RESUMO
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. Systematic review registration: PROSPERO, identifier CRD42021239936.
RESUMO
Objective::To observe the effect and mechanism of modified Si Junzitang combined with heat-sensitive moxibustion on interleukin-17(IL-17), interleukin-22(IL-22), interleukin-1α(IL-1α) and serum cystatin C(Cys-C )in serum and exhale breath condensate(EBC) of patients with chronic obstructive pulmonary disease at stable stage(COPD, Qi deficiency of lung and spleen). Method::Totally 120 cases of COPD(Qi deficiency of lung and spleen) treated in pulmonary department and thermal moxibustion department of Affiliated Hospital of Jiangxi University of traditional Chinese medicine from January 2019 to June 2019 were included and randomly divided into traditional Chinese medicine group, heat-sensitive moxibustion group and control group. The patients in traditional Chinese medicine group were treated with Si Junzitang, the patients in heat-sensitive Moxibustion group were treated with heat-sensitive moxibustion in addition to traditional Chinese medicine group, and the patients in control group were treated with placebo. All of the 3 groups were treated with oxygen and bronchodilator according to the guidelines. All groups received 3 consecutive courses of treatment, 20 days per course. After 3 courses of treatment, the clinical efficacy of the three groups, the forced expiratory volume in one second (FEV1), the forced expiratory volume in the estimated value in one second (FEV1%), the forced vital capacity (FVC), and IL-17, IL-22, IL-1α in serum and exhale breath condensate (EBC) were measured. Result::There were no statistically significant difference in general clinical data, lung function levels (FEV1, FEV1%, FVC), serum and EBC levels of IL-17, IL-22, IL-1α and Cys-C in the first three groups. The total clinical effective rate of traditional Chinese medicine group was better than the control group (P<0.05), the heat-sensitive moxibustion group was better than the traditional Chinese medicine group (P<0.05) and significantly better than the control group (P<0.01). Compared with the patients before treatment, the level of lung function was improved, while IL-17, IL-22, IL-1α and Cys-C in serum and EBC were reduced(P<0.05). The traditional Chinese medicine group was superior to that in the control group (P<0.05), the heat-sensitive moxibustion group was superior to that in the traditional Chinese medicine group (P<0.05) and significantly superior to that in the control group (P<0.01). Conclusion::Modified Si Junzitang combined with heat-sensitive moxibustion has an anti-inflammatory effect on COPD by stimulating bullishness of human body, improving body immunity, inhibiting inflammatory cytokines, reducing levels of inflammation cytokines IL-17, IL-22, IL-1α, and chronic inflammation markers serum Cys-C and inflammatory reaction, increasing the lung capacity, improving ventilation function and pulmonary function, so as to effectively relieve chest tightness asthma and other symptoms in COPD patients, and improve the clinical efficacy.