Effects of Astragaulus Membranaceus on Pulmonary Tuberculosis: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

GAO Peng ¹ ,  XIAO Ping ¹ , CHEN Qingfeng ¹ , YANG Yanling ¹ , ZHAO Guiling ² , WANG Liming ¹ , ZHOU Ping ¹ , HE Qiang ¹ , WEI Xisheng ¹

1. Institute of Infection, the First Hospital of Lanzhou University, Lanzhou 730000, China;2. Department of Nephrepathy, the First Hospital of Lanzhou University, Lanzhou 730000, China;

Corresponding author：

XIAO Ping, Email: 1057798719@qq.com

Keywords：

Astragaulus membranaceus; Pulmonary tuberculosis; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20110122

Video：

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Objective 　To assess the effect of astragaulus membranaceus in the treatment of pulmonary tuberculosis.
Methods 　Through applying the methods provided by the Cochrane Collaboration, the randomized controlled trials (RCTs) or quasi-RCTs of astragaulus membranaceus in the treatment of pulmonary tuberculosis were searched in The Cochrane Library (Issue 3, 2010), CNKI (1991 to May 2010), VIP (1989 to May 2010), EMbase (1981 to May 2010), and PubMed (1981 to May 2010). Two reviewers independently screened the included studies, extracted the data, assessed the quality, and cross checked then. The RevMan 5.0 software was used to conduct meta-analyses.
Results 　Twelve RCTs involving 1 054 patients were included. All trials were tested in the mainland China. The results of meta-analyses showed that: a) The astragaulus membranaceus could assist the conventional drug to cure pulmonary tuberculosis, promote sputum negative conversion, focal absorption and cavity reduction in lung; b) The astragaulus membranaceus could reduce the adverse reactions of the conventional drug; c) The astragaulus membranaceus combined with the conventional drug could improve the patients’ symptoms and signs; and d) The astragaulus membranaceus combined with the conventional drug could reduce the bacterial relapse rates in follow-up after treatment.
Conclusion　 The current evidence shows that the astragaulus membranaceus has some effects and is relatively safe to treat pulmonary tuberculosis. However, it is far from enough to recommend astragaulus membranaceus as a conventional adjuvant therapy for pulmonary tuberculosis because of no sufficient evidence obtained from this study for its small sample and low methodology quality. Therefore, more double-blind multi-center RCTs with high quality, large sample, and adequate follow up are required for further verification.

Citation： GAO Peng,XIAO Ping,CHEN Qingfeng,YANG Yanling,ZHAO Guiling,WANG Liming,ZHOU Ping,HE Qiang,WEI Xisheng. Effects of Astragaulus Membranaceus on Pulmonary Tuberculosis: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2011, 11(6): 698-705. doi: 10.7507/1672-2531.20110122 Copy

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12.	周义乾, 刘玉林, 刘清珍. 黄芪注射液对肺结核患者T细胞亚群的影响及近期疗效. 第四军医大学学报, 1999, 20(10): 57-59.
13.	许社娟, 陈敏珠. 黄芪多糖的抑瘤作用及其机制. 中国医院药学杂志, 2005, 25(1): 923-925.
14.	World Health Organization. WHO/CDS/TB/2003.313. Geneva: World Health Organization; 2003. Treatment of tuberculosis: Guidelines for national programmes.
15.	中华医学会结核病学分会. 中国结核病分类法. 中华结核和呼吸杂志, 1998, 21(12): 716-717.
16.	刘军. 黄芪注射液辅助治疗初治菌阳肺结核疗效观察. 中国民间疗法, 2010, 2(18): 38-39.
17.	李爱民, 刘林刚. 黄芪注射液辅助治疗复治肺结核疗效观察. 医药论坛杂志, 2008, 16(29): 122-123.
18.	张立宏, 马祥勤. 抗结核药物联用复方黄芪胶囊治疗耐药肺结核的临床研究. 临床肺科杂志, 2005, 5(10): 665-666.
19.	王伟, 阮祥林. 抗结核药伍用黄芪治疗难治性肺结核疗效分析. 中国医师杂志, 2004, 6(9): 1282.
20.	钟炳图. 黄芪注射液佐治耐药肺结核疗效观察. 浙江中西医结合杂志, 2004, 2(14): 83-84.
21.	贡献华. 胸腺因子D与黄芪治疗老年肺结核30例疗效分析. 中国综合临床, 2004, 3(20): 231-232.
22.	来中海, 江振英. 黄芪注射液佐治老年活动期肺结核近期疗效观察. 中国中西医结合杂志, 2004, 7(24): 609.
23.	和风云, 何静. 化疗并用黄芪注射液治疗复治肺结核33例. 中国基层医药, 2004, 11(2): 232-233.
24.	张定琳, 景巧珍. 黄芪注射液在肺结核治疗中的作用. 实用医技杂志, 2002, 6(9): 434-435.
25.	牛红蕊, 袁亮. 黄芪注射液辅助治疗老年肺结核的疗效观察. 中国中西医结合杂志, 2001, 5(21): 349-350.
26.	张达, 范金鑫. 标准化疗方案加黄芪注射液治疗初治涂阳肺结核. 齐齐哈尔医学院学报, 2000(1)21: 69-72.
27.	蔡青山, 马海燕. 黄芪注射液对耐多药肺结核患者T淋巴细胞亚群的影响. 现代中西医结合杂志, 2000, 9(24): 2449-2450.
28.	王英明, 刘玉岭. 黄芪注射液的临床应用与研究. 中原医刊, 2002, 10(29): 32-34.
29.	许廷生, 梁秀兰. 黄芪的临床新应用. 中国社区医师, 2003, 5(62): 6-7.
30.	叶新水. 黄芪注射液临证应用研究. 实用中医内科杂志, 2004, 1(18): 21-23.

