中医药治疗轻型、普通型新型冠状病毒肺炎疗效和安全性的Meta分析

Efficacy and Safety of Traditional Chinese Medicine for Patients with Mild or Common COVID-19:A Meta-analysis

目的系统评价中医药治疗轻型、普通型新型冠状病毒肺炎(COVID-19)的疗效和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、万方、知网和维普数据库,搜集中医药治疗新冠肺炎的随机对照试验(RCT)和队列研究,检索时限均从建库至2020年4月。采用Revman 5.3软件进行Meta分析。结果共纳入6个RCT、4个队列研究,包括832例患者。Meta分析结果显示:治疗组在提高总有效率[RR=1.26,95%CI(1.14,1.40),P<0.00001],缩短发热持续时间[WMD=-1.21,95%CI(-1.71,-0.71),P<0.00001],提高新冠肺炎患者病毒核酸转阴率[RR=1.47,95%CI(1.05,2.05),P=0.03],降低肺炎加重率[RR=0.40,95%CI(0.23,0.70),P=0.001],调控白细胞计数、淋巴细胞计数、淋巴细胞百分比等方面均优于对照组,两组差异有统计学意义。但两组肺炎吸收率、新冠肺炎相关症状(包括发热、乏力、咳嗽等)消失率、不良反应发生率等结局指标的差异无统计学意义。结论中医药治疗新冠肺炎疗效较好、能缩短患者发热时间、降低肺炎加重率、提高机体免疫力且不增加不良反应的发生。受纳入研究数量和质量限制,上述结论尚待更多高质量研究予以验证。

Objective:To evaluate the efficacy and safety of traditional Chinese medicine(TCM)for mild,common Coronavirus Disease 2019(COVID-19).Methods:PubMed,EMbase,The Cochrane Library,WanFang Data,CNKI and VIP databases were searched to collect randomized controlled trials(RCTs)and cohort studies about TCM for patients with COVID-19 from inception to April 2019.Meta-analysis was carried out with Revman 5.3 software.Results:A total of 6 RCTs and 4 cohort studies involving 832 patients were included.Meta-analysis results showed that,compared with the control group,the treatment group could improve the total effective rate[RR=1.26,95%CI(1.14,1.40),P<0.00001],shorten the duration of fever[WMD=-1.21,95%CI(-1.71,-0.71),P<0.00001],increase the negative rate of viral nucleic acid[RR=1.47,95%CI(1.05,2.05),P=0.03],reduce the exacerbation rate of pneumonia[RR=0.40,95%CI(0.23,0.70),P=0.001],regulate WBC,LYM,LYM%better with significant difference.However,there were no statistically significant differences in the pneumonia absorption rate,the disappearance rate of COVID-19-related symptoms(including fever,fatigue,cough,etc.),and the incidence of adverse reactions between the two groups.Conclusion:Traditional Chinese medicine has a good effect on the treatment of COVID-19,which can shorten the patient′s fever time,reduce the rate of exacerbation of pneumonia,and improve the body′s immunity without increasing the occurrence of adverse reactions.Limited by the number and quality of included studies,the above conclusions need to be further verified by more high-quality researches.