Efficacy and Safety of Combined Treatment with Traditional Herbal Medicine and Western Medicine for Children with Pertussis-like Syndrome: Systematic Review and Meta-Analysis.

: Pertussis-like syndrome (PLS) presents symptoms similar to whooping cough but without detection. This study assessed the efficacy and safety of combined treatment herbal and Western medicine (HM and WM, respectively) for PLS. Eleven English, Chinese, Korean, and Japanese databases were searched until 1 December 2024. Randomized clinical trials (RCTs) that compared HM with WM versus WM alone in children with PLS were included. Independent searches and risk-of-bias analyses were conducted. Random-effects and fixed-effects models were utilized. Dichotomous outcomes are presented as the risk ratio (RR) with 95% confidence interval (CI), and continuous outcomes as either the standard mean difference (SMD) or mean difference (MD) with 95% CI. A total of 23 RCTs (performed in China) with 1938 participants were included. The meta-analysis showed that HM with WM is more effective than WM in improving the total effective rate [ = 1888; RR = 1.20; 95% CI: 1.16-1.24; < 0.001], reducing the disappearance time of main symptoms (especially spastic cough) [ = 815; MD = -3.31; 95% CI: -3.51--3.11; < 0.001], shortening the recovery time of routine blood parameters to the normal range [ = 472; MD = -2.79; 95% CI: -3.06--2.52; < 0.001], and decreasing hospitalization duration [ = 703; MD = -2.61; 95% CI: -2.85--2.38; < 0.001]. Only mild adverse events were reported, with a lower occurrence rate in HM with WM cohorts than in WM cohorts. The quality of evidence ranged from moderate to very low. : HM combined with WM is effective and safe for PLS in children, offering a potential alternative for symptom relief.