A Meta-Analysis of Treatment Effects on Viral Pneumonia Using TCM Injections Specified in the Clinical Guideline for COVID-19 in China

Abstract

Objectives: The purpose of this study is to analyze the efficacy of traditional Chinese medicine (TCM) injections specified in the clinical guideline for COVID-19 by conducting a meta-analysis of viral pneumonia data.

Methods: TCM injections data on viral pneumonia were collected until July 31, 2021. CNKI, PubMed, EMBASE, and the Cochrane electronic database were used to collect the clinical data. "COVID-19," "Viral pneumonia," "Tanreqing," "Xiyanping," "Reduning," "Xingnaojing," "Xuebijing," "Shenmai," "Shengmai," and "Shenfu" were used as keywords. All data collected were mainly about TCM injections and viral pneumonia. Furthermore, studies that included results such as the total effective rate, cough disappearance time, antipyretic time, lung rhomboid disappearance time, and adverse drug reaction were collected for the meta-analysis to identify the efficacy of TCM injections. However, data unrelated to TCM injections specified in the clinical guidelines for COVID-19 or viral pneumonia were excluded. The quality of included RCTs was assessed by the Cochrane Risk of Bias Tool, and Review Manager 5.3 software was used to conduct the meta-analysis.

Results: A total of 18 studies with 1540 patients were included in this study. The results of the meta-analysis showed that the total effective rate OR = 4.61 (95% CI 2.92, 7.25, p = 1.00/ I² = 0%); the cough disappearance time SMD -1.23 (-1.37, -1.09, p < 0.00001/ I² = 94%); the antipyretic time SMD -1.26 (-1.40, -1.11, p < 0.00001/ I²=94%); lung rhomboid disappearance time SMD -1.17 (-1.33, -1.02, p < 0.00001/ I² = 89%); and adverse drug reaction was OR 0.36 (95% CI 0.20, 0.64, p = 0.21/ I² = 30%). From the results, the treatment group (TCM injection) showed better efficacy than the control group (Western medication).

Conclusion: Xiyanping, Reduning, and Tanreqing injections may yield benefits as COVID-19 treatments. However, clinical trials on TCM injections for the treatment of COVID-19 are still lacking. More high-quality clinical trials are still required.

Keywords: covid-19; sars-cov-2; tcm injection; viral pneumonia.