Journal of Traditional Chinese Medicine ›› 2023, Vol. 43 ›› Issue (2): 212-220.DOI: 10.19852/j.cnki.jtcm.2023.02.003
• Meta Analysis • Previous Articles Next Articles
GUO Wen1, LI Xuanlin1, ZHAO Hulei2, LEI Siyuan1, XIE Yang2, LI Jiansheng1()
Received:
2023-01-08
Accepted:
2023-04-19
Online:
2023-04-15
Published:
2023-03-14
Contact:
Prof. LI Jiansheng, Co-construction Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment & Chinese Medicine Development of Henan Province/ Henan Key Laboratory of Chinese Medicine for Respiratory Disease, Henan University of Chinese Medicine, Zhengzhou 450046, China. li_js8@163.com. Telephone: +86-371-65676568
Supported by:
GUO Wen, LI Xuanlin, ZHAO Hulei, LEI Siyuan, XIE Yang, LI Jiansheng. Effectiveness of Chinese herbal medicine combined with conventional medicine on acute exacerbation of chronic obstructive pulmonary disease: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2023, 43(2): 212-220.
Study | Sample size | Sex (M/F) | Age | Intervention | Duration (days) | Follow- up | Outcome | |||
---|---|---|---|---|---|---|---|---|---|---|
T | C | T | C | |||||||
Huang MR et al 2019 | 40 | 40 | T: 26/14 C: 23/17 | T: 65.6±4.2 C: 64.9±4.9 | Mengshiguntan decoction+CWM | Placebo+CWM | 14 | NR | ||
Li JS et al 2011 | 34 | 31 | T: 23/11 C: 19/12 | T: 63.90±11.37 C: 65.70±12.31 | Huoxuehuayu decoction+CWM | Placebo+CWM | 14 | NR | ⑤ | |
Li JS et al 2016 | 173 | 180 | T: 126/47 C: 126/54 | T: 68.01±8.07 C: 67.87±8.36 | 3 CHM granules△+CWM | Placebo+CWM | 7-21 | 6 months | ⑦⑧ | |
Li JS et al 2020 | 189 | 189 | T: 155/34 C: 163/26 | T: 65.73±8.47 C: 66.94±7.61 | 3 CHM granules△+CWM | Placebo+CWM | 14 | 3 months | ⑦⑧⑨ | |
Liu M et al 2014 | 122 | 122 | T: 88/34 C: 82/40 | T: 70.1±9.8 C: 70.7±9.8 | Xuanbaichengqi granules+CWM | Placebo+CWM | 10 | NR | ⑤⑥⑨ | |
Liu JY et al 2018 | 30 | 30 | T: 27/3 C: 28/2 | T: 64.80±6.55 C: 65.67±5.36 | Qingfei granules+CWM | Placebo+CWM | 10 | NR | ②③⑦⑨ | |
Zhang WJ et al 2018 | 30 | 30 | T: 19/11 C: 21/9 | T: 63.45±9.67 C: 65.76±10.42 | Gubenquyujiedu granules+CWM | Placebo+CWM | 10 | NR | ②⑤⑥⑨ | |
Zhe Z et al 2017 | 51 | 56 | T: 26/25 C: 28/28 | T: 67.85±7.82 C: 66.87±8.65 | Compound Fo’ercao decoction +CWM | Placebo+CWM | 14 | NR | ⑨ | |
Zheng FJ et al 2016 | 122 | 122 | T: 84/38 C: 82/40 | T: 69.9±10.3 C: 70.7±9.8 | Rhubarb granules+CWM | Placebo+CWM | 10 | NR | ②⑤⑥⑨ |
Table 1 Characteristics of the included studies
Study | Sample size | Sex (M/F) | Age | Intervention | Duration (days) | Follow- up | Outcome | |||
---|---|---|---|---|---|---|---|---|---|---|
T | C | T | C | |||||||
Huang MR et al 2019 | 40 | 40 | T: 26/14 C: 23/17 | T: 65.6±4.2 C: 64.9±4.9 | Mengshiguntan decoction+CWM | Placebo+CWM | 14 | NR | ||
