Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis

Objectives: Chinese herb medicine (CHM) is one of the most popular complementary and alternative therapies, which has been widely used to treat Refractory Mycoplasma Pneumoniae Pneumonia (RMPP). However, the effect and safety of CHM remain controversial. Hence, we conducted this meta-analysis to eva...

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Main Authors: Xiaoying Ling, Xun Sun, Huimin Kong, Shanshan Peng, Zheng Yu, Jiali Wen, Bin Yuan
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-06-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2021.678631/full
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author Xiaoying Ling
Xun Sun
Huimin Kong
Shanshan Peng
Zheng Yu
Jiali Wen
Bin Yuan
author_facet Xiaoying Ling
Xun Sun
Huimin Kong
Shanshan Peng
Zheng Yu
Jiali Wen
Bin Yuan
author_sort Xiaoying Ling
collection DOAJ
description Objectives: Chinese herb medicine (CHM) is one of the most popular complementary and alternative therapies, which has been widely used to treat Refractory Mycoplasma Pneumoniae Pneumonia (RMPP). However, the effect and safety of CHM remain controversial. Hence, we conducted this meta-analysis to evaluate whether CHM combination therapy could bring benefits to children and adolescents with RMPP.Methods: Seven databases were used for data searching through November 11, 2020 following the PRISMA checklist generally. Review Manager 5.3, Trial sequential analysis 0.9.5.10 Beta software and Stata16.0 were applied to perform data analyses. Mean difference or risk ratio was adopted to express the results, where a 95% confidence interval (CI) was applied.Results: In general, this research enrolled 17 trials with 1,451 participants. The overall pooled results indicated that CHM was beneficial for children and adolescents with RMPP by improving the clinical efficacy rate [RR = 1.20, 95% CI (1.15, 1.25), p < 0.00001], shortening antipyretic time [MD = −2.60, 95% CI (−3.06, −2.13), p < 0.00001], cough disappearance time [MD = −2.77, 95% CI (−3.12, −2.42), p < 0.00001], lung rale disappearance time [MD = −2.65, 95% CI (−3.15, −2.15), p < 0.00001], lung X-ray infiltrates disappearance time [MD = −2.75, 95% CI (−3.33, −2.17), p < 0.00001], reducing TNF-α level [MD = −5.49, 95% CI (−7.21, −3.77), p < 0.00001]. Moreover, subgroup results suggested that removing heat-phlegm and toxicity therapy had more advantages in shortening antipyretic time, cough disappearance time, lung X-ray infiltrates disappearance time and reducing TNF-α level. Meanwhile promoting blood circulation therapy seemed to be better at relieving lung rale. However, regarding adverse events, the two groups displayed no statistical difference [RR = 0.97, 95% CI (0.60, 1.57), p = 0.91].Conclusion: Despite of the apparently positive results in relieving clinical symptoms, physical signs and reducing inflammation, it is premature to confirm the efficacy of CHM in treating RMPP because of the limitation of quality and the number of the included studies. More large-scale, double-blind, well-designed, randomized controlled trials are needed in future research.
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spelling doaj.art-2f38be3e023b423cbdf369abd4ff10be2022-12-21T22:33:43ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122021-06-011210.3389/fphar.2021.678631678631Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-AnalysisXiaoying LingXun SunHuimin KongShanshan PengZheng YuJiali WenBin YuanObjectives: Chinese herb medicine (CHM) is one of the most popular complementary and alternative therapies, which has been widely used to treat Refractory Mycoplasma Pneumoniae Pneumonia (RMPP). However, the effect and safety of CHM remain controversial. Hence, we conducted this meta-analysis to evaluate whether CHM combination therapy could bring benefits to children and adolescents with RMPP.Methods: Seven databases were used for data searching through November 11, 2020 following the PRISMA checklist generally. Review Manager 5.3, Trial sequential analysis 0.9.5.10 Beta software and Stata16.0 were applied to perform data analyses. Mean difference or risk ratio was adopted to express the results, where a 95% confidence interval (CI) was applied.Results: In general, this research enrolled 17 trials with 1,451 participants. The overall pooled results indicated that CHM was beneficial for children and adolescents with RMPP by improving the clinical efficacy rate [RR = 1.20, 95% CI (1.15, 1.25), p < 0.00001], shortening antipyretic time [MD = −2.60, 95% CI (−3.06, −2.13), p < 0.00001], cough disappearance time [MD = −2.77, 95% CI (−3.12, −2.42), p < 0.00001], lung rale disappearance time [MD = −2.65, 95% CI (−3.15, −2.15), p < 0.00001], lung X-ray infiltrates disappearance time [MD = −2.75, 95% CI (−3.33, −2.17), p < 0.00001], reducing TNF-α level [MD = −5.49, 95% CI (−7.21, −3.77), p < 0.00001]. Moreover, subgroup results suggested that removing heat-phlegm and toxicity therapy had more advantages in shortening antipyretic time, cough disappearance time, lung X-ray infiltrates disappearance time and reducing TNF-α level. Meanwhile promoting blood circulation therapy seemed to be better at relieving lung rale. However, regarding adverse events, the two groups displayed no statistical difference [RR = 0.97, 95% CI (0.60, 1.57), p = 0.91].Conclusion: Despite of the apparently positive results in relieving clinical symptoms, physical signs and reducing inflammation, it is premature to confirm the efficacy of CHM in treating RMPP because of the limitation of quality and the number of the included studies. More large-scale, double-blind, well-designed, randomized controlled trials are needed in future research.https://www.frontiersin.org/articles/10.3389/fphar.2021.678631/fullrefractory Mycoplasma pneumoniae pneumoniaChinese herbal medicinecomplementary and alternative medicinemeta-analysiseffectiveness
spellingShingle Xiaoying Ling
Xun Sun
Huimin Kong
Shanshan Peng
Zheng Yu
Jiali Wen
Bin Yuan
Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis
Frontiers in Pharmacology
refractory Mycoplasma pneumoniae pneumonia
Chinese herbal medicine
complementary and alternative medicine
meta-analysis
effectiveness
title Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis
title_full Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis
title_fullStr Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis
title_full_unstemmed Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis
title_short Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis
title_sort chinese herbal medicine for the treatment of children and adolescents with refractory mycoplasma pneumoniae pneumonia a systematic review and a meta analysis
topic refractory Mycoplasma pneumoniae pneumonia
Chinese herbal medicine
complementary and alternative medicine
meta-analysis
effectiveness
url https://www.frontiersin.org/articles/10.3389/fphar.2021.678631/full
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