Traditional Chinese medicine for airway remodelling in patients with asthma: A systematic review of randomized controlled trials

IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE
Ying-lan Lyu , Jing-ze Song , Yan Huang , Wan-xin Fu , Hui-lin Zhang , Chun-li Lu , Wan-di Feng , Bao-sheng Zhao , Yan-yan Meng
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引用次数: 0

Abstract

Introduction

This systematic review aimed to evaluate the effectiveness and safety of traditional Chinese medicine (TCM) interventions for airway remodelling in patients with asthma.

Methods

A systematic search was conducted of 8 international and Chinese databases and 2 clinical trial registries from the inception of the database to March 2022. The data were analysed for the outcomes of lung function, matrix metalloproteinases-9 (MMP-9), tissue inhibitor of metalloproteinases-1 (TIMP-1), and adverse events. The Cochrane “Risk of bias” tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used to assess the methodological quality and the certainty of the evidence. Descriptive analysis was employed to summarize the outcomes of TCM. The PROSPERO ID is CRD42022318617. This work was financially supported by the National Natural Science Foundation of China (No. 82,004,167).

Results

Twenty RCTs involving 1790 patients with asthma were included. The trials were at unclear or high risk of bias. The certainty of the evidence ranged from very low certainty to low certainty. The TCM used in each trial was different. Compared to those of conventional medicine, 9 trials showed greater effects of TCM alone or combined with conventional medicine on lung function, as indicated by the FEV1, FVC, and FEV1/FVC. Nine trials showed that TCM significantly reduced the expression of MMP-9 and TIMP-1. Five trials reported adverse events.

Conclusion

TCM alone or in combination with conventional medicine alleviated airway remodelling symptoms in patients with asthma. However, additional high-quality randomized trials are still needed to confirm the beneficial effectiveness of TCM.

中医药治疗哮喘患者的气道重塑:随机对照试验的系统回顾
导言本系统综述旨在评估中医药干预哮喘患者气道重塑的有效性和安全性。方法系统检索了从数据库建立之初到2022年3月的8个国际和中国数据库以及2个临床试验登记。对数据进行了分析,结果包括肺功能、基质金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制剂-1(TIMP-1)和不良事件。采用 Cochrane "偏倚风险 "工具和建议评估、发展和评价分级法(GRADE)评估方法学质量和证据的确定性。采用描述性分析来总结中医药的成果。PROSPERO ID为CRD42022318617。结果纳入了 20 项 RCT,涉及 1790 名哮喘患者。这些试验的偏倚风险不明确或很高。证据的确定性从很低的确定性到较低的确定性不等。每项试验中使用的中医药各不相同。与传统药物相比,9项试验显示,单独使用中医药或与传统药物联合使用中医药对肺功能(如FEV1、FVC和FEV1/FVC)的影响更大。9项试验显示,中药能明显降低MMP-9和TIMP-1的表达。五项试验报告了不良反应。然而,仍需要更多高质量的随机试验来证实中药的益处。
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来源期刊
European Journal of Integrative Medicine
European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-
CiteScore
4.70
自引率
4.00%
发文量
102
审稿时长
33 days
期刊介绍: The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.
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