背景:当患者尽管接受常规治疗仍继续咳嗽时,包括草药和/或针灸的东亚传统医学(EATM)已被频繁使用。以前对EATM治疗慢性咳嗽的系统评价主要是在草药上进行的,针对导致咳嗽的患者。在临床实践中,EATM干预措施不仅限于草药,考虑到慢性咳嗽通常是由两种或多种疾病或非特异性原因引起的,全面的调查是临床相关的。我们检查了EATM治疗慢性咳嗽的研究现状。
方法:基于Arksey和O\'Malley\的范围审查方法框架,总共有六个英语,中文,韩语,和日本电子数据库在2022年8月进行了搜索。包括针对慢性咳嗽患者(无论其病因如何)的EATM的任何临床研究。
结果:在纳入的474项研究中,研究设计主要为随机对照试验(72.4%),人口平均分布在儿童和成人之间。大多数研究中没有报告咳嗽的原因(56.1%)。咳嗽的常见原因是上呼吸道咳嗽综合征和呼吸道感染(9.5%,each),其次是混合原因(7.6%),非特异性病因(5.9%),和胃食管反流病(4.0%)。EATM平均进行了19.1天,最常见的是中草药(80.6%)。常规药物经常用作对照(81.2%)。对于结果,总有效率是最常用的(94.3%),其次是咳嗽严重程度(53.8%)。EATM治疗在大多数研究中显示出积极的结果。
结论:在未来的EATM研究中,有必要明确慢性咳嗽的病因或报告该研究针对非特异性慢性咳嗽.此外,应进行高质量的研究,评估EATM与安慰剂对照治疗的疗效,使用经过验证的评估工具。
BACKGROUND: When patients continue to experience cough despite conventional treatment, East Asian traditional medicine (EATM) including herbal medicine and/or acupuncture has been frequently used. Previous systematic reviews of EATM treatment for chronic cough have been conducted mainly on herbal medicine, targeting patients with conditions that cause cough. In clinical practice, EATM interventions are not limited to herbal medicine, and considering that chronic cough is often caused by two or more conditions or unspecific causes, a comprehensive investigation is clinically relevant. We examined the current research status of EATM for chronic cough.
METHODS: Based on Arksey and O\'Malley\'s scoping review methodological framework, a total of six English, Chinese, Korean, and Japanese electronic databases were searched on August 2022. Any clinical studies on EATM targeting chronic cough patients (regardless of their cause) were included.
RESULTS: Among 474 included studies, the study designs were mainly randomized controlled trials (72.4%), and the population was evenly distributed between children and adults. The cause of cough was not reported in most studies (56.1%). The common cause of cough was upper airway cough syndrome and post-respiratory infection (9.5%, each), followed by mixed cause (7.6%), nonspecific cause (5.9%), and gastroesophageal reflux disease (4.0%). EATM was conducted for a mean of 19.1 days, and herbal medicine was the most common (80.6%). Conventional medication was frequently used as a control (81.2%). For outcomes, the total effective rate was the most frequently utilized (94.3%), followed by cough severity (53.8%). EATM treatment showed positive outcomes in most studies.
CONCLUSIONS: In future EATM studies, it is necessary to either specify the cause of chronic cough or to report that the study was targeting nonspecific chronic cough. In addition, high-quality studies assessing the efficacy of EATM with placebo control treatment should be conducted, using validated evaluation tools.