Objective: To systematically evaluate the efficacy and safety of conventional therapy combined with moxibustion in the treatment of chronic obstructive pulmonary disease (COPD) in stable phase based on Meta-analysis medicine.
Methods: The randomized controlled trials (RCTs) of moxibustion as adjuvant therapy for COPD were retrieved from the databases of CNKI, Wanfang, SinoMed, PubMed, Web of Science, Cochrane Library and Ebsco. RevMan5.3 software was used for Meta analysis, and the quality of evidence was evaluated according to GRADE standards.
Results: A total of 16 RCTs were included, involving 1425 patients. The results of Meta-analysis showed that: compared with the conventional treatment, ①the adjuvant therapy with moxibustion had advantages in reducing the number of acute exacerbations [MD=-0.31, 95%CI:-0.49--0.13, P=0.0006]; ②the adjuvant therapy with moxibustion improved lung function significantly [FEV1% (MD=4.00, 95%CI:2.63-5.37, P<0.000 01) and FEV1/FVC (MD=3.56, 95%CI:1.69-5.43, P=0.000 2)]; ③the adjuvant therapy with moxibustion could extend the 6 min walking distance (6WMD) (MD=35.00, 95%CI:18.02-51.99, P<0.000 1); ④the adjuvant therapy with moxibustion could improve the modified British Medical Research Council breathing questionnaire (mMRC) classification significantly (MD=-0.62, 95%CI:-1.18--0.05, P=0.03); ⑤no adverse reaction was reported in the included literature.
Conclusion: The efficacy of moxibustion as adjuvant therapy for COPD in stable phase is better than that of simple conventional therapy. Due to insufficient clinical evidence and the limitations of this study, clinical safety is unclear and further evidence is needed to support the results.
目的：基于Meta分析系统评价常规疗法联合灸法治疗慢性阻塞性肺疾病（COPD）稳定期的有效性与安全性。方法：计算机检索中国期刊全文数据库（CNKI）、万方学术期刊全文数据库（Wanfang）、中国生物医学文献数据库（SinoMed）、PubMed、Web of Science、Cochrane Library、Ebsco中运用灸法辅助治疗COPD稳定期的临床随机对照试验（RCT）文献，采用RevMan5.3软件进行Meta分析，并按照GRADE标准进行证据质量评价。结果：纳入16篇RCT文献，涉及1425例患者。与常规治疗相比，Meta分析结果显示：①联合灸法在降低急性加重次数[MD=-0.31，95%CI（-0.49~-0.13），P=0.000 6]方面更具优势；②联合灸法对肺功能第1秒用力呼气容积占预计值百分比（FEV1%）[MD=4.00,95%CI（2.63~5.37），P<0.000 01]及FEV1与用力肺活量比值（FEV1/FVC）[MD=3.56，95%CI(1.69~5.43)，P=0.000 2]的改善更佳；③联合灸法能延长6 min步行距离[MD=35.00，95%CI（18.02~51.99），P<0.000 1]；④联合灸法对改良版英国医学研究委员会呼吸问卷（mMRC）分级[MD=-0.62，95%CI(-1.18~-0.05)，P=0.03]的改善更佳；⑤纳入文献均未报告不良反应。结论：灸法辅助治疗COPD稳定期疗效优于单纯常规治疗，因临床证据不足，安全性尚不能得出明确结论，且因本研究具有一定的局限性，研究结果仍需进一步证据支持。.
Keywords: Meta-analysis; chronic obstructive pulmonary disease (COPD); moxibustion therapy; randomized controlled trial (RCT).