Abstract: OBJECTIVE: To evaluate the effectiveness and safety of Xuanbai Chengqi decoction(宣白承气汤, XBCQD) plus Western Medicine(WM) in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.METHODS: Randomized controlled trials(RCTs) investigating the effect of XBCQD on severe pneumonia with symptom pattern of phlegm-heat obstructing lung, were included in this study. Seven electronic databases were searched up to March 2019.Meta-analysis was conducted by Review Manager5.3 software. Risk ratio(RR) and mean difference(MD) with 95% confidence interval(CI) were used as effect estimation.RESULTS: Eleven RCTs were included, involving992 participants. Meta-analysis showed that XBCQD combined with WM achieved better effectiveness than WM alone in terms of total effective rate[RR = 1.23, 95%CI(1.16, 1.30)], clinical pulmonary infection score [CPIS, MD =-2.02, 95%CI(-2.42,-1.63)], acute physiology and chronic health evaluation Ⅱ [APACHE Ⅱ, MD =-6.81, 95% CI(-8.26,5.37)], mechanical ventilation time [MD =-101.41,95%CI(-140.47,-62.34)], and lactic acid content in arterial blood [MD =-2.41, 95%CI(-2.64,-2.18)].CONCLUSION: XBCQD combined with WM had better benefit than WM alone to the patients of severe pneumonia with the symptom pattern of phlegm-heat obstructing lung. However, due to low quality of the included studies, more rigorously designed studies were required to further evaluate the effectiveness and safety of XBCQD in the treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.

Key words: Pneumonia, Symptom complex, Meta-analysis, Randomized controlled trial, Xuanbai Chengqi decoction