中药汤剂与中成药分别联合西药治疗新型冠状病毒肺炎不良反应发生率的Meta分析对比

Meta-analysis and comparison of the incidence of adverse reactions between Chinese herbal decoction and Chinese patent medicine combined with Western medicine in the treatment of COVID-19

目的分析中药汤剂(以下简称“汤剂”)和中成药分别与西药联用治疗新型冠状病毒肺炎(以下简称“新冠肺炎”)时对不良反应发生率的影响,从安全性角度为临床治疗方案提供参考。方法检索中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库及PubMed数据库中中西联合用药治疗新冠肺炎的随机对照试验研究并提取相关信息,利用Cochrane协作网偏倚风险评价工具评价筛选后文献的质量,并利用软件Review Manager 5.4以不良反应发生情况为结局指标分别对汤剂联合西药和中成药联合西药进行Meta分析。结果按照既定规则筛选后最终纳入17篇文献,其中中西结合组患者所服中药为汤剂的有10篇,其余7篇为中成药。Meta分析结果显示,汤剂联合西药的不良反应发生率显著低于单独服用西药[RR=0.49(0.35,0.69),P<0.0001],中成药联合西药的不良反应发生率显著高于单独服用西药[RR=2.16(1.11,4.20),P=0.02]。结论临床治疗新冠肺炎时,在降低不良反应发生率方面,汤剂与西药联合优于中成药与西药联合。

Objective To analyze the effects of TCM decoction(hereinafter referred to as“decoction”)and Chinese patent medicine combined with Western medicine respectively on the incidence of adverse reactions in the treatment of COVID-19(hereinafter referred to as“COVID-19”),and to provide reference for clinical treatment plan from the perspective of safety.Methods The randomized controlled trials on the treatment of COVID-19 with Chinese and Western combination drugs were searched from CNKI,VIP,Wanfang and PubMed databases and relevant information was extracted.The quality of the screened literature was evaluated using the Cochrane Collaboration Bias risk assessment tool.Meta-analysis of decoction combined with Western medicine and Chinese patent medicine combined with Western medicine was conducted using software Review Manager 5.4 with the occurrence of adverse reactions as outcome index.Results After screening according to the established rules,17 articles were finally included,among which 10 were Chinese medicine decoction taken by patients in the combination of Chinese and Western medicine group,and the remaining 7 were Chinese patent medicine.Meta-analysis results showed that the incidence of adverse reactions in decoction combined with Western medicine was significantly lower than that in western medicine alone[RR=0.49(0.35,0.69),P<0.0001],and the incidence of adverse reactions in Chinese patent medicine combined with Western medicine was significantly higher than that in western medicine alone[RR=2.16(1.11,4.20),P=0.02].Conclusion In clinical treatment of COVID-19,the combination of decoction with Western medicine is superior to the combination of Chinese patent medicine with Western medicine in reducing the incidence of adverse reactions.