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2019年冠状病毒病的中药:系统评价与荟萃分析

Chinese medical drugs for coronavirus disease 2019: A systematic review and meta-analysis.

作者信息

Pang Wentai, Liu Zhi, Li Nan, Li Yuyun, Yang Fengwen, Pang Bo, Jin Xinyao, Zheng Wenke, Zhang Junhua

机构信息

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.

出版信息

Integr Med Res. 2020 Sep;9(3):100477. doi: 10.1016/j.imr.2020.100477. Epub 2020 Jul 28.

Abstract

BACKGROUND

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.

METHOD

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.

RESULT

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3ed/7452197/987f08c95a95/gr1.jpg

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