连花清瘟治疗新型冠状病毒肺炎有效性和安全性的系统评价与 Meta 分析。
Efficacy and Safety of Lianhua Qingwen for Patients with COVID-19: A Systematic Review and Meta-Analysis.
机构信息
Key Laboratory of Shaanxi Administration of Traditional Chinese Medicine for Traditional Chinese Medicine Compatibility, Shaanxi University of Chinese Medicine, Xi'an, 712046, China.
Nanjing Bestform Pharmaceutical Technology Co., Ltd., Nanjing, 210032, China.
出版信息
Chin J Integr Med. 2022 Jul;28(7):650-660. doi: 10.1007/s11655-022-3578-8. Epub 2022 Jul 1.
BACKGROUND
Corona virus disease 2019 (COVID-19) has spread around the world since its outbreak, and there is no ascertained effective drug up to now. Lianhua Qingwen (LHQW) has been widely used in China and overseas Chinese, which had some advantages in the treatment of COVID-19.
OBJECTIVE
To evaluate the efficacy and safety of LHQW for COVID-19 by conducting a systematic review with meta-analysis.
METHODS
A comprehensive literature search was conducted in 12 electronic databases from their establishment to October 30, 2021. Note Express 3.2.0 was used for screening of trials, and the data was independently extracted in duplicate by 2 researchers. The risk of bias of randomized controlled trials (RCTs) and retrospective studies were assessed by using the Cochrane collaboration tool and Newcastle Ottawa Scale, respectively, followed by data analysis using RevMan 5.3. The RCTs or retrospective studies to treat COVID-19 using LHQW were included. The intervention measures in the experimental group were LHQW alone or combined with chemical drugs (LCWC), and that in the control group were chemical drugs (CDs). Outcome measures included computed tomography (CT) recovery rate, disappearance rates of primary (fever, cough, fatigue), respiratory, gastrointestinal and other symptoms, exacerbation rate and adverse reaction. Subgroup analysis was conducted according to whether LHQW was combined with CDs and the different treatment methods in the control group.
RESULTS
Nine trials with 1,152 participants with COVID-19 were included. The CT recovery rates of LHQW and LCWC were 1.36 and 1.32 times of CDs, respectively (P<0.05). Compared with CDs, LCWC remarkably increased the disappearance rates of fever, cough, fatigue, expectoration, shortness of breath, and muscle soreness (P<0.05). LHQW also obviously decreased the exacerbation rate, which was 0.45 times of CDs alone (P<0.05). There was no obvious difference between LCWC and CDs in adverse reaction (P>0.05).
CONCLUSIONS
LHQW was more suitable for treating COVID-19 patients with obvious expectoration, shortness of breath and muscle soreness. LHQW had advantages in treating COVID-19 with no obvious exacerbation. (PROSPERO No. CRD42021235937).
背景
自 2019 年新冠疫情爆发以来，新冠病毒病（COVID-19）已在全球范围内传播，目前尚无确定有效的药物。连花清瘟（LHQW）在中国及海外华人中已广泛应用，在 COVID-19 的治疗中具有一定优势。
目的
通过系统评价和荟萃分析评估 LHQW 治疗 COVID-19 的疗效和安全性。
方法
从各数据库建库起至 2021 年 10 月 30 日，全面检索 12 个电子数据库。采用 Note Express 3.2.0 进行试验筛选，由 2 名研究人员独立提取数据。采用 Cochrane 协作工具和纽卡斯尔-渥太华量表分别评估随机对照试验（RCT）和回顾性研究的偏倚风险，然后使用 RevMan 5.3 进行数据分析。纳入单独使用 LHQW 或联合化学药物（LCWC）治疗 COVID-19 的 RCT 或回顾性研究。实验组的干预措施为 LHQW 单独或联合化学药物（LCWC），对照组为化学药物（CDs）。结局指标包括 CT 恢复率、主要（发热、咳嗽、乏力）、呼吸、胃肠道等症状消失率、加重率和不良反应。根据 LHQW 是否联合 CDs 以及对照组的不同治疗方法进行亚组分析。
结果
共纳入 9 项 RCT，包含 1152 例 COVID-19 患者。LHQW 和 LCWC 的 CT 恢复率分别是 CDs 的 1.36 和 1.32 倍（P<0.05）。与 CDs 相比，LCWC 显著提高了发热、咳嗽、乏力、咳痰、呼吸急促和肌肉酸痛的消失率（P<0.05）。LHQW 还明显降低了加重率，为 CDs 单独治疗的 0.45 倍（P<0.05）。LCWC 与 CDs 相比，不良反应发生率差异无统计学意义（P>0.05）。
结论
LHQW 更适用于治疗伴有明显咳痰、呼吸急促和肌肉酸痛的 COVID-19 患者。LHQW 在 COVID-19 无明显加重方面具有优势。（PROSPERO 注册号：CRD42021235937）。
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