连花清瘟联合常规西药治疗新型冠状病毒肺炎疗效与安全性的系统评价

Efficacy and safety of Lianhua Qingwen granules/capsules combined with conventional Western medicine for treating COVID-19:a systematic review and meta-analysis

目的 运用meta分析系统评价连花清瘟联合常规西药治疗新型冠状病毒肺炎(COVID-19)的临床疗效与安全性。方法 从Embase, The Cochrane Library, PubMed, VIP,Wan Fang Data和CNKI 6个数据库中检索收集连花清瘟治疗COVID-19的随机对照试验(RCTs),检索时限为2019年12月1日至2021年6月30日。按照纳入和排除标准筛选试验、提取资料并进行质量评价后,采用RevMan 5.3软件进行统计分析。结果 共纳入6篇RCTs,在纳入研究文献中,单组样本量从21例到148例,共涉及884例COVID-19患者。与常规西药治疗组相比,连花清瘟颗粒/胶囊联合常规西药治疗组临床疗效显著(RR=1.21,95%CI:1.12~1.31,P<0.001)。连花清瘟可以改善发热、咳嗽、乏力等主要症状,连花清瘟颗粒/胶囊联合常规西药治疗组发热消失率(RR=1.35,95%CI:1.14~1.60,P=0.000 5),咳嗽消失率(RR=1.90,95%CI:1.24~2.90,P=0.003),乏力消失率(RR=1.49,95%CI:1.13~1.97,P=0.004),均比常规西药治疗组高。连花清瘟对兼症改善也有一定疗效,连花清瘟颗粒/胶囊联合常规西药治疗组气短消失率(RR=3.93,95%CI:1.89~8.17,P=0.000 3),肌肉酸痛消失率(RR=1.83,95%CI:1.02~3.27,P=0.04),均比常规西药治疗组高。与常规西药治疗组对比,连花清瘟颗粒/胶囊联合常规西药治疗组缩短了退热、咳嗽消失以及乏力消失时间(P<0.05)。结论 连花清瘟联合常规西药治疗对于COVID-19的症状改善疗效显著,并且可以缩短主症消失时间,不良反应少。

Objective To assess the clinical efficacy and safety of Lianhua Qingwen granules/capsules combined with conventional Western medicine in the treatment of coronavirus disease 2019(COVID-19)by using meta-analysis.Methods This study searched Embase,The Cochrane Library,PubMed,VIP,Wan Fang Data,and CNKI to collect the randomized controlled trials(RCTs)of Lianhua Qingwen granules/capsules in the treatment of COVID-19.The retrieval time ranged from December 1,2019 to June 30,2021.After screening the tests according to the inclusion and exclusion criteria,extracting the data and evaluating the research quality,RevMan 5.3 software was used for statistical analysis.Results A total of 6 RCTs were included.Among the included studies,the sample size of a single group ranged from 21 to 148 cases,involving a total of 884 COVID-19 patients.Compared with the conventional Western medicine treatment group,the clinical efficacy of Lianhua Qingwen granules/capsules combined with conventional Western medicine group was significant(RR=1.21,95%CI:1.12-1.31,P<0.001).Lianhua Qingwen could improve the main symptoms such as fever,cough,and fatigue.The fever disappearance rate(RR=1.35,95%CI:1.14-1.60,P=0.0005),cough disappearance rate(RR=1.90,95%CI:1.24-2.90,P=0.003),and fatigue disappearance rate(RR=1.49,95%CI:1.13-1.97,P=0.004)in Lianhua Qingwen granules/capsules combined with conventional Western medicine group were higher than those in conventional Western medicine treatment group.Lianhua Qingwen also had some curative effects on the accompanied symptoms.The disappearance rate of shortness of breath(RR=3.93,95%CI:1.89-8.17,P=0.0003)and the disappearance rate of muscle soreness(RR=1.83,95%CI:1.02-3.27,P=0.04)in Lianhua Qingwen granules/capsules combined with conventional Western medicine group were higher than those in conventional Western medicine treatment group.Besides,compared with conventional Western medicine treatment group,Lianhua Qingwen granules/capsules combined with conventional Western medicine group shortened the disappearance time of fever,cough and fatigue(P<0.05).Conclusion Lianhua Qingwen granules/capsules combined with conventional Western medicine can significantly improve the symptoms of COVID-19 and shorten the disappearance time of the main symptoms of COVID-19,with fewer adverse reactions.