First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China.
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China.
Complement Ther Clin Pract. 2021 Feb;42:101297. doi: 10.1016/j.ctcp.2020.101297. Epub 2020 Dec 16.
This review aimed at systematically evaluating the efficacy and safety of Yinqiao powder combined with western medicine in the treatment of pneumonia.
A systematic search for randomized controlled trials (RCTs) focusing on pneumonia treatment using a combination of Yinqiao powder and western medicine was performed in PubMed, the Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang, Weipu (VIP) and CBM. The retrieval time limit was from the establishment of the database to June 2020. Two researchers independently screened the literature, extracted the data and evaluated the bias risk of the included studies. A meta-analysis was performed using RevMan5.3 software. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Fifteen RCTs involving 1705 patients were included in the analysis. The meta-analysis results revealed the total effective rate of the treatment group [RR = 1.21, 95% CI (1.15, 1.27), P < 0.00001], bacterial clearance rate [RR = 1.13, 95% CI (1.05, 1.22), P = 0.001], adverse reactions [RR = 0.54, 95% CI (0.38, 0.76), P = 0.0005]. There were statistically significant differences in the cooling time, T cell number, procalcitonin (PCT) and C-reactive protein (CRP) value decline rate (P < 0.05). There was no statistically significant difference in the decline rate of neutrophils and leukocytes (P > 0.05).
The current evidence indicated that the Yinqiao powder combined with western medicine can improve total efficiency in the treatment of pneumonia patients. The combination therapy performed better when compared to western medicine alone in the cooling time, bacterial clearance rate, T cell count, decline rates of CRP and PCT as well as in the incidences of adverse reactions. However, there was no significant difference in the decline rates of neutrophils and leucocytes between the two groups. The funnel plot, Egger's test and Begg's test indicated publication bias, which may be associated with unpublished negative study results. Due to the limitation of the quality and quantity of the included studies, more high-quality studies should be performed to verify our conclusions.
本综述旨在系统评价银翘散联合西药治疗肺炎的疗效和安全性。
在 PubMed、Cochrane 图书馆、EMBASE、Web of Science、中国知网、万方、维普（VIP）和 CBM 中系统检索银翘散联合西药治疗肺炎的随机对照试验（RCT）。检索时间限定为数据库建立至 2020 年 6 月。两位研究者独立筛选文献、提取数据并评估纳入研究的偏倚风险。使用 RevMan5.3 软件进行荟萃分析。采用推荐评估、制定与评价（GRADE）方法评估证据质量。
纳入 15 项 RCT，共 1705 例患者。荟萃分析结果显示，治疗组总有效率[RR=1.21，95%CI（1.15，1.27），P<0.00001]、细菌清除率[RR=1.13，95%CI（1.05，1.22），P=0.001]、不良反应[RR=0.54，95%CI（0.38，0.76），P=0.0005]差异均有统计学意义。降温时间、T 细胞数、降钙素原（PCT）和 C 反应蛋白（CRP）值下降率差异有统计学意义（P<0.05），中性粒细胞和白细胞下降率差异无统计学意义（P>0.05）。
现有证据表明，银翘散联合西药可提高肺炎患者的总有效率，在降温时间、细菌清除率、T 细胞数、CRP 和 PCT 值下降率及不良反应发生率方面，联合治疗优于单纯西药治疗，但两组中性粒细胞和白细胞下降率差异无统计学意义。漏斗图、Egger 检验和 Begg 检验提示可能存在发表偏倚，这可能与未发表的阴性研究结果有关。由于纳入研究的质量和数量有限，需要开展更多高质量研究来验证我们的结论。
