Compared with the control group,traditional Chinese medicine can improve clinical efficiency [OR=3.40;95%CI(2.61,4.44)];reduce pulmonary artery pressure[SMD=-1.20;95%CI(-1.91,-0.49)];decreased pulmonary artery systolic pressure [SMD=-0.53;95%CI(-0.69,-0.37)];decreased pulmonary artery diastolic pressure [SMD=-0.86;95%CI(-1.14,-0.57)];decreased mean pulmonary artery pressure[SMD=-0.64;95%CI(-0.92,-0.35)];improve blood oxygen partial pressure[SMD=0.49;95%CI(0.32,0.66)];reduce blood carbon dioxide partial pressure[SMD=-0.39;95%CI(-0.69,-0.10)];Extend patient's six-minute walk distance [SMD=1.12;95%CI(0.58,1.66)];improve FEV1/expected value(%)[SMD=0.57;95%CI(0.31,0.84)] and FEV1/FVC(%)[SMD=0.53;95%CI(0.20,0.86)];also can improved syndrome score of TCM [SMD=-0.98;95%CI(-1.24,-0.73)].There was no statistical difference between the observation group and the control group in affecting MSAP [SMD=-0.11;95% CI(-0.44,0.21)].Conclusion:1.In treat of chronic obstructive pulmonary disease with pulmonary hypertension,TCM has clinical efficacy,it can improve the patient's symptoms score of TCM,reduce pulmonary artery pressure.it can improve the anoxia condition and lung function indicators,prolong the 6 minutes walk distance of patients.2.Chinese medicine has fewer adverse reactions and is worthy of clinical promotion.