中西医结合治疗新型冠状病毒肺炎疗效和安全性的Meta分析

Meta-analysis of the Efficacy and Safety of Integrated Traditional Chinese and Western Medicine in the Treatment of COVID-19

目的系统评价中西医结合治疗新型冠状病毒肺炎(COVID-19)的临床疗效及安全性。方法计算机检索中国知网、维普网、万方、PubMed、Embase、CBM等数据库和相关网站收集文献,检索时间从建库至2021年6月20日,中文检索主题词为:“西医”“中医药”“中西医结合”“新型冠状病毒肺炎”“新冠肺炎”。英文检索主题词为:“NCP”“SARA-COV-2”“COV-2019”“traditional Chinese medicine”。由2位研究员各自独立提取资料,采用Revman 5.4软件进行Meta分析。结果严格按照纳入和排除标准,共纳入16篇文献,其中6篇随机对照试验研究(RCT),10篇为队列研究,共有1320例新冠肺炎患者。Meta分析结果:总有效率[RR=1.27,95%CI(1.14,1.41),P<0.0001],CT好转率[RR=1.20,95%CI(1.09,1.31),P=0.0001],主要症状消失率[RR=1.40,95%CI(1.23,1.60),P<0.00001],主要症状消失时间[MD=-1.2,95%CI(-1.60,-0.80),P<0.00001],肺炎转重率[RR=0.35,95%CI(0.21,0.57),P<0.0001],实验室检查显示;LYM%[MD=2.46,95%CI(-0.42,5.34)P=0.09]和CPR[MD=-8.77,95%CI(-12.51,-5.03)]。其中亚组分析症状中咳嗽消失时间,不良反应率,WBC差异均无统计学意义;未来还需要更完整的且高质量的RCT试验设计来验证中西医结合治疗对于新型冠状病毒肺炎的治疗效果。结论与单独使用西医常规治疗相比,中西医结合治疗新冠病毒性肺炎效果较佳。

Objective To systematically evaluate the clinical efficacy and safety of integrated traditional Chinese and Western medicine in the treatment of new coronavirus pneumonia(COVID-19).Methods CNKI,VIP.com,Wanfang,PubMed,Embase.com,CBM and other databases were searched and related websites were used to collect literature from the establishment of the database to June 20,2021.The Chinese search subject terms were“Western Medicine”“Traditional Chinese Medicine”“Integration of Traditional Chinese and Western Medicine”“New Coronary Virus Pneumonia”and“New Coronary Pneumonia”.The English search subject terms were“NCP”“SARA-COV-2”“COV-2019”and“traditional Chinese medicine”.Data were extracted independently by two researchers,and Meta-analysis was performed using Revman 5.4 software.Results In strict accordance with the inclusion and exclusion criteria,a total of 16 articles were involved,including 6 randomized controlled trials(RCT)and 10 cohort studies,with a total of 1320 patients with new coronary pneumonia.Meta analysis results were as follows:total effective rate[RR=1.27,95%CI(1.14,1.41),P<0.0001],CT improvement rate[RR=1.20,95%CI(1.09,1.31),P=0.0001],main Symptom disappearance rate[RR=1.40,95%CI(1.23,1.60),P<0.00001],main symptom disappearance time[MD=-1.2,95%CI(-1.60,-0.80),P<0.00001],pneumonia turns Severity rate[RR=0.35,95%CI(0.21,0.57),P<0.0001].Laboratory examination showed that there were significant differences in LYM%[MD=2.46,95%CI(-0.42,5.34)P=0.09]and CPR[MD=-8.77,95%CI(-12.51,-5.03)].In subgroup analysis,it showed no statistically significant differences in cough disappearance time,adverse reaction rate and WBC.A more complete and high-quality RCT trial design was needed to validate the efficacy of integrated Chinese and Western medicine for COVID-19 in the future.Conclusion Compared with the routine treatment of Western medicine,the effect of integrated traditional Chinese and Western medicine in the treatment of novel coronavirus pneumonia is better.