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中药对 COVID-19 的附加作用:系统评价和荟萃分析。

The add-on effect of Chinese herbal medicine on COVID-19: A systematic review and meta-analysis.

机构信息

School of Public Health, Lanzhou University, Lanzhou, China.

Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China; Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou, China.

出版信息

Phytomedicine. 2021 May;85:153282. doi: 10.1016/j.phymed.2020.153282. Epub 2020 Jul 11.

Abstract

BACKGROUND

Chinese herbal medicine (CHM) is thought to be a potential intervention in the treatment of coronavirus disease (COVID-19).

PURPOSE

This study aimed to investigate the efficacy and safety of CHM or CHM combination therapy for COVID-19.

STUDY DESIGN

Systematic review and meta-analysis METHODS: We searched for relevant studies in the CNKI, CBM, Wanfang Data, PubMed, Cochrane Library, Embase, and other resources from their inception to April 15, 2020. Randomized controlled trials, cohort studies, and case-control studies on CHM or CHM combination therapy for COVID-19 were included. Meta-analysis was performed according to the Cochrane Handbook.

RESULTS

Overall, 19 studies with 1474 patients were included. Meta-analysis showed that the overall clinical effectiveness (OR = 2.67, 95% CI 1.83-3.89, I = 0%), improvement in the CT scan (OR = 2.43, 95% CI 1.80-3.29, I = 0%), percentage of cases turning to severe/critical (OR = 0.40, 95% CI 0.24-0.67, I = 17.1%), reverse transcription-polymerase chain reaction (RT-PCR) negativity rate (OR = 2.55, 95% CI 1.06-6.17, I = 56.4%) and disappearance rate of symptoms (fever, cough, and fatigue) were superior by combined CHM treatment of COVID-19. However, there was no statistical difference between the two groups in terms of length of hospital stay (WMD = -0.46, 95% CI -3.87 - 2.95, I = 99.5%), and rate of adverse effects (OR = 1.21, 95% CI 0.48-3.07, I = 43.5%). The quality of evidence was very low to low.

CONCLUSION

The combined treatment of COVID-19 with Chinese and Western medicine may be effective in controlling symptoms and reducing the rate of disease progression due to low quality evidence.

摘要

背景

中药(CHM)被认为是治疗冠状病毒病(COVID-19)的一种潜在干预手段。

目的

本研究旨在调查 CHM 或 CHM 联合疗法治疗 COVID-19 的疗效和安全性。

研究设计

系统评价和荟萃分析

方法

我们从建库到 2020 年 4 月 15 日,在知网、CBM、万方数据、PubMed、Cochrane 图书馆、Embase 等资源中检索了有关 CHM 或 CHM 联合治疗 COVID-19 的相关研究。纳入 CHM 或 CHM 联合治疗 COVID-19 的随机对照试验、队列研究和病例对照研究。根据 Cochrane 手册进行荟萃分析。

结果

共纳入 19 项研究,共 1474 例患者。荟萃分析显示,总体临床疗效(OR=2.67,95%CI 1.83-3.89,I²=0%)、CT 扫描改善(OR=2.43,95%CI 1.80-3.29,I²=0%)、转为重症/危重症的病例比例(OR=0.40,95%CI 0.24-0.67,I²=17.1%)、逆转录-聚合酶链反应(RT-PCR)阴性率(OR=2.55,95%CI 1.06-6.17,I²=56.4%)和症状(发热、咳嗽、乏力)消失率方面,联合 CHM 治疗 COVID-19 更优。但两组患者的住院时间(WMD=-0.46,95%CI-3.87-2.95,I²=99.5%)和不良反应发生率(OR=1.21,95%CI 0.48-3.07,I²=43.5%)差异无统计学意义。证据质量为极低到低。

结论

由于证据质量低,中西药联合治疗 COVID-19 可能在控制症状和降低疾病进展率方面有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a34f/7831541/12f29beba2b3/gr1_lrg.jpg

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