Department of Clinical Pharmacy, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University.
Institute for Drug Evaluation, Peking University Health Science Center, Beijing, PR China.
Medicine (Baltimore). 2021 May 28;100(21):e26059. doi: 10.1097/MD.0000000000026059.
: Coronavirus disease 2019 (COVID-19) is an emerging and rapidly evolving disease, with no recommended effective anti-coronavirus treatments. Traditional Chinese Medicine (TCM) has been widely used to treat COVID-19 in China, and the most used one is Lianhuaqingwen (LH). This study aimed to assess the efficacy and safety of LH combined with usual treatment vs usual treatment alone in treating mild or moderate COVID-19 by a meta-analysis of randomized controlled trials (RCTs).
: We systematically searched the Medline (OVID), Embase, the Cochrane Library, and 4 Chinese databases from inception to July 2020 to include the RCTs that evaluated the efficacy and safety of LH in combination with usual treatment vs usual treatment for mild or moderate COVID-19. A meta-analysis was performed to calculate the risk ratio (RR) and 95% confidence interval (CI) for binary outcomes and mean difference (MD) for continuous outcomes.
: A total of 5 RCTs with 824 individuals with mild or moderate COVID 19 were included. Compared with the usual treatment alone, LH in combination with usual treatment significantly improved the overall clinical efficacy (RR = 2.39, 95% CI 1.61-3.55), increased the rate of recovery of chest computed tomographic manifestations (RR = 1.80, 95% CI 1.08-3.01), reduced the rate of conversion to severe cases (RR = 0.47, 95% CI 0.29-0.74), shorten the duration of fever (MD = -1.00, 95% CI -1.17 to -0.84). Moreover, LH in combination with usual treatment did not increase the occurrence of the adverse event compared to usual treatment alone.
: Our meta-analysis of RCTs indicated that LH in combination with usual treatment may improve the clinical efficacy in patients with mild or moderate COVID-19 without increasing adverse events. However, given the limitations and poor quality of included trials in this study, further large-sample RCTs or high-quality real-world studies are needed to confirm our conclusions.
2019 年冠状病毒病（COVID-19）是一种新兴的、迅速发展的疾病，目前尚无推荐的有效抗冠状病毒治疗方法。中药（TCM）在中国已广泛用于治疗 COVID-19，其中使用最多的是连花清瘟（LH）。本研究旨在通过对随机对照试验（RCT）的荟萃分析，评估 LH 联合常规治疗与单独常规治疗在治疗轻度或中度 COVID-19 中的疗效和安全性。
我们系统地检索了 Medline（OVID）、Embase、Cochrane 图书馆和 4 个中文数据库，从建库到 2020 年 7 月，纳入评估 LH 联合常规治疗与单独常规治疗轻度或中度 COVID-19 的疗效和安全性的 RCT。采用荟萃分析计算二分类结局的风险比（RR）和 95%置信区间（CI）以及连续结局的均数差（MD）。
共纳入 5 项 RCT，涉及 824 例轻度或中度 COVID-19 患者。与单独常规治疗相比，LH 联合常规治疗可显著提高总临床疗效（RR=2.39，95%CI 1.61-3.55），增加胸部计算机断层扫描表现恢复率（RR=1.80，95%CI 1.08-3.01），降低转为重症病例的比例（RR=0.47，95%CI 0.29-0.74），缩短发热持续时间（MD=-1.00，95%CI-1.17 至-0.84）。此外，LH 联合常规治疗与单独常规治疗相比，不良反应发生率并未增加。
本 RCT 荟萃分析表明，LH 联合常规治疗可能改善轻度或中度 COVID-19 患者的临床疗效，且不增加不良反应。然而，鉴于本研究纳入试验的局限性和质量较差，需要进一步开展大样本 RCT 或高质量真实世界研究来证实我们的结论。
