中西医结合治疗新型冠状病毒肺炎的系统评价

目的 系统评价中西医结合治疗新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）的疗效，为COVID-19的临床治疗提供依据。方法 计算机检索PubMed、Medline、EMbase、中国期刊全文数据库（CNKI）、万方、维普（VIP）数据库，搜集中西医结合治疗COVID-19的临床研究，检索时间截止到2021年2月，由2位研究人员按照纳入和排除标准，独立检索、筛选文献并提取数据，采用Stata12.0软件进行Meta分析。结果 最终纳入27项研究共2215例患者，包括12项随机对照试验（randomized controlled trial，RCT）和15项回顾性研究，Meta分析结果显示中西医结合治疗能显著缩短COVID-19患者住院时间WMD=-0.84，95% CI（-1.42，-0.27），P=0.004]，提高COVID-19治疗有效率RR=1.14，95% CI（1.08，1.21），P=0.000]、肺部CT好转率RR=1.19，95% CI（1.04，1.35），P=0.000]和核酸转阴率RR=1.40，95% CI（1.16，1.69），P=0.000]，改善COVID-19患者临床症状WMD=-0.82，95% CI（-1.08，-0.55），P=0.000]，降低转危重率RR=0.37，95% CI（0.25，0.56），P=0.000]；此外，与单纯西医治疗相比，接受中西医结合治疗的COVID-19患者发热、咳嗽和乏力症状消失率显著提高，持续时间显著缩短（P<0.05）。亚组分析结果与上述结果一致，均具有统计学差异（P<0.05）。结论 中西医结合治疗COVID-19优于单纯西医治疗，可显著提高治疗有效率、肺部CT好转率和核酸转阴率，降低普通患者转换为危重患者的比例，改善新冠肺炎患者的主要临床症状，对新冠肺炎的治疗具有积极的临床意义。

Systematic review of integrated traditional Chinese and western medicine in treatment of COVID-19

Objective To systematically evaluate the efficacy of integrated traditional Chinese and western medicine in the treatment of COVID-19, and to provide evidence for the clinical treatment of COVID-19. Methods PubMed, Medline, EMbase, CNKI, Wanfang and VIP databases were searched by computer to collect clinical studies on the treatment of COVID-19 combined with traditional Chinese and western medicine. The retrieval time was up to February 2021. According to the inclusion and exclusion criteria, two researchers independently retrieved and screened literatures and extracted data, and Meta-analysis was performed using Stata 12.0 software. Results A total of 27 studies were included in the Meta-analysis, including 12 RCTs and 15 retrospective studies, involving 2215 patients. The results of Meta-analysis showed that integrated traditional Chinese and western medicine could significantly shorten the length of hospital stay for COVID-19 patientsWMD=-0.84, 95% CI (-1.42, -0.27), P=0.004]; The effective rateRR=1.14, 95% CI (1.08, 1.21), P=0.000], lung CT improvement rateRR=1.19, 95% CI (1.04, 1.35), P=0.000], and nucleic acid negative conversion rateRR=1.40, 95% CI (1.16, 1.69), P=0.000] was increased; Patients'' clinical symptoms was improvedWMD=-0.82, 95% CI (-1.08, -0.55), P=0.000] and the rate of transforming to severe disease was reducedRR=0.37, 95%CI (0.25, 0.56), P=0.000]. In addition, compared with western medicine treatment alone, the disappearance rate of fever, cough and fatigue in COVID-19 patients treated with integrated Chinese and western medicine was significantly increased and the duration was significantly shortened (P<0.05). The results of subgroup analysis were consistent with the above results, with statistical differences (P<0.05). Conclusion The treatment of COVID-19 with integrated Chinese and western medicine is better than that with western medicine alone, and can significantly improve the treatment efficiency, CT improvement rate and nucleic acid negative conversion rate, reduce the proportion of ordinary patients converted to critical patients and improve the main clinical symptoms of COVID-19 patients. Thus the treatment of integrated Chinese and western medicine has positive clinical value for COVID-19.