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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

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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"

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