Jiang Lanhui, Li Ka, Wu Taixiang
Chinese Evidence-BasedMedicine Centre,West China Hospital,Sichuan University, Chengdu, China.
Cochrane Database Syst Rev. 2012 Feb 15;2012(2):CD004560. doi: 10.1002/14651858.CD004560.pub4.
Acute bronchitis is one of the most common diagnoses made by primary care physicians. It is traditionally treated with antibiotics (although the evidence for their effectiveness is weak, and modest at best) and other even less effective treatments. Chinese medicinal herbs have also been used as a treatment.
This review aimed to summarise the existing evidence on the comparative effectiveness and safety of Chinese medicinal herbs for treating uncomplicated acute bronchitis.
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4) which includes the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to 19 September 19, 2011), EMBASE (1988 to 19 September 2011) and CNKI and the Chinese Biomedical Database (CBM) (1980 to 19 September, 2011).
Randomised controlled trials (RCTs) comparing Chinese medicinal herbs with placebo, antibiotics or other Western medicines for the treatment of uncomplicated acute bronchitis.
At least two review authors independently extracted data and assessed trial quality.
In this updated review, 74 studies involving 6877 participants were reported as RCTs by the study authors. None of them met the inclusion criteria for this review. Out of the 74 trials, we identified 39 as non-RCTs and 35 compared different Chinese herbal medicines in the intervention and control groups.
AUTHORS' CONCLUSIONS: There is insufficient quality data to recommend the routine use of Chinese herbs for acute bronchitis. Trial design limitations of the individual studies meant that we could not draw any conclusions about the benefits of Chinese herbs for acute bronchitis. In addition, the safety of Chinese herbs is unknown due to the lack of toxicological evidence for these herbs, although adverse events were reported in some case reports.
急性支气管炎是基层医疗医生做出的最常见诊断之一。传统上,该病使用抗生素治疗(尽管其有效性证据薄弱,充其量只是一般)以及其他效果更差的治疗方法。中草药也被用作一种治疗手段。
本综述旨在总结关于中草药治疗单纯性急性支气管炎的比较有效性和安全性的现有证据。
我们检索了Cochrane对照试验中心注册库(CENTRAL)(《Cochrane图书馆》2011年第4期),其中包括Cochrane急性呼吸道感染组的专业注册库、MEDLINE(1966年至2011年9月19日)、EMBASE(1988年至2011年9月19日)以及中国知网和中国生物医学数据库(CBM)(1980年至2011年9月19日)。
比较中草药与安慰剂、抗生素或其他西药治疗单纯性急性支气管炎的随机对照试验(RCT)。
至少两名综述作者独立提取数据并评估试验质量。
在本次更新的综述中,研究作者报告有74项研究涉及6877名参与者,被列为RCT。但其中没有一项符合本综述的纳入标准。在这74项试验中,我们确定39项为非RCT,35项在干预组和对照组中比较了不同的中草药。
目前没有足够的高质量数据来推荐常规使用中草药治疗急性支气管炎。个别研究的试验设计存在局限性,这意味着我们无法就中草药治疗急性支气管炎的益处得出任何结论。此外,由于缺乏这些草药的毒理学证据,中草药的安全性尚不清楚,尽管在一些病例报告中报告了不良事件。