PDF(Pubmed)
Abstract：
Objectives: Chronic cough is a frequent condition worldwide that significantly impairs quality of life. Herbal medicine (HM) has been used to treat chronic cough due to the limited effectiveness of conventional medications. This study aimed to summarize and determine the effects of HM on patients with chronic cough. Methods: A comprehensive search of 11 databases was conducted to find randomized controlled clinical trials (RCTs) that reported the effects of HM for patients with chronic cough on 16 March 2023. The primary outcome was cough severity, and the secondary outcomes included cough-related quality of life, cough frequency, total effective rate (TER), and cough recurrence rate. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool, and the certainty of the evidence for effect estimates was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations tool. Results: A total of 80 RCTs comprising 7,573 patients were included. When HM was used as an alternative therapy to conventional medication, there were inconsistent results in improving cough severity. However, HM significantly improved cough-related quality of life and TER and significantly lowered the cough recurrence rate compared with conventional medication. When used as an add-on therapy to conventional medication, HM significantly improved cough severity, cough-related quality of life, and TER and significantly lowered the recurrence rate. In addition, HM had a significantly lower incidence of adverse events when used as an add-on or alternative therapy to conventional medication. The subgroup analysis according to age and cause of cough also showed a statistically consistent correlation with the overall results. The certainty of the evidence for the effect of HM was generally moderate to low due to the risk of bias in the included studies. Conclusion: HM may improve cough severity and cough-related quality of life, and lower the cough recurrence rate and incidence of adverse events in patients with chronic cough. However, due to the high risk of bias and clinical heterogeneity of the included studies, further high-quality placebo-controlled clinical trials should be conducted using a validated and objective assessment tool. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023418736, CRD42023418736.
摘要：
目标：慢性咳嗽是世界范围内常见的疾病，严重损害生活质量。由于常规药物的疗效有限，草药（HM）已用于治疗慢性咳嗽。本研究旨在总结和确定HM对慢性咳嗽患者的影响。方法：对11个数据库进行了全面搜索，以找到随机对照临床试验（RCTs），这些试验报告了HM对2023年3月16日慢性咳嗽患者的影响。主要结果是咳嗽严重程度，次要结局包括咳嗽相关的生活质量，咳嗽频率,总有效率(TER)，咳嗽复发率。使用Cochrane偏倚风险工具评估纳入研究的方法学质量，效果估计证据的确定性是使用建议分级来评估的，评估,发展,和评估工具。结果：共纳入80例RCTs，包括7573例患者。当HM被用作常规药物的替代疗法时，在改善咳嗽严重程度方面存在不一致的结果.然而,与常规药物相比，HM显着改善了咳嗽相关的生活质量和TER，并显着降低了咳嗽复发率。当用作常规药物的附加疗法时，HM显著改善咳嗽严重程度，咳嗽相关的生活质量，和TER，并显着降低复发率。此外,当用作常规药物的附加或替代疗法时，HM的不良事件发生率显着降低。根据年龄和咳嗽原因的亚组分析也显示出与总体结果在统计学上一致的相关性。由于纳入研究的偏倚风险，HM效应证据的确定性通常为中等至低。结论:HM可改善咳嗽严重程度和咳嗽相关生活质量。降低慢性咳嗽患者的咳嗽复发率和不良事件发生率。然而,由于纳入研究的偏倚风险和临床异质性高，应使用经过验证的客观评估工具进行进一步的高质量安慰剂对照临床试验.系统审查注册：https://www。crd.约克。AC.uk/prospro/display_record.php?ID=CRD42023418736,CRD42023418736。
