Efficacy and Safety of Lianhua Qingwen for Patients with COVID-19: A Systematic Review and Meta-Analysis / 中国结合医学杂志

BACKGROUND@#Corona virus disease 2019 (COVID-19) has spread around the world since its outbreak, and there is no ascertained effective drug up to now. Lianhua Qingwen (LHQW) has been widely used in China and overseas Chinese, which had some advantages in the treatment of COVID-19.@*OBJECTIVE@#To evaluate the efficacy and safety of LHQW for COVID-19 by conducting a systematic review with meta-analysis.@*METHODS@#A comprehensive literature search was conducted in 12 electronic databases from their establishment to October 30, 2021. Note Express 3.2.0 was used for screening of trials, and the data was independently extracted in duplicate by 2 researchers. The risk of bias of randomized controlled trials (RCTs) and retrospective studies were assessed by using the Cochrane collaboration tool and Newcastle Ottawa Scale, respectively, followed by data analysis using RevMan 5.3. The RCTs or retrospective studies to treat COVID-19 using LHQW were included. The intervention measures in the experimental group were LHQW alone or combined with chemical drugs (LCWC), and that in the control group were chemical drugs (CDs). Outcome measures included computed tomography (CT) recovery rate, disappearance rates of primary (fever, cough, fatigue), respiratory, gastrointestinal and other symptoms, exacerbation rate and adverse reaction. Subgroup analysis was conducted according to whether LHQW was combined with CDs and the different treatment methods in the control group.@*RESULTS@#Nine trials with 1,152 participants with COVID-19 were included. The CT recovery rates of LHQW and LCWC were 1.36 and 1.32 times of CDs, respectively (P<0.05). Compared with CDs, LCWC remarkably increased the disappearance rates of fever, cough, fatigue, expectoration, shortness of breath, and muscle soreness (P<0.05). LHQW also obviously decreased the exacerbation rate, which was 0.45 times of CDs alone (P<0.05). There was no obvious difference between LCWC and CDs in adverse reaction (P>0.05).@*CONCLUSIONS@#LHQW was more suitable for treating COVID-19 patients with obvious expectoration, shortness of breath and muscle soreness. LHQW had advantages in treating COVID-19 with no obvious exacerbation. (PROSPERO No. CRD42021235937).

Electrophysiological responsiveness and clinical outcomes of local corticosteroid injection in the treatment of carpal tunnel syndrome / Responsividade eletrofisiológica e desfechos clínicos da injeção local de corticosteroide no tratamento da síndrome do túnel do carpo

ABSTRACT Carpal tunnel syndrome (CTS) is the most common mononeuropathy caused by entrapment of the median nerve at the wrist. Common treatment options for CTS include oral analgesics, splinting, hand therapy, local injections with steroids or surgery. Objective: The aim of the present study was to assess the short-term clinical and electrophysiological outcomes of local corticosteroid injection (LCI) in patients with symptomatic CTS. Methods: Electrophysiological parameters were evaluated before and three months after LCI. Moreover, the Numeric Rating Scale (NRS), the Boston Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) were administered before and after the injection. A mixture of 1 mL (40 mg) of methylprednisolone and 1 mL of 0.5% bupivacaine were injected blindly on the volar side of the forearm between the tendons of the radial carpal flexor muscle and long palmar muscle. Results: A total of 25 patients (45 hands) were enrolled in the study. Twenty women and five men with a mean age of 49.28 ± 11.37 years were included. A statistically significant difference was noted for improvement of sensory conduction velocities, sensory peak latency, and motor distal latency (p = 0.001) after LCI. A significant difference was recorded between pre- and post-injection for NRS, SSS and FSS scores (p = 0.000). Conclusion: Local corticosteroid injection for CTS provides a short-term improvement in neurophysiological and clinical outcomes such as pain intensity, symptom severity and functional ability.

RESUMO A síndrome do túnel do carpo (STC) é a mononeuropatia mais comum causada pelo aprisionamento do nervo mediano no punho. Opções comuns de tratamento para STC incluem analgésicos orais, splinting, terapia de mão, injeções locais com esteroides ou cirurgia. Objetivo: O objetivo do presente estudo foi avaliar os resultados clínicos e eletrofisiológicos de curto prazo da injeção de corticosteroide local (ICL) em pacientes com STC sintomática. Métodos: Os parâmetros eletrofisiológicos foram avaliados antes e três meses após a ICL. Além disso, a Escala Numérica de Avaliação (NRS), a Escala de Gravidade de Sintomas de Boston (BSS) e a Escala de Status Funcional (FSS) foram administradas antes e após a injeção. Uma mistura de 1 ml (40 mg) de metilprednisolona e 1 ml de bupivacaína a 0,5% foi injetada cegamente no lado do antebraço entre os tendões do músculo flexor radial do carpo e o músculo palmar longo. Resultados: Um total de 25 pacientes (45 mãos) foi incluído no estudo. Vinte mulheres e cinco homens com idade média de 49,28 ± 11,37 anos foram incluídos. Foi observada diferença estatisticamente significante para melhora das velocidades de condução sensitiva, latência de pico sensorial, latência motora distal (p = 0,001) após a ICL. Uma diferença significativa foi registrada entre pré e pós-injeção para os escores NRS, BSS e FSS (p = 0,000). Conclusão: A ICL para STC fornece uma melhoria a curto prazo em resultados neurofisiológicos e clínicos, tais como intensidade da dor, gravidade dos sintomas e capacidade funcional.