Meta-analysis and trial sequential analysis of Huaiqihuang granules in treatment of cough variant asthma in pediatrics

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine Pub Date : 2025-06-05 DOI:10.1016/j.eujim.2025.102511

Qiaoling Li, Jing Peng, Linhui Liu

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引用次数: 0

Abstract

Introduction

Many individuals with cough variant asthma (CVA) utilize Huaiqihuang granules to alleviate symptoms. However, there is a lack of systematic reviews investigating its efficacy and safety for CVA.

Methods

A computer-based retrieval of various databases was conducted to search for randomized controlled trials (RCTs) on the treatment of CVA in children using Huaiqihuang granules combined with Western medicine. The search encompassed eight databases, including China National Knowledge Infrastructure (CNKI), Wangfang, VIP (VIP Information Co.Ltd.), PubMed, Web of Science, The Cochrane Library, Embase, and Sinomed database, and covered literature up to April 2025. Articles were screened and selected based on predefined inclusion and exclusion criteria. The quality of the included articles was assessed, followed by a meta-analysis using RevMan5.3. The quality of evidence was graded using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) system. Additionally, trial sequential analysis (TSA) was performed using TSA 0.9.5.10 beta software.

Results

A total of 17 RCTs were included in the analysis, encompassing a total sample size of 1,742 patients. Results showed that the combination of Huaiqihuang granules with conventional Western medicine significantly enhanced clinical efficacy and reduced recurrence rates compared to Western medicine alone. This combination also improved immune parameters, including CD4+/CD8+, and modulated inflammatory markers such as inflammatory factors interleukin-4 (IL-4) and interferon-gamma (IFN-γ), while restoring immunoglobulin levels (IgA, IgE, IgG). Additionally, it improved pulmonary function indices, including FEV1, FEV1/FVC and PEF. No significant differences were observed in the incidence of adverse reactions between the two groups. TSA demonstrated that the total effective rate curve surpassed both the traditional and TSA boundaries, corroborating the clinical efficacy. According to the GRADE assessment, outcomes related to treatment efficacy, recurrence rate, IFN-γ, CD4+, and incidence of adverse reactions were rated as moderate-quality evidence, whereas the remaining outcomes were assessed as low-quality evidence.

Conclusion

The integration of Huaiqihuang granules with conventional Western medicine in the management of CVA significantly enhances clinical efficacy, reduces recurrence rates, improves immune parameters, restores pulmonary function, ameliorates inflammatory markers, and normalizes immunoglobulin levels, in comparison to the use of Western medicine alone.

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怀芪黄颗粒治疗小儿咳嗽变异性哮喘的meta分析和试验序贯分析

许多咳嗽变异性哮喘（CVA）患者使用槐芪黄颗粒缓解症状。然而，缺乏对其治疗CVA的有效性和安全性的系统评价。方法计算机检索各类数据库，检索槐七黄颗粒联合西药治疗儿童CVA的随机对照试验（rct）。检索包括中国知网、网方、维普、PubMed、Web of Science、The Cochrane Library、Embase、Sinomed等8个数据库，涵盖截至2025年4月的文献。根据预先确定的纳入和排除标准对文章进行筛选和选择。评估纳入文章的质量，然后使用RevMan5.3进行meta分析。采用建议评估、发展和评价等级（Grade）系统对证据质量进行分级。采用TSA 0.9.5.10 beta软件进行试验序列分析（TSA）。结果共纳入17项随机对照试验，总样本量为1742例。结果表明，与单用西药相比，怀七黄颗粒联合西药治疗可显著提高临床疗效，降低复发率。该组合还改善了免疫参数，包括CD4+/CD8+，并调节炎症标志物，如炎症因子白介素-4 （IL-4）和干扰素-γ (IFN-γ)，同时恢复免疫球蛋白水平（IgA, IgE, IgG）。FEV1、FEV1/FVC、PEF等肺功能指标均有改善。两组患者不良反应发生率无显著差异。TSA显示总有效率曲线超越传统和TSA边界，证实了临床疗效。根据GRADE评估，与治疗疗效、复发率、IFN-γ、CD4+和不良反应发生率相关的结果被评为中等质量证据，而其余结果被评估为低质量证据。结论与单用西药相比，槐芪黄颗粒联合西药治疗CVA临床疗效显著提高，复发率降低，免疫指标改善，肺功能恢复，炎症指标改善，免疫球蛋白水平正常化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

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.