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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (1): 9-19.doi: 10.3736/jcim20090102

• Systematic Review • Previous Articles     Next Articles

Tanreqing Injection for community-acquired pneumonia: A systematic review of randomized evidence

Hong-li Jiang,  Bing Mao, Yun-qing Zhong , Hong-mei Yang , Juan-juan Fu    

  1. Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China
  • Received:2008-07-30 Accepted:2008-09-09 Online:2009-01-20 Published:2009-01-15

Objective

To evaluate the efficacy and safety of Tanreqing Injection, a compound traditional Chinese herbal medicine, for community-acquired pneumonia.
Methods

Literatures about randomized controlled trials of Tanreqing Injection for community-acquired pneumonia were reviewed. Related literatures were selected and analyzed according to different treatment strategies of the trials. The methodological quality of the trials was assessed by the Jadad scale, and evaluation was performed.
Results

Twelve randomized controlled trials meeting the inclusion criteria were selected and reviewed. As Tanreqing combined group (Tanreqing Injection plus antibiotics and basic therapy) was compared with antibiotics group (antibiotics plus basic therapy), the meta-analysis indicated that the relative risk (RR) for the total cure rate was 1.51, and 95% confidence interval (CI) was [1.29, 1.77]; RR for the total obvious effect rate was 1.31, and 95% CI was [1.20,1.43]; RR for the effective rate was 1.17, and 95% CI was [1.11, 1.23]. The weighted mean difference (WMD) in disappearance time of fever between the two groups was –1.24, and 95% CI was [–1.71, –0.76]. The RR values between the two groups for the total obvious effect rate of cough and expectoration were 1.42 and 1.27, and 95% CIs were [1.16, 1.74] and [1.04, 1.55] respectively. The RR values between the two groups in absorption of chest X-ray shadow and neutrophil number were 1.19, 1.10 and 95% CIs were [1.09, 1.30], [1.03, 1.17] respectively. The differences were all statistically significant. Serious systematic adverse reactions had not been reported in the trials.
Conclusion

The effect of combined therapy with Tanreqing Injection plus antibiotics and basic therapy is better than that of antibiotics plus basic therapy. Tanreqing Injection can improve the symptoms of cough and expectoration, shorten the fever time and facilitate the absorption of chest X-ray shadow, without any significant adverse reactions. However, further high-quality trials are needed.

Key words: Tanreqing Injection, Community-acquired pneumonia, Randomized controlled trials, Systematic review, Meta-analysis

Figure 1

Study selection process for randomized controlled trials"

Table 1

Clinical characteristics of enrolled trials"

Study Intervention Cases (male/female) Duration
(days)
Age (years)
Treatment group Control group Treatment group Control group Treatment group Control group
Feng et al[8] Tanreqing and antibiotics Antibiotics 29 (18/11) 27 (17/10) 10-14 46.22±12.26 45.25±13.04
Jiu[9] Tanreqing and azithromycin Azithromycin 34 (18/16) 34 (19/15) 7-14 18-75 20-70
Wen et al[10] Tanreqing and cefuroxime Cefuroxime 50 (31/19) 49 (27/22) 10 22-74 23-72
Chen et al [11] Tanreqing and antibiotics Antibiotics 32 (18/14) 32 (17/15) 10 72.52±9.31 71.94±9.65
Qu[12] Tanreqing and antibiotics Antibiotics 40 (24/16) 40 (22/18) 14 23-74 21-75
Zhang[13] Tanreqing and levofloxacin Levofloxacin 48 (28/20) 50 (26/24) 10 69.00±13.00 72.00±14.00
Liu[14] Tanreqing and levofloxacin Levofloxacin 20 (12/8) 20 (10/10) 7 52.15±12.75 54.00±11.35
Liu et al[15] Tanreqing and antibiotics Antibiotics 50 (28/22) 50 (29/21) 7 42.35±12.36 41.67±11.28
Yang[16] Tanreqing and cefoperazone Cefoperazone 42 (25/17) 40 (24/16) 10 72.00±8.40 72.00±8.70
Song et al[17] Tanreqing and azithromycin Azithromycin 24 (14/10) 24 (12/12) 7 35-80 33-79
Li et al[18] Tanreqing, azithromycin
and cefuroxime
Azithromycin
and cefuroxime
50 (30/20) 49 (31/18) 12 71.60±13.20 72.20±12.80
Yan et al[19] Tanreqing Clindamycin 20 (13/7) 20 (11/9) 28 73.54±1.33 70.71±2.12

Table 2

Methodological quality of enrolled trials"

