Dongzhimen Hospital Key Laboratory, Beijing University of Chinese Medicine, Beijing 100700, China; Key Laboratory of Internal Medicine of Chinese Medicine, Ministry of Education, Beijing University of Chinese Medicine, Beijing 100700, China.
School of Medical Information Engineering, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong Province, China.
J Integr Med. 2023 Sep;21(5):441-454. doi: 10.1016/j.joim.2023.08.001. Epub 2023 Aug 5.
The coronavirus disease 2019 (COVID-19) continues to spread worldwide. Integrated Chinese and Western medicine have had some successes in treating COVID-19.
This study aims to evaluate the efficacy and safety of three traditional Chinese medicine drugs and three herbal formulas (3-drugs-3-formulas) in patients with COVID-19.
Relevant studies were identified from 12 electronic databases searched from their establishment to April 7, 2022.
Randomized controlled trials (RCTs), non-RCTs and cohort studies that evaluated the effects of 3-drugs-3-formulas for COVID-19. The treatment group was treated with one of the 3-drugs-3-formulas plus conventional treatment. The control group was treated with conventional treatment.
Two evaluators screened and selected literature independently, then extracted basic information and assessed risk of bias. The treatment outcome measures were duration of main symptoms, hospitalization time, aggravation rate and mortality. RevMan 5.4 was used to analyze the pooled results reported as mean difference (MD) with 95% confidence interval (CI) for continuous data and risk ratio (RR) with 95% CI for dichotomous data.
Forty-one studies with a total of 13,260 participants were identified. Our analysis suggests that compared with conventional treatment, the combination of 3-drugs-3-formulas might shorten duration of fever (MD = -1.39; 95% CI: -2.19 to -0.59; P < 0.05), cough (MD = -1.57; 95% CI: -2.16 to -0.98; P < 0.05) and fatigue (MD = -1.36; 95% CI: -2.21 to -0.51; P < 0.05), decrease length of hospital stay (MD = -2.62; 95% CI -3.52 to -1.72; P < 0.05), the time for nucleic acid conversion (MD = -2.92; 95% CI: -4.26 to -1.59; P < 0.05), aggravation rate (RR = 0.49; 95% CI: 0.38 to 0.64; P < 0.05) and mortality (RR = 0.34; 95% CI: 0.19 to 0.62; P < 0.05), and increase the recovery rate of chest computerized tomography manifestations (RR = 1.22; 95% CI: 1.14 to 1.3; P < 0.05) and total effectiveness (RR = 1.24; 95% CI: 1.09 to 1.42; P < 0.05).
The 3-drugs-3-formulas can play an active role in treating all stages of COVID-19. No severe adverse events related to 3-drugs-3-formulas were observed. Hence, 3-drugs-3-formulas combined with conventional therapies have effective therapeutic value for COVID-19 patients. Further long-term high-quality studies are essential to demonstrate the clinical benefits of each formula. Please cite this article as: You LZ, Dai QQ, Zhong XY, Yu DD, Cui HR, Kong YF, Zhao MZ, Zhang XY, Xu QQ, Guan ZY, Wei XX, Zhang XC, Han SJ, Liu WJ, Chen Z, Zhang XY, Zhao C, Jin YH, Shang HC. Clinical evidence of three traditional Chinese medicine drugs and three herbal formulas for COVID-19: A systematic review and meta-analysis of the Chinese population. J Integr Med. 2023; 21(5): 441-454.
新型冠状病毒病 2019（COVID-19）继续在全球范围内传播。中西医结合在治疗 COVID-19 方面取得了一些成功。
本研究旨在评估三种中药药物和三种草药配方（3 药 3 方）在 COVID-19 患者中的疗效和安全性。
从 12 个电子数据库中检索相关研究，检索时间从数据库建立到 2022 年 4 月 7 日。
评价 3 药 3 方治疗 COVID-19 效果的随机对照试验（RCT）、非 RCT 和队列研究。治疗组采用 3 药 3 方加常规治疗，对照组采用常规治疗。
两名评估员独立筛选和选择文献，然后提取基本信息并评估偏倚风险。治疗结局指标为主要症状持续时间、住院时间、加重率和死亡率。使用 RevMan 5.4 分析报告为均数差（MD）的汇总结果，95%置信区间（CI）用于连续数据，风险比（RR）用于二分类数据。
共纳入 41 项研究，共计 13260 名参与者。我们的分析表明，与常规治疗相比，3 药 3 方联合治疗可能缩短发热持续时间（MD=-1.39；95%CI：-2.19 至-0.59；P<0.05）、咳嗽（MD=-1.57；95%CI：-2.16 至-0.98；P<0.05）和疲劳（MD=-1.36；95%CI：-2.21 至-0.51；P<0.05），缩短住院时间（MD=-2.62；95%CI：-3.52 至-1.72；P<0.05），核酸转换时间（MD=-2.92；95%CI：-4.26 至-1.59；P<0.05），加重率（RR=0.49；95%CI：0.38 至 0.64；P<0.05）和死亡率（RR=0.34；95%CI：0.19 至 0.62；P<0.05），提高胸部计算机断层扫描表现的恢复率（RR=1.22；95%CI：1.14 至 1.3；P<0.05）和总有效率（RR=1.24；95%CI：1.09 至 1.42；P<0.05）。
3 药 3 方可在 COVID-19 的各个阶段发挥积极作用。未观察到与 3 药 3 方相关的严重不良事件。因此，3 药 3 方联合常规疗法对 COVID-19 患者具有有效的治疗价值。需要进一步开展长期高质量研究，以证明每种配方的临床获益。请引用本文作为：You LZ, Dai QQ, Zhong XY, Yu DD, Cui HR, Kong YF, Zhao MZ, Zhang XY, Xu QQ, Guan ZY, Wei XX, Zhang XC, Han SJ, Liu WJ, Chen Z, Zhang XY, Zhao C, Jin YH, Shang HC. 三种中药药物和三种草药配方治疗 COVID-19 的临床证据：中国人群的系统评价和荟萃分析。综合医学杂志。2023; 21(5): 441-454.
