KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.
Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, South Korea.
PLoS One. 2024 Feb 8;19(2):e0296898. doi: 10.1371/journal.pone.0296898. eCollection 2024.
When patients continue to experience cough despite conventional treatment, East Asian traditional medicine (EATM) including herbal medicine and/or acupuncture has been frequently used. Previous systematic reviews of EATM treatment for chronic cough have been conducted mainly on herbal medicine, targeting patients with conditions that cause cough. In clinical practice, EATM interventions are not limited to herbal medicine, and considering that chronic cough is often caused by two or more conditions or unspecific causes, a comprehensive investigation is clinically relevant. We examined the current research status of EATM for chronic cough.
Based on Arksey and O'Malley's scoping review methodological framework, a total of six English, Chinese, Korean, and Japanese electronic databases were searched on August 2022. Any clinical studies on EATM targeting chronic cough patients (regardless of their cause) were included.
Among 474 included studies, the study designs were mainly randomized controlled trials (72.4%), and the population was evenly distributed between children and adults. The cause of cough was not reported in most studies (56.1%). The common cause of cough was upper airway cough syndrome and post-respiratory infection (9.5%, each), followed by mixed cause (7.6%), nonspecific cause (5.9%), and gastroesophageal reflux disease (4.0%). EATM was conducted for a mean of 19.1 days, and herbal medicine was the most common (80.6%). Conventional medication was frequently used as a control (81.2%). For outcomes, the total effective rate was the most frequently utilized (94.3%), followed by cough severity (53.8%). EATM treatment showed positive outcomes in most studies.
In future EATM studies, it is necessary to either specify the cause of chronic cough or to report that the study was targeting nonspecific chronic cough. In addition, high-quality studies assessing the efficacy of EATM with placebo control treatment should be conducted, using validated evaluation tools.
当患者在常规治疗后仍持续咳嗽时,东亚传统医学(EATM)包括草药和/或针灸经常被使用。之前对 EATM 治疗慢性咳嗽的系统评价主要针对草药,针对的是引起咳嗽的病症患者。在临床实践中,EATM 干预措施不仅限于草药,并且由于慢性咳嗽通常由两种或多种病症或非特异性原因引起,因此全面调查在临床上具有相关性。我们考察了 EATM 治疗慢性咳嗽的当前研究状况。
根据 Arksey 和 O'Malley 的范围综述方法学框架,我们于 2022 年 8 月检索了六个英文、中文、韩文和日文电子数据库。纳入了针对慢性咳嗽患者(无论其病因如何)的 EATM 的任何临床研究。
在纳入的 474 项研究中,研究设计主要是随机对照试验(72.4%),且人群在儿童和成人之间分布均衡。大多数研究未报告咳嗽的病因(56.1%)。咳嗽的常见病因是上气道咳嗽综合征和呼吸道感染后(各 9.5%),其次是混合病因(7.6%)、非特异性病因(5.9%)和胃食管反流病(4.0%)。EATM 治疗的平均持续时间为 19.1 天,最常用的是草药(80.6%)。常规药物经常被用作对照(81.2%)。对于结局,总有效率是最常被使用的(94.3%),其次是咳嗽严重程度(53.8%)。大多数研究表明 EATM 治疗具有积极的效果。
在未来的 EATM 研究中,有必要明确慢性咳嗽的病因,或者报告研究针对的是非特异性慢性咳嗽。此外,应该使用经过验证的评估工具,开展高质量的、以安慰剂对照治疗评估 EATM 疗效的研究。