Study Randomization Allocation concealment Blinding Withdrawls Jadad score ITT Baseline
Feng et al[8] Not mentioned No No No 1 No Similar
Jiu[9] Not mentioned No No No 1 No Similar
Wen et al[10] Not mentioned No No No 1 No P>0.05
Chen et al[11] Not mentioned No No No 1 No P>0.05
Qu[12] Not mentioned No No No 1 No P>0.05
Zhang[13] Not mentioned No No No 1 No P>0.05
Liu[14] Not mentioned No No No 1 No P>0.05
Liu et al[15] Random-number table No No No 2 No P>0.05
Yang[16] Not mentioned No No No 1 No P>0.05
Song et al[17] Not mentioned No No No 1 No P>0.05
Li et al[18] Quasi-randomized No No No 1 No P>0.05
Yan et al[19] Not mentioned No No Yes 2 No P>0.05

Figure 2

Total cure rates in Tanreqing combined group and antibiotics group"

Figure 3

Total obvious effect rates in Tanreqing combined group and antibiotics group"

Figure 4

Total effective rates in Tanreqing combined group and antibiotics group"

Figure 5

Disappearance time of fever in Tanreqing combined group and antibiotics group"

Figure 6

Total obvious effect rates of cough and expectoration in Tanreqing combined and antibiotics group"

Figure 7

Absorption of chest X-ray shadow of Tanreqing combined group and antibiotics group"

Figure 8

Improvement of blood routine test in Tanreqing combined group and antibiotics group"

Figure 9

Adverse reactions in Tanreqing combined group and antibiotics group"

Figure 10

Funnel plot for total cure rate"

Figure 11

Sensitivity analysis of the total cure rates in Tanreqing combined group and antibiotics group"

