中国中医急症2017,11(26),1899-1902+1910DOI:10.3969/j.issn.1004-745X.2017.11.006培土生金法治疗慢性阻塞性肺疾病临床疗效的Meta分析王益斐郦岳周杨马黄钢李国法浙江省诸暨市中医医院导出/参考文献关注分享收藏打印摘要：目的系统评价培土生金法在治疗慢性阻塞性肺疾病(C0PD)中的临床疗效。方法通过计算机检索数据库Pubmed>Embase、TheCochranelibrary、中国知网和万方数据库，检索年限为2008年1月至2016年12月，同时查阅会议摘要和相关网站，按纳入与排除标准筛选文献，并根据改良Jachd量表评价文献质量并提取资料，运用ReviewManager5.3软件进行Meta分析。结果最终纳入14篇文献，其中英文2篇，共包含1049例患者分析的结果显示，培土生金法治疗可以明显提高C0PD患者的总有效率［优势比(0R)=5.15,95%可信区间(95%CI)(3.08,8.61),1X0.00001］、增加白蛋白(ALB)水平［SMD二0.57,95%CI(0.36,0.77),1X0.00001］、前白蛋白(PALB)［SMD=0.70,95%CI(0.45,0.94),P<0.00001］>生存质量评分［SMD二-0.64,95%CI(-0.90,-0.39),P<0.00001］、并能明显改善肺功能的部分指标。各指标的漏斗图显示各研究没有发表偏倚。结论培土生金法治疗可明显提高C0PD(肺脾气虚证)患者的疗效、营养状况、生存质量及肺功能。纳入文献数量偏少，有些文献质量偏低，仍需要更多更好的随机、双盲、对照试验予以证实。关键词：培土生金;慢性阻塞性肺疾病；Meta分析;随机对照试验;作者简介：王益斐电子邮箱:doctorwyf11200163收稿日期:2017-06-21基金：浙江省中快药科学研究基金项目(2016ZA197)AMetaAnalysis:EffeetivenessoftheMethodofStrengtheningEarthtoGenerateMetalonChronicObstruetivePulmonaryDiseaseWANGYifeiLIYueZHOUYangZhujiHospitalofTCMinZhejiangProvince;Abstract：Objective:Tosystematicllyevaluatetheclinicaleffectivenessofthemethodofstrengtheningearthtogeneratemetalintreatmentofchronicobstruetivepulmonary.Methods:RelevantliteraturewassearchedinPubMed,Embase,theCochraneLibrary,CNKIandWanfangdatabasefrom2008-01to2016~12.Atthesametime,theabstractsandrelatedwebsitesweresearched.Theliteraturewasscreenedaccordingtoinclusionandexclusioncriteria,andthequalityofthe1iteraturewasassessedandextractedbymodifiedJadadscale.Meta-analysiswasconductedbyReviewManager5.3software.Results:Thefinalinclusionof14s,including2inEnglish,containingatotalof1049patients.Theresultsofm巳ta~analysisshowedthatthemethodofstrengtheningearthtogeneratemetalimprovedthetotaleffectiverateinthetreatmentofCOPDpatients[(OR)二5.15,95%confidenceinterval(95%CI)(3.08.61),P<0.00001],thelevelofALB[SMD=0.57,95%CI(0.36,0.77),P<0.00001],PALB[SMD=0.70,95%CI(0.45,0.94),P<0.00001],andscoreoflifequality[SMD=-0.64,95%CT(-0.90,-0.39),P<0.00001],andcouldsignificantlyimprovesomeoftheindicatorsofthelungfunction.Theindexofthefunnelmapshowedthattherewasnopublishbiasinstudies.Conclusion:Themethodofstrengtheningearthtogeneratemetalcanobviouslyimprovethecurativeeffect,nutritionalstatus,qualityoflifeandpulmonaryfunctionofCOPDpatieiitswithsyndrometypeofQideficiencyoflungandspleen.Thenumberofincluded1iteratureistoosmall,andsomeliteraturequalityislow,stillneedingmoreandbetterrandomized,double-blind,controlledtrialstobeconfirmed.Keyword：Strengtheningearthtogeneratemetal;COPD;MetdAnalysis;Randomizedcontrolledtrials;Received：2017-06-21慢性阻塞性肺疾病（COPD）具有病情缠绵、迁延难愈、高致病率、高死亡率的特点［1-2］°冃前COPD的西医治疗主要有支气管舒张药物、祛痰药、吸入性糖皮质激素等，在急性期疗效尚可，但远期疗效欠显著。近年来中I矢药在治疗COPD中取得了较大进展，中医认为COPD多为本虚标实之证，早期病位在肺，之后传之脾脏，J4中焦脾土的病变是此病传变或恶化的关键。陈士铎《石室秘录》所云“治肺之法，正治...