中药改善新型冠状病毒感染恢复期患者临床症状的系统评价

Effectiveness of traditional Chinese medicine for clinical symptoms during the recovery period of COVID-19 infection:a systematic review

目的系统评价中药改善新型冠状病毒感染恢复期患者临床症状的有效性与安全性。方法计算机检索CNKI、WanFang Data、SinoMed、VIP、PubMed、Cochrane Library和EMbase数据库,搜集研究目的相关的临床研究,检索时限均为建库至2023年2月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入8项研究,其中4项随机对照试验、4项非随机对照试验,包括740例患者。Meta分析结果显示:中药汤剂对比空白对照可有效缓解患者乏力症状[MD=-1.07,95%CI(-1.46,-0.68),P<0.01]。中成药联合常规西药治疗与常规西药治疗相比,可有效改善患者咳嗽症状[MD=-0.80,95%CI(-1.30,-0.30),P<0.01]、咽干症状[MD=-0.86,95%CI(-1.22,-0.51),P<0.01]、胸闷症状[MD=-0.58,95%CI(-0.79,-0.36),P<0.01]、提升总有效率[RR=1.42,95%CI(1.18,1.71),P<0.01]。结论当前证据表明,中药可有效改善新型冠状病毒感染恢复期患者的乏力、咳嗽、咽干、胸闷等临床症状。受纳入研究数量和质量的限制,今后尚需更多高质量研究予以验证。

Objective To systematically review the efficacy and safety of traditional Chinese medicine on clinical symptoms during the recovery period of COVID-19.Methods The CNKI,WanFang Data,SinoMed,VIP,PubMed,Cochrane Library and EMbase databases were electronically searched to collect studies related to objectives from inception to February 2023.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was then performed using RevMan 5.4 software.Results A total of 8 studies involving 740 patients were included in the meta-analysis,including 4 randomized controlled trials(RCTs)and 4 non-RCTs.The results of the meta-analysis showed that traditional Chinese medicine could effectively relieve patients’fatigue symptoms compared with blank control(MD=−1.07,95%CI−1.46 to−0.68,P<0.01).Chinese patent medicine combined with conventional Western medicine treatment effectively improved cough symptoms in patients compared with conventional Western medicine treatment(MD=−0.80,95%CI−1.30 to−0.30,P<0.01),symptoms of dry pharynx(MD=−0.86,95%CI−1.22 to−0.51,P<0.01),symptoms of chest tightness(MD=−0.58,95%CI−0.79 to−0.36,P<0.01),and total efficiency(RR=1.42,95%CI 1.18 to 1.71,P<0.01).Conclusion Current evidence shows that traditional Chinese medicine can effectively improve the clinical symptoms such as fatigue,cough,dry pharynx and chest tightness in patients with novel coronavirus infection in the recovery period.Due to the limited quality and quantity of the included studies,more high-quality studies are required to verify the above conclusion.