Chinese Herbal Medicine for the Treatment of Children and Adolescents With Refractory Mycoplasma Pneumoniae Pneumonia: A Systematic Review and a Meta-Analysis

Abstract

Objectives: Chinese herb medicine (CHM) is one of the most popular complementary and alternative therapies, which has been widely used to treat Refractory Mycoplasma Pneumoniae Pneumonia (RMPP). However, the effect and safety of CHM remain controversial. Hence, we conducted this meta-analysis to evaluate whether CHM combination therapy could bring benefits to children and adolescents with RMPP.Methods: Seven databases were used for data searching through November 11, 2020 following the PRISMA checklist generally. Review Manager 5.3, Trial sequential analysis 0.9.5.10 Beta software and Stata16.0 were applied to perform data analyses. Mean difference or risk ratio was adopted to express the results, where a 95% confidence interval (CI) was applied.Results: In general, this research enrolled 17 trials with 1,451 participants. The overall pooled results indicated that CHM was beneficial for children and adolescents with RMPP by improving the clinical efficacy rate [RR = 1.20, 95% CI (1.15, 1.25), p < 0.00001], shortening antipyretic time [MD = −2.60, 95% CI (−3.06, −2.13), p < 0.00001], cough disappearance time [MD = −2.77, 95% CI (−3.12, −2.42), p < 0.00001], lung rale disappearance time [MD = −2.65, 95% CI (−3.15, −2.15), p < 0.00001], lung X-ray infiltrates disappearance time [MD = −2.75, 95% CI (−3.33, −2.17), p < 0.00001], reducing TNF-α level [MD = −5.49, 95% CI (−7.21, −3.77), p < 0.00001]. Moreover, subgroup results suggested that removing heat-phlegm and toxicity therapy had more advantages in shortening antipyretic time, cough disappearance time, lung X-ray infiltrates disappearance time and reducing TNF-α level. Meanwhile promoting blood circulation therapy seemed to be better at relieving lung rale. However, regarding adverse events, the two groups displayed no statistical difference [RR = 0.97, 95% CI (0.60, 1.57), p = 0.91].Conclusion: Despite of the apparently positive results in relieving clinical symptoms, physical signs and reducing inflammation, it is premature to confirm the efficacy of CHM in treating RMPP because of the limitation of quality and the number of the included studies. More large-scale, double-blind, well-designed, randomized controlled trials are needed in future research.

Metabolomics Based on Peripheral Blood Mononuclear Cells to Dissect the Mechanisms of Chaigui Granules for Treating Depression

“…Under normal conditions, T lymphocyte interactions maintain normal immune function. When the number and function of T lymphocytes change, however, it could lead to a disruption of cellular immune function. , CD4+ T cells represent the key immune response cells, while CD8+ T cells represent the immune effector cells. A reduction of the CD4+/CD8+ ratio is an important feature of immune disorders .…”

Efficacy and safety of Chinese herbal medicine for pneumonia convalescence in children: A systematic review and meta-analysis

“…We tried to reduce clinical heterogeneity based on clinical characteristics (Higgins et al, 2003;Ioannidis et al, 2008). The severity of pneumonia in children, different therapies, treatment courses, evaluation criteria, and whether it was based on syndrome differentiation of TCM were the potential reasons for clinical heterogeneity (Melsen et al, 2014;Ling et al, 2021). Subgroup and sensitivity analyses revealed that different subgroup factors were not the cause of heterogeneity.…”

“…Pediatric pneumonia prevention and treatment studies have mainly focused on the acute or severe phase of pneumonia. Clinical studies have demonstrated the clinical efficacy of CHM in the treatment of acute or severe pneumonia (Ling et al, 2021;Peng et al, 2022). Nonetheless, more attention has been paid to the therapeutic effect in the recovery stage.…”

Sinomenine attenuates lipopolysaccharide‐induced inflammation and apoptosis of WI‐38 cells by reducing glutathione S‐transferase M1 expression

“…Chinese herbal medicines and their bioactive monomers have great potential for the treatment of pneumonia in children, including community‐acquired pneumonia and mycoplasma pneumonia (Ling et al, 2021; Mi et al, 2018). Sinomenine (Figure 1a) is one of the bioactive alkaloids extracted from the Chinese medicinal plant Sinomenium acutum (Tang et al, 2018).…”