Chinese medicine Phragmites communis (Lu Gen) for acute respiratory tract infections: a systematic review and meta-analysis of randomized controlled trials
Chinese medicine Phragmites communis (Lu Gen) for acute respiratory tract infections: a systematic review and meta-analysis of randomized controlled trials
Background: acute respiratory tract infections (ARTIs) are the most common cause of morbidity and mortality worldwide, with most people experiencing at least one episode per year. Current treatment options are mainly symptomatic therapy. Antivirals, antibiotics, and glucocorticoids are of limited benefit for most infections. Traditional Chinese medicine has shown potential benefits in the treatment of ARTIs.
Objective: the objective of this study was to determine the efficacy, effectiveness, and safety of Phragmites communis Trin. (P. communis, a synonym of Phragmites australis (Cav.) Trin. ex Steud) as monotherapy or as part of an herb mixture for ARTIs.
Method: eight databases and two clinical trial registries were searched from inception to 8 February 2023 for randomized controlled trials (RCTs) evaluating any preparation involving P. communis without language restrictions. The Risk of Bias Tool 2.0 was used to assess the risk of bias of the included trials. RevMan 5.3 software was used for data analyses with effects estimated as risk ratios (RRs), mean differences (MDs), or standardized mean differences (SMDs) with 95% confidence intervals (CIs). The online GRADEpro tool was used to assess the certainty of the evidence, if available.
Results: forty-two RCTs involving 6,879 patients with ARTIs were included, with all trials investigating P. communis as part of an herbal mixture. Of the included trials, the majority (38/42) were considered high risk. Compared to the placebo, P. communis preparations improved the cure rate [RR = 1.60, 95% CI (1.13, 2.26)] and fever clearance time [MD = −2.73 h, 95% CI (−4.85, −0.61)]. Compared to usual care alone, P. communis preparations also significantly improved the cure rate [RR = 1.57, 95% CI (1.36, 1.81)] and fever clearance time [SMD = −1.24, 95% CI (−2.37, −0.11)]. P. communis preparations plus usual care compared to usual care alone increased the cure rate [RR = 1.55, 95% CI (1.35, 1.78)], shortened the fever clearance time [MD = −19.31 h, 95% CI (−33.35, −5.27)], and improved FEV1 [ MD = 0.19 L, 95% CI (0.13, 0.26)] and FVC [ MD = 0.16 L, 95% CI (0.03, 0.28)].
Conclusion: low- or very low-certainty evidence suggests that P. communis preparations may improve the cure rate of ARTIs, shorten the fever clearance time in febrile patients, and improve the pulmonary function of patients with acute exacerbation of chronic obstructive pulmonary disease or chronic bronchitis. However, these findings are inconclusive and need to be confirmed in rigorously designed trials.
acute respiratory tract infections, Chinese herbal medicine, meta-analysis, Phragmites australis (Cav.) Trin. ex Steud, Phragmites communis, randomized controlled trials, systematic review
Fang, Min
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Kong, Ling-Yao
04548378-127a-4925-8048-56834dad4bb5
Ji, Guang He
b3b338ea-2001-4693-b9e5-0ccf4ae6926e
Pu, Feng-Lan
770382e3-2f3b-46cf-a7f1-2041aefe7104
Su, You-Zhu
ebabd709-6830-4ebf-8e43-0b9f6e6d651e
Li, Yu-Fei
1b01d14f-942f-433e-95fb-5d43e9f12429
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Trill, Jeanne
c952c8c6-6168-4dda-9185-7b92ff232fb5
Liu, Jian Ping
1ac69bb8-ead3-44be-91d1-d3ed8554a9e9
6 March 2024
Fang, Min
f2e0535d-d833-4380-8fe9-9fe3044ecd95
Kong, Ling-Yao
04548378-127a-4925-8048-56834dad4bb5
Ji, Guang He
b3b338ea-2001-4693-b9e5-0ccf4ae6926e
Pu, Feng-Lan
770382e3-2f3b-46cf-a7f1-2041aefe7104
Su, You-Zhu
ebabd709-6830-4ebf-8e43-0b9f6e6d651e
Li, Yu-Fei
1b01d14f-942f-433e-95fb-5d43e9f12429
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Trill, Jeanne
c952c8c6-6168-4dda-9185-7b92ff232fb5
Liu, Jian Ping
1ac69bb8-ead3-44be-91d1-d3ed8554a9e9
Fang, Min, Kong, Ling-Yao, Ji, Guang He, Pu, Feng-Lan, Su, You-Zhu, Li, Yu-Fei, Moore, Michael, Willcox, Merlin, Trill, Jeanne, Hu, Xiao-Yang and Liu, Jian Ping
(2024)
Chinese medicine Phragmites communis (Lu Gen) for acute respiratory tract infections: a systematic review and meta-analysis of randomized controlled trials.
