Chen Yuan-Bin, Shergis Johannah L, Wu Zhen-Hu, Guo Xin-Feng, Zhang Anthony L, Wu Lei, Fan Fei-Ting, Xu Yin-Ji, Xue Charlie C, Lin Lin
Department of Respiratory Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia.
Evid Based Complement Alternat Med. 2021 Mar 2;2021:5853137. doi: 10.1155/2021/5853137. eCollection 2021.
Herbal medicine is commonly used by patients with chronic cough, but the role of herbal medicine for cough variant asthma (CVA) has not yet been clearly defined. For the first time, we performed a meta-analysis to integrate the current evidence of randomized controlled trials (RCTs) on this topic and assess the efficacy of herbal medicine in adults with CVA.
A comprehensive search was conducted in electronic databases to identify RCTs of herbal medicine for adult CVA. Cochrane systematic review methods were followed, and the Grading of Recommendations Assessment, Development, and Evaluation was performed to evaluate the quality of evidence.
Twenty-eight RCTs were included. Compared with placebo, moderate-quality evidence from two studies showed that herbal medicine was associated with reduced cough symptom score (CSS) (MD -1.15 points; 95% CI, -1.67 to -0.63) and visual analogue scale (VAS) (MD -1.76 points; 95% CI, -2.66 to -0.86). Compared with montelukast, low- to moderate-quality evidence from 11 studies indicated that herbal medicine was associated with improved Leicester Cough Questionnaire (LCQ) (MD 2.38 points; 95% CI, 1.32 to 3.44), reduced CSS (SMD -0.81 points; 95% CI, -1.09 to -0.53), and VAS (MD -1.34 points; 95% CI, -1.82 to -0.86). There were no significant differences between herbal medicine and ICS plus bronchodilator.
In adults with CVA, herbal medicine may result in improved quality of life and reduced cough frequency and severity scores compared with placebo or montelukast. Herbal medicine was not better than ICS plus a bronchodilator but the evidence is very uncertain.
慢性咳嗽患者常用草药治疗，但草药在咳嗽变异性哮喘（CVA）中的作用尚未明确界定。我们首次进行了一项荟萃分析，整合该主题随机对照试验（RCT）的现有证据，并评估草药对成年CVA患者的疗效。
在电子数据库中进行全面检索，以确定成人CVA草药治疗的RCT。遵循Cochrane系统评价方法，并采用推荐意见分级评估、制定与评价（GRADE）对证据质量进行评价。
纳入28项RCT。与安慰剂相比，两项研究的中等质量证据表明，草药治疗可降低咳嗽症状评分（CSS）（MD -1.15分；95%CI，-1.67至-0.63）和视觉模拟量表（VAS）评分（MD -1.76分；95%CI，-2.66至-0.86）。与孟鲁司特相比，11项研究的低至中等质量证据表明，草药治疗可改善莱斯特咳嗽问卷（LCQ）评分（MD 2.38分；95%CI，1.32至3.44），降低CSS（SMD -0.81分；95%CI，-1.09至-0.53）和VAS评分（MD -1.34分；95%CI，-1.82至-0.86）。草药与吸入性糖皮质激素（ICS）加支气管扩张剂之间无显著差异。
在成年CVA患者中，与安慰剂或孟鲁司特相比，草药治疗可能改善生活质量，降低咳嗽频率和严重程度评分。草药治疗不比ICS加支气管扩张剂更好，但证据非常不确定。
