Lu Zhao-Jun, Wu Li-Yin, Mou Yan-Yan, Duan Han-Min, Chen Ru-Cheng, Xiao Yao, Zheng Wei-Jun
School of Public Health,Zhejiang Chinese Medical University Hangzhou 310053,China.
Zhongguo Zhong Yao Za Zhi. 2021 Feb;46(4):1000-1009. doi: 10.19540/j.cnki.cjcmm.20200508.501.
To systematically evaluate the clinical efficacy and safety of Lianhua Qingwen in the treatment of adult pneumonia. The randomized controlled trial of Lianhua Qingwen combined with conventional Western medicine in the treatment of pneumonia were retrieved from PubMed, EMbase, Wanfang database, VIP database, and CNKI from the establishment of database to March 2020. Two researchers independently conducted literature screening and data extraction, and the third researcher was in charge of arbitration in case of any disagreement. Outcome indicators included total clinical effective rate, symptom improvement time, and incidence of adverse events. R 3.6.1 was used for Meta-analysis, and RevMan 5.3 was used for quality evaluation. Twenty-two studies were included, with a total of 2 007 patients, including 1 017 patients in the experimental group and 990 patients in the control group. The results showed that the total clinical effective rate of the experimental group was higher than that of the control group(RR=1.11, 95%CI[1.08, 1.15], P<0.001), and the antifebrile time(MD=-1.81, 95%CI[-2.42,-1.21], P<0.001), cough duration(MD=-2.32, 95%CI[-2.89,-1.76], P<0.001), rale duration(MD=-2.19, 95%CI[-2.74,-1.63], P<0.001), imaging recovery time(MD=-2.17, 95%CI[-2.76,-1.58], P<0.001) and post-treatment CRP(MD=-4.07, 95%CI[-6.39,-1.75], P<0.001] were all significantly lower than those of the control group. However, it did not proved that the experimental group was safer than the control group(RR=0.84, 95%CI[0.57, 1.24], P=0.382). The results confirmed that Lianhua Qingwen combined with conventional Western medicine in the treatment of pneumonia could improve the clinical treatment efficiency, shorten the time of fever, cough, rale disappearance and imaging recovery, improve CRP index and accelerate the recovery of pneumonia patients. However, the literatures included in this study had a low quality, and the conclusions still need to be further confirmed by more high-quality, multi-center, rigorously designed randomized controlled trial.
为系统评价连花清瘟治疗成人肺炎的临床疗效及安全性。检索PubMed、EMbase、万方数据库、维普数据库和中国知网中自建库至2020年3月关于连花清瘟联合传统西药治疗肺炎的随机对照试验。由两名研究人员独立进行文献筛选和数据提取,如有分歧则由第三名研究人员负责仲裁。结局指标包括总临床有效率、症状改善时间和不良事件发生率。采用R 3.6.1进行Meta分析,RevMan 5.3进行质量评价。共纳入22项研究,共计2007例患者,其中试验组1017例,对照组990例。结果显示,试验组总临床有效率高于对照组(RR=1.11,95%CI[1.08,1.15],P<0.001),退热时间(MD=-1.81,95%CI[-2.42,-1.21],P<0.001)、咳嗽持续时间(MD=-2.32,95%CI[-2.89,-1.76],P<0.001)、啰音持续时间(MD=-2.19,95%CI[-2.74,-1.63],P<0.001)、影像学恢复时间(MD=-2.17,95%CI[-2.76,-1.58],P<0.001)及治疗后CRP(MD=-4.07,95%CI[-6.39,-1.75],P<0.001)均显著低于对照组。然而,未证实试验组比对照组更安全(RR=0.84,95%CI[0.57,1.24],P=0.382)。结果证实,连花清瘟联合传统西药治疗肺炎可提高临床治疗效率,缩短发热、咳嗽、啰音消失及影像学恢复时间,改善CRP指标,加速肺炎患者康复。然而,本研究纳入的文献质量较低,结论仍需更多高质量、多中心、设计严谨的随机对照试验进一步证实。