龚美萍 陈思文 向红 彭斌

【摘 要】 目的：系统评价补中益气汤治疗变应性鼻炎（AR）的临床疗效及安全性。方法：在知网、万方、维普、PubMed、生物医学全文数据库、Cochrane图书馆中检索补中益气汤治疗AR的临床实验，文献检索时间从建库至今，语种涵盖中英文。对筛选后的文献，使用 Cochrane 系统评价手册评估其偏倚风险，然后用RevMan 5.3软件对符合标准的RCT进行Meta分析。结果：文章纳入10篇文献，涉及658例患者。Meta分析结果表明，治疗组和对照组比较：总有效率高[OR=3.17，95% CI（2.01，5.00），P<0.00001]，差异具有统计学意义;不良反应程度较轻，多可自行缓解。结论：单用补中益气汤或联用西药治疗AR的临床总有效率优于单用西药治疗者，两种干预措施安全性较好，但纳入的文献样本量较少，且可能存在发表性偏倚，故仍需纳入更多大样本、高质量、多中心的RCT来证实其结论。

【关键词】 变应性鼻炎;补中益气汤;Meta分析

【中图分类号】R765.21   【文献标志码】 A    【文章编号】1007-8517（2021）11-0077-04

Abstract：Objective To evaluate the clinical efficacy and safety of Buzhong Yiqi Decoction in the treatment of allergic rhinitis （AR）.Method We searched CNKI， Wanfang， VIP， PubMed， biomedical full text database and Cochrane Library for clinical trials of Buzhong Yiqi Decoction in the treatment of AR， Since the establishment of the database， the literature retrieval time covers both Chinese and English. After screening， the risk of bias was assessed by Cochrane system evaluation manual， and then meta-analysis of RCTs that met the criteria was performed by Revman 5.3 software.Result Ten articles were included in this paper， 658 patients were involved. Meta analysis showed that the total effective rate of the treatment group was higher than that of the control group [OR= 3.17，95% CI（2.01，5.00）， P<0.00001]; The adverse reactions were mild and could be relieved by themselves.Conclusion The total effective rate of AR treated with Buzhong Yiqi Decoction alone or combined with western medicine is better than that of Western medicine alone， The safety of the two interventions was good，However， the number of included literature samples is small， and there may be publication bias， so it is still necessary to include more large sample， high-quality， multi center RCT to confirm the conclusion.

Keywords：Allergic Rhinitis; Buzhong Yiqi Decoction; Meta Analysis

變应性鼻炎（Allergic rhinitis，AR）又称过敏性鼻炎，是由于易感人群在接触过敏原后，发生的由IgE介导的鼻黏膜Ⅰ型变态反应性疾病[1]，临床表现主要有鼻塞、鼻痒、打喷嚏、流大量水样涕[2]，是耳鼻喉科的一种常见疾病。目前，临床上主要采用抗组胺药、肾上腺糖皮质激素、白三烯拮抗剂等西药进行治疗[3]，但具有一定的副作用，加之本病很难彻底根治，且停药后易复发，给患者的工作和日常生活带来诸多困扰。

AR属于中医“鼻鼽”范畴[4]，多因肺、脾、肾三脏的亏虚，加外感风寒邪气而致病，故治疗时应以益气固表、扶正祛邪为主，而补中益气汤可健脾补肺、益气固表，临床试验也表明补中益气汤治疗AR的疗效较好，但缺少客观系统的评价。故笔者主要对补中益气汤治疗AR的总有效率及安全性进行Meta分析，以期为临床治疗AR提供依据。

1 资料与方法

1.1 文献纳入标准 ①研究类型：补中益气汤治疗AR的随机对照试验……