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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (8): 706-716.doi: 10.3736/jcim20090802

• Systematic Review • Previous Articles     Next Articles

Chinese medicine for acute upper respiratory tract infection: A systematic review of randomized controlled trials

 Wen-bing Zhang,  Hong-li Jiang, Wei Zhou, Yun-qing Zhong, Hong-mei Yang, Juan-juan Fu, Bing Mao   

  1. Department of Integrated Traditional Chinese and Western Medicine» West China Hospital, Sichuan University,Chengdu 610041, Sichuan Province» China
  • Received:2009-03-03 Accepted:2009-05-14 Online:2009-08-20 Published:2009-08-15
  • Contact: Bing Mao E-mail:maobing@medmail.com.cn

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Objective

To evaluate the efficacy and safety of new drugs of traditional Chinese medicine (TCM) for acute upper respiratory tract infection (common cold).Methods: Reports regarding randomized controlled trials of Chinese medicine for common cold were reviewed. Related reports were selected and the methodological quality of the trials was assessed by the Jadad scale. Meanwhile, the stratified analysis was made according to different TCM syndrome types of common cold.
Results

Thirteen randomized controlled trials consistent with the inclusion criteria were selected and reviewed. As TCM treatment group was compared with control group, the meta analysis indicated that the relative risk (RR) for obviously effective rate was 1.10, and the 95% confidence interval (CI) was [1.05, 1.16]; the weighted mean difference (WMD) of the onset time of lowering body temperature was –1.70, and the 95% CI was [–2.76, –0.65]. There were significant differences in the above evaluation indexes between the two groups (P=0.000 2, P=0.002). The WMD of disappearing time of fever was –1.32, and the 95% CI was [–3.14, 0.49], while there was no significant difference between the two groups (P=0.15). As the common cold patients with wind-heat syndrome in the TCM treatment group were compared with those in the control group, the meta analysis indicated that the RR for obviously effective rate was 1.11, the 95% CI was [1.05, 1.19], and there was significant difference between the two groups (P=0.000 7). As the common cold patients with wind-cold syndrome in the TCM treatment group were compared with those in the control group, the meta analysis indicated that the RR for obviously effective rate was 1.07, the 95% CI was [0.99, 1.16], and there was no significant difference between the two groups (P=0.10). Serious adverse reactions had not been reported in the trials.
Conclusion

TCM new drugs developed in recent years for preventing and treating common cold have better therapeutic effects than the old ones. They can accelerate the onset time of lowering body temperature and improve the symptoms of common cold without any significant adverse reactions. Because of lacking of placebo-controlled and blank-controlled studies, further high-quality trials are still needed.

Key words: Traditional Chinese herbal drug, Acute upper respiratory tract infections, Randomized controlled trial, 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) Age ($\bar{x}$±s, yesrs)
Treatment Control Treatment Control Syndrome Treatment Control
Chang et al[7] Jinlian Qingre
capsule		 Jinlian Qingre granule 116 (47/69) 110 (36/74) Wind-heat 39.57±13.26 41.85±13.02
Chang et al[8] Chaige Qingre
granule		 Fufang Shuanghua granule 76 (36/40) 27 (11/16) Wind-heat 35.24±15.15 39.22±17.35
Chang et al[9] Andrographolide
drop-pill		 Andrographolide tablet 138 (67/71) 136 (62/74) Wind-heat 37.18±13.64 36.09±14.43
Guo[10] Yinma antivirus
granule		 Yingqiao Jiedu granule 40 (19/21) 40 (15/25) Wind-heat 31.23±8.04 28.63±6.08
Huang[11] Daqinglong
granule		 Ganmao Qingre granule 116 (47/69) 114 (51/63) Wind-cold 32.72±17.92 29.94±15.65
Ke[12] Shuanghuanglian
dispersible tablet		 Shuanghuanglian granule 118 (53/65) 119 (54/65) Wind-heat 28.92±8.19 29.02±8.04
Li[13] Shuangjinlian
oral liquid		 Shuanghuanglian oral liquid 119 (55/64) 119 (60/59) Wind-heat 37.31±12.60 38.72±13.90
Li et al[14] Rendong Ganmao
granule		 Antivirus granule 35 (9/26) 35 (11/24) Wind-heat 45.40±14.16 41.17±14.56
Lu[15] Gegen decoction Jinfang mixture 120 (60/60) 120 (57/63) Wind-cold Did not report
mean age		 Did not report
mean age
Mao et al[16] Lianpu
granule		 Shuanghuanglian oral liquid 60 (21/39) 20 (8/12) Wind-heat 31.20±12.92 30.00±12.04
Wang et al[17] Shuangjie capsule Chaihuang tablet 310(137/173) 101 (56/45) Wind-heat 37.60±12.90 38.20±13.20
Zhang et al[18] Mahuang Zhisou
capsule		 Mahuang Zhisou pill 114 (44/70) 116 (47/69) Wind-cold 38.37±11.82 38.16±11.98
Zuo[19] Jiuwei Qianghuo
capsule		 Jiuwei Qianghuo concentration 24 (13/11) 24 (15/9) Wind-cold 36.40±4.82 37.80±4.41

Table 2

Methodological quality of enrolled trials"

Study Randomization Allocation concealment Blinding Withdraw Jadad score ITT Baseline
Chang et al[7] Stratified random Yes Yes Yes 7 Yes P>0.05
Chang et al[8] Stratified random Yes Yes Yes 7 Yes P>0.05
Chang et al[9] Stratified random Yes Yes Yes 7 Yes P>0.05
Guo[10] Random number No Yes No 4 No P>0.05
Huang[11] Stratified random Yes Yes No 6 No P>0.05
Ke[12] No description No Yes Yes 4 Yes P>0.05
Li[13] Stratified random Yes Yes Yes 7 Yes P>0.05
Li et al[14] No description No Yes Yes 4 No P>0.05
Lu[15] No description No Yes Yes 4 No P>0.05
Mao et al[16] Random number No Yes Yes 6 Yes P>0.05
Wang et al[17] Stratified random Yes Yes Yes 7 Yes P>0.05
Zhang et al[18] Stratified random Yes Yes Yes 7 Yes P>0.05
Zuo[19] No description No Yes Yes 4 No PP>0.05

Figure 2

Total obviously effective rates in treatment group and control group"

Figure 3

Onset time of lowering body temperature in treatment group and control group"

Figure 4

Disappearing time of fever in treatment group and control group"

Figure 5

Total obviously effective rates in common cold patients with wind-cold syndrome and wind-heat syndrome"

Figure 6

Adverse reactions in treatment group and control group"

Figure 7

Funnel plot for total obviously effective rate"

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