Li JS et al 2011 | 34 | 31 | T: 23/11 C: 19/12 | T: 63.90±11.37 C: 65.70±12.31 | Huoxuehuayu decoction+CWM | Placebo+CWM | 14 | NR | ⑤ | |
Li JS et al 2016 | 173 | 180 | T: 126/47 C: 126/54 | T: 68.01±8.07 C: 67.87±8.36 | 3 CHM granules△+CWM | Placebo+CWM | 7-21 | 6 months | ⑦⑧ | |
Li JS et al 2020 | 189 | 189 | T: 155/34 C: 163/26 | T: 65.73±8.47 C: 66.94±7.61 | 3 CHM granules△+CWM | Placebo+CWM | 14 | 3 months | ⑦⑧⑨ | |
Liu M et al 2014 | 122 | 122 | T: 88/34 C: 82/40 | T: 70.1±9.8 C: 70.7±9.8 | Xuanbaichengqi granules+CWM | Placebo+CWM | 10 | NR | ⑤⑥⑨ | |
Liu JY et al 2018 | 30 | 30 | T: 27/3 C: 28/2 | T: 64.80±6.55 C: 65.67±5.36 | Qingfei granules+CWM | Placebo+CWM | 10 | NR | ②③⑦⑨ | |
Zhang WJ et al 2018 | 30 | 30 | T: 19/11 C: 21/9 | T: 63.45±9.67 C: 65.76±10.42 | Gubenquyujiedu granules+CWM | Placebo+CWM | 10 | NR | ②⑤⑥⑨ | |
Zhe Z et al 2017 | 51 | 56 | T: 26/25 C: 28/28 | T: 67.85±7.82 C: 66.87±8.65 | Compound Fo’ercao decoction +CWM | Placebo+CWM | 14 | NR | ⑨ | |
Zheng FJ et al 2016 | 122 | 122 | T: 84/38 C: 82/40 | T: 69.9±10.3 C: 70.7±9.8 | Rhubarb granules+CWM | Placebo+CWM | 10 | NR | ②⑤⑥⑨ |
Outcome | Number of studies | Number of patients | RR/MD | 95%CI | I2 value (%) | P value | |
---|---|---|---|---|---|---|---|
T | C | ||||||
CAT scores | 3 | 373 | 355 | ?2.08 | ?2.85, ?1.31 | 10 | <0.000 01 |
PaO2 | 4 | 279 | 281 | 4.51 | 1.97, 7.04 | 0 | 0.0005 |
PaCO2 | 3 | 274 | 274 | ?2.87 | ?4.28, ?1.46 | 0 | <0.0001 |
Length of hospitalization | 3 | 392 | 399 | ?1.87 | ?3.33, ?0.42 | 86 | 0.01 |
Acute exacerbation rate | 2 | 343 | 325 | 0.60 | 0.43, 0.83 | 0 | 0.002 |
Table 2 Meta-analysis outcomes
Outcome | Number of studies | Number of patients | RR/MD | 95%CI | I2 value (%) | P value | |
---|---|---|---|---|---|---|---|
T | C | ||||||
CAT scores | 3 | 373 | 355 | ?2.08 | ?2.85, ?1.31 | 10 | <0.000 01 |
PaO2 | 4 | 279 | 281 | 4.51 | 1.97, 7.04 | 0 | 0.0005 |
PaCO2 | 3 | 274 | 274 | ?2.87 | ?4.28, ?1.46 | 0 | <0.0001 |
Length of hospitalization | 3 | 392 | 399 | ?1.87 | ?3.33, ?0.42 | 86 | 0.01 |
Acute exacerbation rate | 2 | 343 | 325 | 0.60 | 0.43, 0.83 | 0 | 0.002 |
Certainty assessment | No. of patients | Effect | Certainty | Importance | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | publication bias | T | C | Relative (95% CI) | Absolute (95% CI) | ||||
Clinical total effective rate | ||||||||||||||
4 | RCTs | seriousa | seriousb | not serious | not serious | none | 123/134 (91.8%) | 91/131 (69.5%) | RR 1.29 (1.07 to 1.56) | 201 more per 1,000 (from 49 more to 389 more) | ⊕⊕?? LOW | CRITICAL | ||
TCM symptom scores | ||||||||||||||
5 | RCTs | not serious | seriousb | not serious | not serious | none | 355 | 360 | - | MD 2.99 lower (4.46 lower to 1.53 lower) | ⊕⊕⊕? MODERATE | CRITICAL | ||
