中药联合常规西药治疗新型冠状病毒病(COVID-19)的疗效:系统评价和荟萃分析的现有证据。

Contribution of traditional Chinese medicine combined with conventional western medicine treatment for the novel coronavirus disease (COVID-19), current evidence with systematic review and meta-analysis.

机构信息

The Key Laboratory of Biotechnology for Medicinal Plants of Jiangsu Province and School of Life Sciences, Jiangsu Normal University, Xuzhou, China.

Department of Laboratory Medicine, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.

出版信息

Phytother Res. 2021 Nov;35(11):5992-6009. doi: 10.1002/ptr.7209. Epub 2021 Jul 13.

Abstract

This study provides current evidence for efficacy and safety of treating COVID-19 with combined traditional Chinese medicine (TCM) and conventional western medicine (CWM). Six databases were searched from January 1 to December 31, 2020. Randomized controlled trials (RCTs), case-control studies (CCTs), and cohort studies on TCM or TCM combined with CWM treatment for COVID-19 were included. The quality of included RCTs was assessed by Cochrane risk of bias tool, and the Newcastle-Ottawa Scale (NOS) was used to assess the quality of cohort studies and CCTs. Review Manager 5.4 software was used to perform meta-analysis. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A total of 35 studies (3,808 patients) composing 19 RCTs and 16 observational studies were included. The results of meta-analysis revealed that comparing with CWM alone, integrated TCM and CWM had significant improvement in total effective rate, improvement rate of chest CT, the rate of disease progression, as well as improvement of fever, fatigue and cough. The overall quality of evidence was very low to moderate. In conclusion, TCM combined with CWM was a potential treatment option for increasing clinical effective rate, improving the clinical symptoms, and preventing disease progression in COVID-19 patients. High-quality clinical trials are required in the further.

摘要

本研究提供了 COVID-19 采用中西医结合治疗的疗效和安全性的最新证据。从 2020 年 1 月 1 日至 12 月 31 日,检索了六个数据库。纳入了针对 COVID-19 的中药(TCM)或 TCM 联合常规西药(CWM)治疗的随机对照试验(RCT)、病例对照研究(CCT)和队列研究。使用 Cochrane 偏倚风险工具评估纳入 RCT 的质量,使用 Newcastle-Ottawa 量表(NOS)评估队列研究和 CCT 的质量。使用 Review Manager 5.4 软件进行荟萃分析。使用推荐评估、制定与评价(GRADE)方法评估证据质量。共纳入 35 项研究(3808 例患者),包括 19 项 RCT 和 16 项观察性研究。荟萃分析结果表明,与单独使用 CWM 相比,中西医结合治疗在总有效率、胸部 CT 改善率、疾病进展率以及发热、乏力和咳嗽改善方面有显著改善。总体证据质量为极低至中度。总之,TCM 联合 CWM 可能是提高 COVID-19 患者临床有效率、改善临床症状和预防疾病进展的一种潜在治疗选择。需要进一步开展高质量的临床试验。

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