Frontiers in Pharmacology, 15, [1242525].
(doi:10.3389/fphar.2024.1242525).
Abstract
Background: acute respiratory tract infections (ARTIs) are the most common cause of morbidity and mortality worldwide, with most people experiencing at least one episode per year. Current treatment options are mainly symptomatic therapy. Antivirals, antibiotics, and glucocorticoids are of limited benefit for most infections. Traditional Chinese medicine has shown potential benefits in the treatment of ARTIs.
Objective: the objective of this study was to determine the efficacy, effectiveness, and safety of Phragmites communis Trin. (P. communis, a synonym of Phragmites australis (Cav.) Trin. ex Steud) as monotherapy or as part of an herb mixture for ARTIs.
Method: eight databases and two clinical trial registries were searched from inception to 8 February 2023 for randomized controlled trials (RCTs) evaluating any preparation involving P. communis without language restrictions. The Risk of Bias Tool 2.0 was used to assess the risk of bias of the included trials. RevMan 5.3 software was used for data analyses with effects estimated as risk ratios (RRs), mean differences (MDs), or standardized mean differences (SMDs) with 95% confidence intervals (CIs). The online GRADEpro tool was used to assess the certainty of the evidence, if available.
Results: forty-two RCTs involving 6,879 patients with ARTIs were included, with all trials investigating P. communis as part of an herbal mixture. Of the included trials, the majority (38/42) were considered high risk. Compared to the placebo, P. communis preparations improved the cure rate [RR = 1.60, 95% CI (1.13, 2.26)] and fever clearance time [MD = −2.73 h, 95% CI (−4.85, −0.61)]. Compared to usual care alone, P. communis preparations also significantly improved the cure rate [RR = 1.57, 95% CI (1.36, 1.81)] and fever clearance time [SMD = −1.24, 95% CI (−2.37, −0.11)]. P. communis preparations plus usual care compared to usual care alone increased the cure rate [RR = 1.55, 95% CI (1.35, 1.78)], shortened the fever clearance time [MD = −19.31 h, 95% CI (−33.35, −5.27)], and improved FEV1 [ MD = 0.19 L, 95% CI (0.13, 0.26)] and FVC [ MD = 0.16 L, 95% CI (0.03, 0.28)].
Conclusion: low- or very low-certainty evidence suggests that P. communis preparations may improve the cure rate of ARTIs, shorten the fever clearance time in febrile patients, and improve the pulmonary function of patients with acute exacerbation of chronic obstructive pulmonary disease or chronic bronchitis. However, these findings are inconclusive and need to be confirmed in rigorously designed trials.
Text
fphar-15-1242525
- Version of Record
More information
Accepted/In Press date: 16 January 2024
Published date: 6 March 2024
Keywords:
acute respiratory tract infections, Chinese herbal medicine, meta-analysis, Phragmites australis (Cav.) Trin. ex Steud, Phragmites communis, randomized controlled trials, systematic review
Identifiers
Local EPrints ID: 488690
URI: http://eprints.soton.ac.uk/id/eprint/488690
ISSN: 1663-9812
PURE UUID: 5ac210c9-b7d0-441f-928d-e0c73e6e716d
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Date deposited: 04 Apr 2024 16:42
Last modified: 11 Jun 2024 01:51
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Contributors
Author:
Min Fang
Author:
Ling-Yao Kong
Author:
Guang He Ji
Author:
Feng-Lan Pu
Author:
You-Zhu Su
Author:
Yu-Fei Li
Author:
Xiao-Yang Hu
Author:
Jian Ping Liu
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