中成药疏风解毒胶囊辅助治疗社区获得性肺炎：一项随机临床试验的系统评价和Meta分析

Chinese Patent Medicine Shufeng Jiedu Capsules as an Adjuvant Therapy for Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

作者信息

Zhang Xiao-Wen, Xia Ru-Yu, Gao Jia-Qi, Liu Jin-Jun, Xu De-Hao, Li Xun, Hu Xiao-Yang, Willcox Merlin, Moore Michael, Dai Meng-Yuan, Trill Jeanne, Fei Yu-Tong, Liu Jian-Ping

机构信息

Centre for Evidence Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

School of Qi-Huang Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Front Pharmacol. 2022 Jul 4;13:923395. doi: 10.3389/fphar.2022.923395. eCollection 2022.

DOI:10.3389/fphar.2022.923395

PMID:35860018

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9289368/

Abstract

Shufeng Jiedu (SFJD) capsules can be used as adjunctive treatment for patients with community-acquired pneumonia, but the effectiveness and safety of SFJD are not clear. This review aims to evaluate the effectiveness and safety of SFJD based on randomized controlled trials (RCTs). A systematic review was conducted by searching PubMed, Embase, Scopus, Web of Science, CENTRAL, CNKI, VIP, CBM, Wanfang and trial registry platforms from their inception to March 2022. Two reviewers screened studies, extracted the data and assessed risk of bias independently. The data were pooled for meta-analysis or presented narratively. Seventeen RCTs involving 1840 participants were included. All trials compared SFJD plus antibiotics to antibiotics, or combined with symptomatic treatment in both groups. The overall certainty of evidence was assessed as moderate to very low certainty. Compared with routine treatment (antibiotics alone or antibiotics plus symptomatic treatment), SFJD plus routine treatment showed beneficial effects in resolution of fever (MD -1.20 days, 95%CI -1.73 to -0.67; 10 RCTs; very low certainty), cough (MD -1.02 days, 95%CI -1.23 to -0.81; 9 RCTs; moderate certainty), phlegm (MD -1.46 days, 95%CI -2.84 to -0.08; 6 RCTs; very low certainty), pulmonary crepitations (MD -1.61 days, 95%CI -2.64 to -0.59; 8 RCTs; low certainty), shortness of breath (MD -2.80 days, 95%CI -2.88 to -2.72; 2 RCTs; low certainty) and chest pain (MD -2.85 days, 95%CI -3.01 to -2.69; 1 RCT; low certainty). There was no significant difference in pathogen clearance (1 RCT). No serious adverse events were reported, but 2.60% (5/192) patients reported nausea in the SFJD groups, 1.04% (2/192) participants in routine group, and no significant difference was identified. Current evidence suggests that adding SFJD may shorten the duration of symptom relief in community-acquired pneumonia for 1-2 days. The adverse events were minor and controllable, and no serious adverse events were reported. Well-reported trials and potential of reducing antibiotics were expected in the future studies.

摘要

疏风解毒（SFJD）胶囊可作为社区获得性肺炎患者的辅助治疗药物，但SFJD的有效性和安全性尚不清楚。本综述旨在基于随机对照试验（RCT）评估SFJD的有效性和安全性。通过检索PubMed、Embase、Scopus、Web of Science、CENTRAL、中国知网、维普、中国生物医学文献数据库、万方数据库以及试验注册平台，对从建库至2022年3月的文献进行了系统综述。两名评价员独立筛选研究、提取数据并评估偏倚风险。数据进行合并以进行荟萃分析或进行描述性呈现。纳入了17项RCT，涉及1840名参与者。所有试验均比较了SFJD联合抗生素与抗生素，或两组均联合对症治疗。证据的总体确定性评估为中度至极低确定性。与常规治疗（单独使用抗生素或抗生素加对症治疗）相比，SFJD加常规治疗在退热（MD -1.20天，95%CI -1.73至-0.67；10项RCT；极低确定性）、止咳（MD -1.02天，95%CI -1.23至-0.81；9项RCT；中度确定性）、化痰（MD -1.46天，95%CI -2.84至-0.08；6项RCT；极低确定性）、肺部啰音（MD -1.61天，95%CI -2.64至-0.59；8项RCT；低确定性）、气短（MD -2.80天，95%CI -2.88至-2.72；2项RCT；低确定性）和胸痛（MD -2.85天，95%CI -3.01至-2.69；1项RCT；低确定性）方面显示出有益效果。病原体清除方面无显著差异（1项RCT）。未报告严重不良事件，但SFJD组有2.60%（5/192）的患者报告恶心，常规组有1.04%（2/192）的参与者报告恶心，差异无统计学意义。目前的证据表明，加用SFJD可能使社区获得性肺炎症状缓解时间缩短1 - 2天。不良事件轻微且可控，未报告严重不良事件。未来研究有望开展报告完善的试验并发挥减少抗生素使用的潜力。