CAT scores | ||||||||||||||
3 | RCTs | not serious | seriousb | not serious | not serious | none | 373 | 355 | - | MD 2.08 lower (2.85 lower to 1.31 lower) | ⊕⊕⊕? MODERATE | CRITICAL | ||
PaO2 | ||||||||||||||
4 | RCTs | not serious | seriousb | not serious | not serious | none | 279 | 281 | - | MD 4.51 higher (1.97 higher to 7.04 higher) | ⊕⊕⊕? MODERATE | IMPORTANT | ||
PaCO2 | ||||||||||||||
3 | RCTs | not serious | seriousb | not serious | not serious | none | 274 | 274 | - | MD 2.87 lower (4.28 lower to 1.46 lower) | ⊕⊕⊕? MODERATE | IMPORTANT | ||
Length of hospitalization | ||||||||||||||
3 | RCTs | not serious | seriousb | not serious | not serious | none | 392 | 399 | - | MD 1.87 lower (3.33 lower to 0.42 lower) | ⊕⊕⊕? MODERATE | IMPORTANT | ||
Acute exacerbation rate | ||||||||||||||
2 | RCTs | not serious | seriousb | not serious | not serious | none | 48/343 (14.0%) | 77/325 (23.7%) | RR 0.60 (0.43 to 0.83) | 95 fewer per 1000 (from 135 fewer to 40 fewer) | ⊕⊕⊕? MODERATE | IMPORTANT |
Table 3 Quality of evidence
Certainty assessment | No. of patients | Effect | Certainty | Importance | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | publication bias | T | C | Relative (95% CI) | Absolute (95% CI) | ||||
Clinical total effective rate | ||||||||||||||
4 | RCTs | seriousa | seriousb | not serious | not serious | none | 123/134 (91.8%) | 91/131 (69.5%) | RR 1.29 (1.07 to 1.56) | 201 more per 1,000 (from 49 more to 389 more) | ⊕⊕?? LOW | CRITICAL | ||
TCM symptom scores | ||||||||||||||
5 | RCTs | not serious | seriousb | not serious | not serious | none | 355 | 360 | - | MD 2.99 lower (4.46 lower to 1.53 lower) | ⊕⊕⊕? MODERATE | CRITICAL | ||
CAT scores | ||||||||||||||
3 | RCTs | not serious | seriousb | not serious | not serious | none | 373 | 355 | - | MD 2.08 lower (2.85 lower to 1.31 lower) | ⊕⊕⊕? MODERATE | CRITICAL | ||
PaO2 | ||||||||||||||
4 | RCTs | not serious | seriousb | not serious | not serious | none | 279 | 281 | - | MD 4.51 higher (1.97 higher to 7.04 higher) | ⊕⊕⊕? MODERATE | IMPORTANT | ||
PaCO2 | ||||||||||||||
3 | RCTs | not serious | seriousb | not serious | not serious | none | 274 | 274 | - | MD 2.87 lower (4.28 lower to 1.46 lower) | ⊕⊕⊕? MODERATE | IMPORTANT | ||
Length of hospitalization | ||||||||||||||
3 | RCTs | not serious | seriousb | not serious | not serious | none | 392 | 399 | - | MD 1.87 lower (3.33 lower to 0.42 lower) | ⊕⊕⊕? MODERATE | IMPORTANT | ||
Acute exacerbation rate | ||||||||||||||
2 | RCTs | not serious | seriousb | not serious | not serious | none | 48/343 (14.0%) | 77/325 (23.7%) | RR 0.60 (0.43 to 0.83) | 95 fewer per 1000 (from 135 fewer to 40 fewer) | ⊕⊕⊕? MODERATE | IMPORTANT |
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