METHODS: Randomized controlled trials on the use of AAT with CWMT in the treatment of bronchial asthma published between 2009 and 2020 were retrieved from the PubMed, Embase, Cochrane Library, and CNKI (Chinese National Knowledge Institute) databases. Studies meeting the inclusion criteria were selected for meta-analysis. Forest plot, sensitivity analysis and publication bias assessment were carried out in this article.
RESULTS: Eight studies involving 1,520 patients were included in the meta-analysis. The clinical effect of AAT with CWMT in the treatment of asthma was superior to that of CWMT [mean difference (MD) =2.66 with 95% confidential interval (CI) (2.03, 3.49); overall effect P value <0.00001 and I2=89%]. There was no difference in adverse events between AAT with CWMT and CWMT [odds ratio (OR) =1.45; 95% CI: 0.62, 3.39; I2=0% and P of overall effect =0.4]. CWMT had higher ineffectiveness rate than AAT with CWMT (OR =0.29; 95% CI: 0.22, 0.38; P=0.33; I2=13%). According to the statistical analysis results, the AAT with CWMT group had higher overall effectiveness rate than the CWMT group (OR =0.29; 95% CI: 0.22, 0.38; P=0.33, fixed-effects model), with low heterogeneity (P=0.29; I2=13%).
CONCLUSIONS: AAT with CWMT has a superior clinical effect to CWMT in patients with asthma, and there is no difference in adverse events between the two treatments. Therefore, AAT with CWMT should be promoted as a treatment for bronchial asthma.
方法:2009年至2020年发表的关于使用AAT和CWMT治疗支气管哮喘的随机对照试验,Embase,科克伦图书馆,和CNKI(中国国家知识研究所)数据库。选择符合纳入标准的研究进行荟萃分析。森林地块,本文进行了敏感性分析和发表偏倚评估。
结果:在荟萃分析中纳入了涉及1,520名患者的8项研究。AAT联合CWMT治疗哮喘的临床疗效优于CWMT[平均差异(MD)=2.66,机密区间(CI)为95%(2.03,3.49);总体疗效P值<0.00001,I2=89%]。AAT与CWMT和CWMT之间的不良事件没有差异[比值比(OR)=1.45;95%CI:0.62,3.39;I2=0%,总体效果P=0.4]。CWMT的无效率高于CWMT的AAT(OR=0.29;95%CI:0.22,0.38;P=0.33;I2=13%)。根据统计分析结果,CWMT组AAT总有效率高于CWMT组(OR=0.29;95%CI:0.22,0.38;P=0.33,固定效应模型),异质性低(P=0.29;I2=13%)。
结论:AAT联合CWMT对哮喘患者的临床疗效优于CWMT,两种治疗方法之间的不良事件没有差异。因此,应推广AAT与CWMT作为支气管哮喘的治疗方法。