PMID- 38007165 OWN - NLM STAT- MEDLINE DCOM- 20240101 LR - 20240319 IS - 1872-7573 (Electronic) IS - 0378-8741 (Linking) VI - 321 DP - 2024 Mar 1 TI - Efficacy and safety of Tanreqing injection for cough caused by acute trachea-bronchitis disease: A systematic review and meta-analysis of randomized controlled trials. PG - 117429 LID - S0378-8741(23)01299-0 [pii] LID - 10.1016/j.jep.2023.117429 [doi] AB - ETHNOPHARMACOLOGICAL RELEVANCE: Tanreqing injection (TRQI) is an intravenous herbal preparation derived from 5 types of traditional Chinese medicines including Scutellariae Radix, Lonicerae Japonicae Flos, Forsythiae Fructus, bear bile powder and goral horn, incorporating baicalin, chlorogenic acid, ursodeoxycholic acid, and goose deoxycholic acid and other compounds known for anti-inflammatory properties, is widely used in China to treat cough caused by acute trachea-bronchitis disease (ATB). AIM OF THE STUDY: To investigate the clinical efficacy and safety of Tanreqing injection (TRQI) with and without Western medicine (WM) for cough caused by acute trachea-bronchitis (ATB). MATERIALS AND METHODS: We systematically searched eight databases, including CENTRAL, Embase, PubMed, Science Direct, Wiley, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang, from inception to August 2023 for randomized clinical trials (RCTs) on TRQI for cough caused by ATB. The critical outcomes of interest were time to symptom disappearance, including time for cough symptom to disappear and time to improve cough and sputum production. Important outcomes included symptom disappearance rate, adverse events (AEs) and lung function. We carried out random-effects meta-analysis using Review Manager 5.4 and assessed the certainty of evidence utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: A total of 2872 citations were identified by our search, of which 26 eligible RCTs enrolled 2731 participants. Low to moderate certainty evidence showed that when compared with WM, TRQI plus WM treatment was associated with a favorable effect on the time for cough symptom to disappear (MD -2.21 d, 95% CI -2.64 to -1.78), time to improve cough and sputum production (MD -0.68 d, 95% CI -0.83 to -0.53), symptom disappearance rate (RR 1.37, 95% CI 1.20 to 1.55), forced vital capacity, and forced expiratory volume in 1 s (MD 0.38 L, 95% CI 0.26 to 0.50; MD 2.92%, 95% CI 1.29 to 4.56, respectively). In terms of AEs, there was no association between TRQI plus WM and WM (RR 0.55, 95% CI 0.14 to 2.21; low-certainty evidence). Very low certainty evidence showed that TRQI alone was associated with reduced time to improve cough and sputum (MD -0.14 d, 95% CI -0.26 to -0.02) and increased symptom disappearance rate (RR 1.89, 95% CI 1.24 to 2.88; low certainty evidence) compared to WM. CONCLUSIONS: The overall efficacy of TRQI or WM for ATB cough is better than that of WM, and TRQI also effectively improve symptoms in patients with similar adverse events. However, due to the lack of methodological rigor of included studies, the present findings should be interpreted with caution. We advocate better high-quality and convincing clinical studies to be performed to prove the effectiveness and safety of TRQIs. CI - Copyright (c) 2023 Elsevier B.V. All rights reserved. FAU - Ma, Ning AU - Ma N AD - Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China. FAU - Pan, Bei AU - Pan B AD - Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China. FAU - Ge, Long AU - Ge L AD - Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China. FAU - Li, Mengting AU - Li M AD - Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China. FAU - Zhu, Hongfei AU - Zhu H AD - Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China. FAU - Deng, Xiyuan AU - Deng X AD - Department of Prenatal Diagnosis Center, Gansu Provincial Maternity and Child-care Hospital, Lanzhou, 730000, China. FAU - Li, Dan AU - Li D AD - Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China. FAU - Wang, Xiaoman AU - Wang X AD - Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China. FAU - Wu, Lei AU - Wu L AD - Guangzhou University of Chinese Medicine, Guangzhou, 510006, China. FAU - Xiao, Jingmin AU - Xiao J AD - Traditional Chinese Medicine Hospital of Guangdong Provincial, Guangzhou, 510120, China. FAU - Lai, Honghao AU - Lai H AD - Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China. FAU - Tian, Jinhui AU - Tian J AD - Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China. FAU - Niu, Junqiang AU - Niu J AD - Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China; The First Hospital of Lanzhou University, Lanzhou, 730000, China. Electronic address: njqldyy@126.com. FAU - Yang, Kehu AU - Yang K AD - Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 730000, China; Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China; Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, 730000, China. Electronic address: yangkh-ebm@lzu.edu.cn. LA - eng PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20231123 PL - Ireland TA - J Ethnopharmacol JT - Journal of ethnopharmacology JID - 7903310 RN - 0 (tanreqing) SB - IM MH - Humans MH - Acute Disease MH - *Bronchitis MH - Cough/drug therapy MH - Randomized Controlled Trials as Topic MH - *Trachea OTO - NOTNLM OT - Acute trachea-bronchitis OT - Chinese traditional OT - Cough OT - Meta-analysis OT - Systematic review OT - Tanreqing COIS- Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/11/26 07:44 MHDA- 2024/01/02 11:42 CRDT- 2023/11/25 19:30 PHST- 2023/06/05 00:00 [received] PHST- 2023/09/01 00:00 [revised] PHST- 2023/11/12 00:00 [accepted] PHST- 2024/01/02 11:42 [medline] PHST- 2023/11/26 07:44 [pubmed] PHST- 2023/11/25 19:30 [entrez] AID - S0378-8741(23)01299-0 [pii] AID - 10.1016/j.jep.2023.117429 [doi] PST - ppublish SO - J Ethnopharmacol. 2024 Mar 1;321:117429. doi: 10.1016/j.jep.2023.117429. Epub 2023 Nov 23.