1. 2 Corbett EL, Watt CJ, Walker N, et al . The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med , 2003, 163(9): 1009-1021.
2. 4 Espinal MA, Kim SJ, Suarez PG, et al. Standard short-course chemotherapy for drug-resistant tuberculosis: Treatment outcomes in 6 countries. JAMA , 2000, 283(19): 2537-2545.
3. 5 Dye C, Watt CJ, Bleed DM, et al . Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally. JAMA , 2005, 293(22): 2767-2775.
4. 8 Seki K, Chisaka M, Eriguchi M, et al . An attempt to integrate Western and Chinese medicine: rationale for applying Chinese medicine as chronotherapy against cancer. Biomed Pharmacother , 2005, 59 Suppl 1: S132-40.
5. 10 Stickel F, Schuppan D. Herbal medicine in the treatment of liver diseases. Dig Liver Dis , 2007, 39(4): 293-304.
6. 11 Ho MJ. Perspectives on tuberculosis among traditional Chinese medical practitioners in New York City's Chinatown. Cult Med Psychiatry , 2006, 30(1): 105-122.
7. 26 World Health Organization; International Union Against Tuberculosis and Lung Disease; Royal Netherlands Tuberculosis Association. Revised international definitions in tuberculosis control. Int J Tuberc Lung Dis , 2001, 5(3): 213-215.
8. 27 Seung KJ, Gelmanova IE, Peremitin GG, et al . The effect of initial drug resistance on treatment response and acquired drug resistance during standardized short-course chemotherapy for tuberculosis. Clin Infect Dis , 2004, 39(9): 1321-1328.
9. 中华人民共和国卫生部疾病预防控制局. 中国结核病防治规划实施工作指南. 2006.
10. World Health Organization. Global tuberculosis control: Surveillance, planning, financing. WHO report. Geneva: World Health Organization; 2007. WHO/HTM/TB/2007.376.
11. 李晓光. 黄芪对结核病的治疗作用研究现状. 临床肺科杂志, 2008, 5(13): 626-627.
12. 周义乾, 刘玉林, 刘清珍. 黄芪注射液对肺结核患者T细胞亚群的影响及近期疗效. 第四军医大学学报, 1999, 20(10): 57-59.
13. 许社娟, 陈敏珠. 黄芪多糖的抑瘤作用及其机制. 中国医院药学杂志, 2005, 25(1): 923-925.
14. World Health Organization. WHO/CDS/TB/2003.313. Geneva: World Health Organization; 2003. Treatment of tuberculosis: Guidelines for national programmes.
15. 中华医学会结核病学分会. 中国结核病分类法. 中华结核和呼吸杂志, 1998, 21(12): 716-717.
16. 刘军. 黄芪注射液辅助治疗初治菌阳肺结核疗效观察. 中国民间疗法, 2010, 2(18): 38-39.
17. 李爱民, 刘林刚. 黄芪注射液辅助治疗复治肺结核疗效观察. 医药论坛杂志, 2008, 16(29): 122-123.
18. 张立宏, 马祥勤. 抗结核药物联用复方黄芪胶囊治疗耐药肺结核的临床研究. 临床肺科杂志, 2005, 5(10): 665-666.
19. 王伟, 阮祥林. 抗结核药伍用黄芪治疗难治性肺结核疗效分析. 中国医师杂志, 2004, 6(9): 1282.
20. 钟炳图. 黄芪注射液佐治耐药肺结核疗效观察. 浙江中西医结合杂志, 2004, 2(14): 83-84.
21. 贡献华. 胸腺因子D与黄芪治疗老年肺结核30例疗效分析. 中国综合临床, 2004, 3(20): 231-232.
22. 来中海, 江振英. 黄芪注射液佐治老年活动期肺结核近期疗效观察. 中国中西医结合杂志, 2004, 7(24): 609.
23. 和风云, 何静. 化疗并用黄芪注射液治疗复治肺结核33例. 中国基层医药, 2004, 11(2): 232-233.
24. 张定琳, 景巧珍. 黄芪注射液在肺结核治疗中的作用. 实用医技杂志, 2002, 6(9): 434-435.
25. 牛红蕊, 袁亮. 黄芪注射液辅助治疗老年肺结核的疗效观察. 中国中西医结合杂志, 2001, 5(21): 349-350.
26. 张达, 范金鑫. 标准化疗方案加黄芪注射液治疗初治涂阳肺结核. 齐齐哈尔医学院学报, 2000(1)21: 69-72.
27. 蔡青山, 马海燕. 黄芪注射液对耐多药肺结核患者T淋巴细胞亚群的影响. 现代中西医结合杂志, 2000, 9(24): 2449-2450.
28. 王英明, 刘玉岭. 黄芪注射液的临床应用与研究. 中原医刊, 2002, 10(29): 32-34.
29. 许廷生, 梁秀兰. 黄芪的临床新应用. 中国社区医师, 2003, 5(62): 6-7.
30. 叶新水. 黄芪注射液临证应用研究. 实用中医内科杂志, 2004, 1(18): 21-23.

Chinese Journal of Evidence-Based Medicine

Effects of Astragaulus Membranaceus on Pulmonary Tuberculosis: A Systematic Review

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