WANG Hanbin 1,2,3 , WU Yanan 2,3 , HUANG Jiayi 1,2,3 , CUI Lu 1,2,3 , LIANG Cui 1,2,3 , HU Xiaoye 1,2,3 , LI Xiuxia 1,3 , ZHANG Yu 4,5
  • 1. Health Technology Assessment Center /Evidence Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;
  • 2. Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, P. R. China;
  • 3. Key Laboratory of Evidence Based Medicine of Gansu Province, Lanzhou University, Lanzhou 730000, P. R. China;
  • 4. Gansu Health Vocational College, Lanzhou 730000, P. R. China;
  • 5. Health Vocational Education Transformation Base of Evidence Based Medicine Center, Lanzhou University, Lanzhou 730000, P. R. China;
LI Xiuxia, Email: lixiuxia@lzu.edu; ZHANG Yu, Email: zhangyu2058@163.com
COPD; Disease burden; Systematic review; Network meta-analysis
10.7507/1672-2531.202409024
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Objective This study aimed to assess the impact of different interventions on the disease burden of chronic obstructive pulmonary disease (COPD). Methods CNKI, VIP, WanFang Data, PubMed, Web of Science, Cochrane Library were electronically searched to collect randomized controlled trials (RCTs) on the disease burden of COPD from inception to October, 2023. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, network meta-analysis was performed by using Stata 16 software and R programming language. Results A total of 69 RCTs involving 26 interventions were included. The results of the network meta-analysis showed that compared with invasive ventilation therapy, non-invasive positive pressure ventilation treatment (SMD=−3.84, 95%CI −5.16 to −2.52) and Erchenzhikeqingfei granules (SMD=−3.04, 95%CI −5.89 to −0.20) were reducing the hospitalization cost of COPD patients (P<0.05). The effects of Jianpi Yifei granules, midazolam, targeted oxygen therapy, non-invasive positive pressure ventilation, and nutritional support protocol on reducing mortality in patients with COPD were superior to conventional treatments (RR=4.50, 95%CI 1.02 to 19.79; RR=4.81, 95%CI 1.25 to 18.52; RR=6.92, 95%CI 3.34 to 14.32; RR=3.56, 95%CI 1.14 to 11.08; RR=2.70, 95%CI 1.86 to 3.92; RR=3.60, 95%CI 2.01 to 6.45). Surface under the cumulative ranking(SUCRA) showed that oxygen therapy prescription had the highest probability of becoming the best measure (75.2%) to reduce mortality in patients with chronic obstructive pulmonary disease, the non-invasive positive pressure ventilation treatment was the most effective intervention(87.4%) to reduce the hospitalization cost of COPD patients. Conclusion Oxygen therapy prescription might be the best measure to reduce mortality and the non-invasive positive pressure ventilation treatment might be the best measure to reduce the hospitalization cost of COPD patients. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.