目的 运用循证医学的方法对穴位敷贴疗法防治慢性阻塞性肺疾病（COPD）的临床疗效及安全性进行系统评价。方法 计算机检索Pubmed、Cochrane Library、Embase、中国知网（CNKI）、万方数据库、维普数据库（VIP）、中国生物医学文献数据库（CBM）等数据库，检索关于穴位敷贴治疗COPD的临床随机对照试验（RCT），检索时间均为各库建库时间至2018年9月，并手工检索相关会议论文和杂志等。由2名评价员根据纳入及排除标准独立对文献进行筛选，数据提取，独立评估。应用Revman5.3软件对数据进行Meta分析。结果 共纳入14篇文献、1293例，包括穴位敷贴治疗组649例，对照组590例，Meta分析结果显示：在常规治疗基础上加用穴位敷贴治疗可明显提高COPD患者的临床有效率[OR = 3.32，95%CI(2.28，4.85)，P < 0.000 01]，改善肺功能FEV1/FVC[MD = 4.12，95%CI(1.16，7.08)，P = 0.006]，BODE指数评分改善[MD = -0.69，95%CI(-1.41，-0.23)，P = 0.003]，减少急性发作次数[MD = -0.66，95%CI(-0.76，-0.57)，P < 0.000 01]，圣乔治呼吸困难问卷（SGRQ）评分明显改善[MD = -8.48，95%CI(-15.89，-1.07)，P = 0.02]，与对照组相比，其差异均有统计学意义。结论 当前有效证据表明，穴位敷贴防治COPD具有一定的优势。但由于所纳入研究存在局限性，质量不高，尚需更多高质量的随机对照研究予以证实。

Objective Evidence-based medicine was used to systematically evaluate the clinical efficacy and safety of acupoint application therapy in the prevention and treatment of chronic obstructive pulmonary disease (COPD).Methods Computer retrieval Pubmed, the Cochrane Library, Embase, China hownet (CNKI), a database of ten thousand, weipu database (VIP), the Chinese biomedical literature database (CBM), such as database retrieval about acupoint sticking therapy of COPD clinical randomized controlled trial (RCT), both for the Library building Library retrieval time time to September 2018, and the manual retrieval related conference papers and magazines. According to the inclusion and exclusion criteria, 2 evaluators independently screened the literature, extracted data, and independently evaluated it. Meta analysis was performed using Revman5.3 software.Results A total of 14 literatures and 1293 cases were included, including 649 cases in the acupoint application group and 590 cases in the control group. Meta-analysis showed that the clinical effective rate of COPD patients could be significantly improved by adding acupoint application therapy on the basis of routine treatment [OR = 3.32, 95% CI (2.28, 4.85), P < 0.000 01], FEV1/FVC [MD = 4.12, 95% CI (1.16, 7.08), P = 0.006], and BODE index score improved [MD = -0.69, 9.000 01]. 5% CI (-1.41, -0.23), P = 0.003), reduced the number of acute episodes [MD = -0.66, 95% CI (-0.76, -0.57, P < 0.00 001], and the score of St. George"s Dyspnea Questionnaire (SGRQ) was significantly improved [MD = -8.48, 95% CI (-15.89, -1.07), P = 0.02]. Compared with the control group, the difference was statistically significant.Conclusion Current effective evidence shows that acupoint application has certain advantages in the prevention and treatment of COPD. However, due to the limitations and low quality of the included studies, more high-quality randomized controlled studies are needed to confirm them.

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