连花清瘟制剂对COVID-19疗效的Meta分析

目的] 系统评价中药连花清瘟制剂对新型冠状病毒肺炎（COVID-19）干预的有效性与安全性。方法] 检索PubMed、MEDLINE、Embase、Cochrane Collaboration、中国知网（CNKI）、维普（VIP）、万方医学网、中国生物医学文献数据库（CBM）,时间为从建库至2020年5月,所有连花清瘟制剂干预COVID-19的临床随机对照试验（RCT）。采用RevMan 5.3软件进行分析。结果] 纳入5项RCT研究,共计纳入824例患者。在常规西药标准治疗基础上联合中药连花清瘟制剂,能够缩短退热时间（MD=-1.04,95%CI=-1.60~-0.48,P=0.000 3）,表明联合中药连花清瘟制剂治疗能一定程度上改善发热症状;可改善咳嗽症状（MD=-1.30,95%CI=-2.55~-0.05,P=0.04）,减少咳嗽例数（RR=1.72,95%CI=1.22~2.43,P=0.002）,表明联合中药连花清瘟制剂具有减轻咳嗽的作用;改善乏力症状（MD=-1.30,95%CI=-2.38~-0.22,P=0.02）,减少乏力例数（RR=1.72,95%CI=1.28~2.32,P=0.000 3）,表明联合中药连花清瘟制剂具有减轻乏力的作用,还能提高临床有效率（RR=1.23,95%CI=1.12~1.34,P<0.000 1）,改善肺部计算机断层扫描（RR=1.21,95%CI=1.09~1.34,P=0.000 5）,减少轻症转重症例数（RR=0.45,95%CI=0.30~0.68,P=0.000 1）,以及改善炎症指标。6个研究中有2个报告了不良事件发生情况。结论] 与常规西药标准治疗相比,联合使用中药连花清瘟制剂能够对COVID-19患者的发热、咳嗽、乏力等临床症状、总有效率、肺部CT、轻症转重症例数、炎症指标等产生一定的干预效应,具有改善缩短发热时间,改善临床症状,提高临床疗效等作用,其安全性尚有待进一步研究证实。

Effect of Lianhua Qingwen preparation on COVID-19: a Meta-analysis

Objective] To systematically review the efficacy and safety of Lianhua Qingwen preparation in the treatment of COVID-19. Methods] We searched all randomized controlled trials (RCTs) of Lianhua Qingwen preparation intervening COVID-19 in PubMed,MEDLINE,Embase,Cochrane Collaboration,CNKI,VIP,Wanfang data,China Biology Medicine (CBM) from the establishment of the database to May 2020. The RevMan 5.3 software was applied for data analysis. Results] A total of 5 RCTs with 824 cases of patients were enrolled in the study. Meta-analysis showed that compared with standard treatment of Western medicine,treatment combined with Lianhua Qingwen preparation could shorten the time of fever (MD=-1.04,95%CI=-1.60~-0.48,P=0.000 3),indicating that the combination of Lianhua Qingwen preparation can improve fever symptoms to some extent. It can improve cough symptoms (MD=-1.30,95%CI=-2.55~-0.05,P=0.04),reduce the number of cough (RR=1.72,95%CI=1.22~2.43,P=0.002),indicating that the combination of Lianhua Qingwen preparation can alleviate cough. It can improve fatigue symptoms (MD=-1.30,95%CI=-2.38~-0.22,P=0.02),reduce the number of fatigue (RR=1.72,95%CI=1.28~2.32,P=0.000 3),indicating that the combination of Lianhua Qingwen preparation can alleviate fatigue. It can improve the clinical total effective rate (RR=1.23,95%CI=1.12~1.34,P<0.000 1),improve lung CT (RR=1.21,95%CI=1.09~1.34,P=0.000 5),reduce number of patients with mild to severe disease (RR=0.45,95%CI=0.30~0.68,P=0.000 1),and improve inflammation index. Two of the six studies reported the occurrence of adverse events. Conclusion] Compared with the conventional western medicine standard treatment,the combined use of Lianhua Qingwen preparation has a certain intervention effect on COVID-19 patients'' fever,cough,fatigue and other clinical symptoms,total effective rate,lung CT,the number of patients with mild to severe diseases,inflammatory indicators,etc.,and has the effects of improving and shortening fever time,improving clinical symptoms and improving clinical efficacy,and its safety needs further study and confirmation.