中西医结合治疗新型冠状病毒肺炎的疗效与安全性：一项系统评价与Meta分析
The efficacy and safety of combined chinese herbal medicine and western medicine therapy for COVID-19: a systematic review and meta-analysis.
作者信息
Li Lu, Xie Hongliang, Wang Ling, Zhang Aolin, Mou Xuan, Lin Yifan, Ma Hongli, Wang Yu, Li Jian, Gao Jingshu, Wang Chi Chiu, Leung Ping Chung, Fan Xiaohui, Wu Xiaoke
机构信息
Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.
Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China.
出版信息
Chin Med. 2022 Jun 21;17(1):77. doi: 10.1186/s13020-022-00600-z.
OBJECTIVE
To systematically review the clinical efficacy and safety of Chinese herbal medicine (CHM) with and without Western medicine (WM) for different severity of COVID-19.
METHODS
CNKI, PubMed, Wanfang Database, ClinicalTrails.gov, Embase, ChiCTR and ICTRP were searched from 01 Jan, 2020 to 30 Jun, 2021. Two authors independently assessed all the randomized clinical trials (RCTs) for trial inclusion, data extraction and quality assessment. Meta-analysis was conducted using Review Manager software (RevMan 5.4.1). Evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Primary outcomes included total effectiveness rate. Secondary outcomes included improvements in symptom improvement and total adverse event rate. Different severity of COVID-19 patients was assessed in subgroup analysis. This study was registered with INPLASY, INPLASY202210072.
RESULTS
22 high quality RCTs involving 1789 participants were included. There were no trial used CHM alone nor compare placebo or no treatment. Compared with WM, combined CHM and WM (CHM-WM) treatment showed higher total effectiveness rate, lower symptom scores of fever, cough, fatigue, dry throat and pharyngalgia, shorter mean time to viral conversion, better Computerized Tomography (CT) image and blood results, fewer total adverse events and worse conditions (P < 0.05). Subgroup analysis showed that the total effectiveness rate of combined CHM-WM group was significantly higher than WM group, especially for mild and moderate patients. No significant differences in mortality and adverse events were found between combined CHM-WM and WM treatment. No serious adverse events and long-term outcomes were reported.
CONCLUSION
Current evidence supported the therapeutic effects and safety of combined CHM-WM treatment on COVID-19, especially for patients with mild and moderate symptoms. Long-term effects of therapy are worthy in further study.
目的
系统评价中药联合或不联合西药治疗不同严重程度新型冠状病毒肺炎（COVID-19）的临床疗效和安全性。
方法
检索中国知网、PubMed、万方数据库、ClinicalTrails.gov、Embase、中国临床试验注册中心（ChiCTR）和国际临床试验注册平台（ICTRP）2020年1月1日至2021年6月30日期间的数据。由两名作者独立评估所有随机临床试验（RCT），以确定试验纳入、数据提取和质量评估。使用Review Manager软件（RevMan 5.4.1）进行荟萃分析。采用推荐分级的评估、制定与评价（GRADE）方法评估证据。主要结局包括总有效率。次要结局包括症状改善情况及总不良事件发生率。在亚组分析中评估不同严重程度的COVID-19患者。本研究已在国际系统评价注册平台（INPLASY）注册，注册号为INPLASY202210072。
结果
纳入22项高质量RCT，共1789名参与者。没有试验单独使用中药，也没有比较安慰剂或不治疗的情况。与西药相比，中药联合西药（CHM-WM）治疗的总有效率更高，发热、咳嗽、乏力、咽干、咽痛的症状评分更低，病毒转阴平均时间更短，计算机断层扫描（CT）图像和血液检查结果更好，总不良事件更少，病情更轻（P<0.05）。亚组分析显示，CHM-WM联合组的总有效率显著高于西药组，尤其是轻度和中度患者。CHM-WM联合治疗与西药治疗在死亡率和不良事件方面无显著差异。未报告严重不良事件和长期结局。
结论
现有证据支持CHM-WM联合治疗COVID-19的疗效和安全性，尤其是对轻、中度症状患者。该疗法的长期效果值得进一步研究。
Zotero 插件