Pang Wentai, Liu Zhi, Li Nan, Li Yuyun, Yang Fengwen, Pang Bo, Jin Xinyao, Zheng Wenke, Zhang Junhua
Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Integr Med Res. 2020 Sep;9(3):100477. doi: 10.1016/j.imr.2020.100477. Epub 2020 Jul 28.
Integration of Chinese medical drugs (CMD) and western medicine (WM) has been widely used in the treatment of Coronavirus Disease 2019 (COVID-19). This systematic review aimed to evaluate the efficacy and safety of CMD for COVID-19.
A literature search was performed in six databases from injection to June 2020. Both randomized controlled trials (RCTs) and quasi-RCTs were considered as eligible. The quality of included RCTs were assessed by Cochrane Risk of Bias Tool, and Review Manager 5.3 software was used to do meta-analysis.
Eleven studies with 1259 patients were included in this study. CMD included herbal decoction and Chinese patent medicine. The methodological quality was evaluated as generally unclear. The results of meta-analysis showed that the integration of CMD and WM had better efficacy than WM in number of patients turned to severe and critical type (RR = 0.47, 95% CI=[0.32, 0.69], P < 0.0001), length of hospital stay (MD= -7.95, 95% CI=[-14.66, -1.24], P = 0.02), defervescence time (MD= -1.20, 95% CI=[-2.03, -0.38], P = 0.004), cough resolution rate (RR = 1.37, 95% CI=[1.15, 1.64], P = 0.0004), fatigue resolution rate (RR = 1.37, 95% CI=[1.02, 1.83], P = 0.04), and tachypnea resolution rate (RR = 2.20, 95% CI=[1.11, 4.39], P = 0.02). As for safety, there was no significant difference between two groups.
CMD may bring potential benefit to patients suffered from COVID-19. However, the quality of included trials is not good enough. High quality study with core outcome set are still required.
中药与西药联合应用已广泛用于新型冠状病毒肺炎(COVID-19)的治疗。本系统评价旨在评估中药治疗COVID-19的疗效和安全性。
检索了6个数据库,检索时间从建库至2020年6月。随机对照试验(RCT)和半随机对照试验均被视为合格研究。采用Cochrane偏倚风险工具评估纳入RCT的质量,并使用Review Manager 5.3软件进行荟萃分析。
本研究纳入11项研究,共1259例患者。中药包括中药汤剂和中成药。方法学质量总体评价为不清楚。荟萃分析结果显示,中西医结合治疗在转为重型和危重型患者数量(RR = 0.47,95%CI=[0.32, 0.69],P < 0.0001)、住院时间(MD = -7.95,95%CI=[-14.66, -1.24],P = 0.02)、退热时间(MD = -1.20,95%CI=[-2.03, -0.38],P = 0.004)、咳嗽缓解率(RR = 1.37,95%CI=[1.15, 1.64],P = 0.0004)、乏力缓解率(RR = 1.37,95%CI=[1.02, 1.83],P = 0.04)和气促缓解率(RR = 2.20,95%CI=[1.11, 4.39],P = 0.02)方面比单纯西药治疗疗效更好。在安全性方面,两组之间无显著差异。
中药可能给COVID-19患者带来潜在益处。然而,纳入试验的质量不够好。仍需要开展具有核心结局指标集的高质量研究。