中西医联合治疗新型冠状病毒肺炎的Meta分析

Meta-analysis of Combined Traditional Chinese and Western Medicine in the Treatment of COVID-19

目的 采用Meta分析评价中西医联合治疗新型冠状病毒肺炎(COVID-19)的有效性与安全性,以便更直观地了解中西医联合治疗COVID-19的临床疗效。方法 计算机检索中国期刊全文数据库、万方数据知识服务平台、中文期刊全文数据库、中国生物医学文献数据库、PubMed、SpringerLink、Cochrane Library、Web of Science数据库,检索时间为2020年1月1日至2023年5月1日。结果 经过纳排标准筛选,最终纳入45篇随机对照试验(RCTs)和21篇回顾性队列研究,共包含7808例患者。Meta分析结果显示:临床症状改善方面,中西医联合治疗可提高COVID-19患者总有效率[OR=2.99,95%CI(2.53,3.53),P<0.000 01],降低死亡率[OR=0.21,95%CI(0.12,0.38),P<0.000 01]、中医证候量表积分[MD=-2.73,95%CI(-3.31,-2.14),P<0.00001];安全性方面,共有41篇文献报道了不良反应发生情况,结果显示中西医联合治疗可降低COVID-19患者不良反应发生率,但差异无统计学意义[OR=0.81,95%CI(0.62,1.06),P=0.12]。证据质量评价结果显示,5个结局指标中,1个为中质量,4个为低质量。结论 相比于西医常规治疗,中西医联合治疗能明显提高COVID-19的总有效率,降低死亡率,改善患者临床症状,且安全性较高。

Objective Meta-analysis was used to evaluate the efficacy and safety of combined traditional Chinese and Western medicine in the treatment of COVID-19,in order to more intuitively understand the clinical efficacy of combined traditional Chinese and Western medicine in the treatment of novel COVID-19.Methods Computer retrieval of CNKI,Wanfang,VIP,China CBM,PubMed,SpringerLink,Cochrane Library,Web of Science database,the retrieval time is January 1,2020 From May 1,2023.Results 45 randomized controlled trials(RCTs)and 21 retrospective cohort studies were finally included,including 7808 patients.Meta-analysis results showed that:In terms of clinical symptom improvement,combined treatment of Chinese and Western medicine can improve the total effective rate of patients with COVID-19[OR=2.99,95%CI(2.53,3.53),P<0.00001],and reduce the mortality rate of patients with COVID-19[OR=0.21,95%CI(0.12,0.38),P<0.00001],TCM syndrome scale score[MD=-2.73,95%CI(-3.31,-2.14),P<0.00001];In terms of safety,a total of 41 literatures reported the occurrence of adverse reactions,and the results showed that combined treatment of Chinese and Western medicine reduced the incidence of adverse reactions in patients with COVID-19[OR=0.81,95%CI(0.62,1.06),P=0.12].The evidence quality evaluation results showed that among the 5 outcome indicators,1 was of medium quality and 4 were of low quality.Conclusion Compared with conventional western medicine treatment,combined treatment of Chinese and Western medicine can significantly improve the total effective rate of COVID-19,reduce mortality,improve clinical symptoms of patients,and have high safety.