关键词: 医学,中国传统, 结核,抗多种药物性, Meta分析, 评价研究

Abstract:

Objective To reevaluate the qualities of literature methodology and report on systematic evaluation/meta-analysis of integrated traditional Chinese and western medicine in the treatment of multidrug-resistant pulmonary tuberculosis (MDR-TB). Methods The databases, including PubMed, EMbase, Cochrane Library, CBM, WanFang, CNKI and VIP databases, were searched by computer to collect systematic evaluation/meta-analysis literatures on the treatment of MDR-TB by integrated traditional Chinese and western medicine. The retrieval time was from the establishment of the database to August 2019. Based on the combination of subject words and free words, 30 literatures were initially screened out, and then 15 repeatedly published literatures and 10 literatures of non-MDR-TB were excluded, finally, 5 literatures were included for research. The methodological quality and report quality of the included literature were evaluated using AMSTAR scale and GRADE classification evaluation system. Results A total of 5 systematic evaluation/meta-analysis literatures were included, and 8 outcome indicators were obtained, including sputum negative conversion rate, lung lesion absorption rate, cavity closure rate, adverse reaction rate, improvement of traditional Chinese medicine (TCM) syndromes, cure rate, and relapse rate and treatment effective rate. All the included literatures compared the western medicine combined with TCM and western medicine alone. According to the AMSTAR scale score, the three literatures were 6 scores with the medium quality; as well as one literature was 7 scores and one was 9 scores with the high quality. GRADE classification showed that among the eight outcome indicators of 5 literatures, sputum negative conversion rate in 1 literature was very low quality, and the remaining 17 indicators were intermediate (3) or low (14) quality. The results of descriptive analysis showed that the combined treatment of traditional Chinese and western medicine for MDR-TB could elevate the sputum negative conversion rate and lung lesion absorption rate at the strengthening and consolidation stages, and improve the clinical symptoms of patients, meanwhile, the cavity closure rate and adverse reaction rate were relatively lower. Conclusion Integrated traditional Chinese and western medicine in the treatment of MDR-TB has synergistic effect, and the methodological quality of systematic evaluation/meta-analysis is medium and advanced, but the evidence strength of conclusion is low. Thus, the methodological quality and report quality of systematic evaluation should be strengthened.

Key words: Medicine,Chinese traditional, Tuberculosis,multidrug-resistant, Meta-analysis, Evaluation studies