Public Health and Preventive Medicine Teaching and Research Center, Basic Medicine College, Henan University of Chinese Medicine, Zhengzhou 450000, China.
Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210000, China.
Am J Emerg Med. 2020 Oct;38(10):2153-2159. doi: 10.1016/j.ajem.2020.06.069. Epub 2020 Jul 8.
Chinese medicine (CM) has been used to treat Novel Coronavirus 2019 (COVID-19) pneumonia in China. This meta-analysis was conducted to evaluate the clinical efficacy and safety of CM in the treatment of COVID-19 pneumonia.
Randomized controlled trials (RCTs) involving CM in the treatment of COVID-19 pneumonia were identified from Cochrane Central Register of Controlled Trials, PubMed, EMBASE, Chinese National Knowledge Infrastructure, Chinese Biomedical Database, Wanfang Database and VIP Information Database. The methodological quality of trials was evaluated with Cochrane Hanadbook criteria, and the Cochrane Collaboration's Review Manager 5.3 software was used for meta-analysis.
A total of 7 valid studies involving 681 patients were included. The meta-analysis exhibited in comparison to conventional treatment, CM combined with conventional treatment significantly improved clinical efficacy (RR = 1.21, 95% CI [1.08,1.36]), and significantly increased viral nucleic acid negative conversion rate (RR = 1.49, 95% CI [1.13,1.97]). CM also prominently reduced pulmonary inflammation (RR = 1.27, 95% CI [1.12,1.44]), and improved host immune function (WBC, MD = 0.92, 95% CI [0.07,1.76]; LYM, MD = 0.33, 95% CI [0.08,0.57]; LYM%, MD = 2.90, 95% CI [2.09,3.71]; CRP, MD = -12.66, 95% CI [-24.40, -0.92]). Meanwhile, CM did not increase the incidence of adverse reactions (RR = 1.17, 95% CI [0.39,3.52]).
According to the allocated data, CM has demonstrated clinical efficacy and safety on COVID-19 pneumonia, which need to be confirmed by high quality, multiple-center, large sample randomized controlled trials.
中医药在中国已被用于治疗新型冠状病毒 2019(COVID-19)肺炎。本荟萃分析旨在评估中医药治疗 COVID-19 肺炎的临床疗效和安全性。
从 Cochrane 对照试验中心注册库、PubMed、EMBASE、中国国家知识基础设施、中国生物医学数据库、万方数据库和 VIP 信息数据库中检索到关于中医药治疗 COVID-19 肺炎的随机对照试验(RCT)。采用 Cochrane 手册标准评估试验的方法学质量,并使用 Cochrane 协作的 Review Manager 5.3 软件进行荟萃分析。
共有 7 项有效研究纳入 681 例患者。荟萃分析显示,与常规治疗相比,中医药联合常规治疗显著提高了临床疗效(RR=1.21,95%CI[1.08,1.36]),显著提高了病毒核酸转阴率(RR=1.49,95%CI[1.13,1.97])。中医药还显著减轻肺部炎症(RR=1.27,95%CI[1.12,1.44]),改善宿主免疫功能(WBC,MD=0.92,95%CI[0.07,1.76];LYM,MD=0.33,95%CI[0.08,0.57];LYM%,MD=2.90,95%CI[2.09,3.71];CRP,MD=-12.66,95%CI[-24.40,-0.92])。同时,中医药并未增加不良反应的发生率(RR=1.17,95%CI[0.39,3.52])。
根据现有数据,中医药在 COVID-19 肺炎方面具有临床疗效和安全性,但需要高质量、多中心、大样本的随机对照试验加以证实。