[1] Ramirez JA . Community-acquired pneumonia in adults[J]. Prim Care, 2003,30(1):155-171
doi: 10.1016/S0095-4543(02)00076-3
[2] Niederman MS, Ahmed QA . Community-acquired pneumonia in elderly patients[J]. Clin Geriatr Med, 2003,19(1):101-120
doi: 10.1016/S0749-0690(02)00061-7
[3] Arnold FW, Ramirez JA, McDonald LC, Xia EL .Hospitalization for community-acquired pneumonia: the pneumonia severity index vs clinical judgment[J]. Chest, 2003,124(1):121-124
doi: 10.1378/chest.124.1.121
[4] Li W, Mao B, Wang G, Wang L, Chang J, Zhang Y, Wan MH, Guo J . A study of the mechanism of Qingre Huatan therapy in treatment of acute exacerbation of chronic obstructive pulmonary disease by improving airway inflammation and mucus hypersecretion[J]. J Chin Integr Med, 2008,6(8):799-805
李文, 毛兵, 王刚, 王蕾, 常静, 张颖, 万美华, 郭佳 . 从气道炎症和气道黏液高分泌研究清热化痰法治疗慢性阻塞性肺疾病急性加重期痰热阻肺证的机制[J]. 中西医结合学报, 2008,6(8):799-805
[5] Zheng XY. Guiding principles for clinical research on new drugs of traditional Chinese medicine(Trial imple-mentation)[M]. Beijing: China Medical-Pharmaceutical Science & Technology Publishing House,2002: 58
郑筱萸 . 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社,2002: 58
[6] Society of Respiratory Diseases, Chinese Medical Association . Guidelines for the diagnosis and treatment of community-acquired pneumonia[J]. Zhonghua Jie He He Hu Xi Za Zhi, 2006,29(10):651-655
doi: 10.3321/j.issn:1671-167X.2006.03.012
中华医学会呼吸病学分会. 社区获得性肺炎诊断和治疗指南[J]. 中华结核和呼吸杂志, 2006,29(10):651-655
doi: 10.3321/j.issn:1671-167X.2006.03.012
[7] Mao B, Wang G, Fan T, Chen XD, Liu J, Wang L, Chang J, Ma JX, Guo J, Fu JJ, Li TQ . Assessing the quality of reporting of randomized controlled trials in traditional Chinese medicine[J]. Zhongguo Xun Zheng Yi Xue Za Zhi, 2007,7(12):880-887
毛兵, 王刚, 樊涛, 陈小东, 刘佳, 王蕾, 常静, 马建昕, 郭佳, 付娟娟, 李廷谦 . 中医药随机对照试验报告质量评价[J]. 中国循证医学杂志, 2007,7(12):880-887
[8] Feng B, Liu J, Zhao XQ . Efficacy of Tanreqing injection in the treatment of 56 patients with community acquired pneumonia[J]. Zhongguo Xin Yao Za Zhi, 2008,17(5):418-419
冯柏, 刘晶, 赵学群 . 痰热清注射液结合抗生素治疗社区获得性肺炎56例[J]. 中国新药杂志, 2008,17(5):418-419
[9] Jiu T . Clinical efficacy of Tanreqing Injection and azithromycin in treating community-acquired pneumonia[J]. Zhongguo Shi Yong Yi Yao, 2007,2(15):107-108
久太 . 痰热清联合阿奇霉素治疗社区获得性肺炎疗效观察[J]. 中国实用医药, 2007,2(15):107-108
[10] Wen R, Tian J . Clinical observation of Tanreqing Injection and cephalosporins in treating community-acquired pneumonia[J]. Zhong Yi Yao Xue Kan, 2006,24(2):374-375
闻锐, 田军 . 痰热清联合头孢治疗社区获得性肺炎临床观察[J]. 中医药学刊, 2006,24(2):374-375
[11] Chen YF, Liu H, Hu XY .Clinical observation of Tanreqing Injection in treating aged community-acquired pneumonia[J].Zhongguo Zhong Yi Ji Zheng, 2006, 15(6): 575, 587
陈云凤, 刘洪, 扈晓宇 .痰热清治疗老年社区获得性肺炎临床观察[J].中国中医急症, 2006, 15(6): 575, 587
[12] Qu F . Clinical efficacy of Tanreqing Injection and antibiotics in treating community-acquired pneumonia[J]. Zhongguo Zhong Yi Ji Zheng, 2007,16(2):154-155
曲凡 . 痰热清注射液联合抗生素治疗社区获得性肺炎疗效观察[J]. 中国中医急症, 2007,16(2):154-155
[13] Zhang LY .Clinical efficacy of Tanreqing Injection and levofloxacin in treating community-acquired pneumonia[J].Zhongguo Zhong Yi Ji Zheng, 2007, 16(7): 774, 799
张理云 .痰热清注射液联合左氧氟沙星治疗社区获得性肺炎疗效观察[J].中国中医急症, 2007, 16(7): 774, 799
[14] Liu M .Clinical efficacy of Tanreqing Injection in treating mild to moderate community acquired pneumonia[J].Zhongguo Zhong Yi Ji Zheng, 2007, 16(7): 774, 799
刘梅 . 痰热清注射液治疗轻、中症社区获得性肺炎疗效观察[J]. 中国中医急症, 2007,16(9):1060-1061
[15] Liu JB, Sun ZJ, Zhang W . Treatment of community acquired pneumonia by Tanreqing Injectin: a clinical observation of 50 cases[J]. Xin Zhong Yi, 2006,38(3):27-29
刘建博, 孙志佳, 张伟 . 痰热清注射液治疗社区获得性肺炎50例疗效观察[J]. 新中医, 2006,38(3):27-29
[16] Yang G . Clinical efficacy of Tanreqing Injection in treating community-acquired pneumonia[J]. Shi Zhen Guo Yi Guo Yao, 2007,18(8):2017-2018
杨罡 . 痰热清注射液治疗社区获得性肺炎疗效研究[J]. 时珍国医国药, 2007,18(8):2017-2018
[17] Song YY, Li SG, Tian ZJ . Clinical efficacy of integrated traditional Chinese and Western medicine therapy in treating allergic diajournal patients with community-acquired pneumonia[J]. Hubei Zhong Yi Za Zhi, 2008,30(2):35-36
宋远瑛, 李树岗, 田正鉴 . 中西医结合治疗过敏体质人群社区获得性肺炎疗效观察[J]. 湖北中医杂志, 2008,30(2):35-36
[18] Li GQ, Bian YJ, Li GX, Li H, Liu ZG, Jin ZY, Liu JL . Efficacy of Tanreqing injection combined with antibiotics for the treatment of patients with acute bacterial pneumonia[J]. Zhongguo Xin Yao Za Zhi, 2008,17(6):509-511
李国勤, 边永君, 李光熙, 李辉, 刘志国, 金在艳, 刘俊玲 . 痰热清结合抗生素治疗急性细菌性肺炎50例[J]. 中国新药杂志, 2008,17(6):509-511
[19] Yan J, Rong XF, Ren QL, Shang XC .Clinical observation of Tanreqing Injection in treating aged patients with community-acquired pneumonia[J].Zhongguo Zhong Yi Ji Zheng, 2006, 15(7): 698, 729
严瑾, 荣晓凤, 任庆兰, 尚晓春 .痰热清注射液治疗老年社区获得性肺炎临床观察[J].中国中医急症, 2006, 15(7): 698, 729
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