Effect of integrated traditional Chinese medicine and western medicine on the treatment of severe acute respiratory syndrome: a meta-analysis

ABSTRACT

Background: Data regarding the treatment efficacy of integrative treatment of Traditional Chinese Medicine (TCM) and Western Medicine (WM) in treating patients with (SARS) are conflicting. The effects of integrative TCM/WM treatment have not been fully quantified. Objectives: To systematically asses the treatment effects of integrated TCM with WM versus WMalone in patients with SARS, incorporating data from recently published studies. Methods: A meta-analysis was conducted, using published randomized and nonrandomized controlled clinical studies that compared the treatment effects of integrative TCM/WM with WMalone from 2002 to 2006.The outcome measurements included mortality rate, cure rate, resolution of pulmonary infiltrate, use of corticosteroid, and time to effervescence. The effect sizes were presented as risk ratio (RR), rate difference (RD), and weighted mean difference (WMD).The pooled effect sizes were calculated by both fixed-effects and random-effects models. Results: A total of 1,678 patients with a diagnosis of SARS were identified, including 866 patients from16 randomized controlled studies and 812 patients from 8 non randomized controlled studies. There were no differences detected in mortality rate or cure rate between treatments. Compared with patients receiving WM treatment alone, patients receiving integrative treatment were more likely to have complete or partial resolution of pulmonary infiltrate (RD=0.18, 95%CI; 0.07 to 0.30), lower average daily dosage (mg) of corticosteroid (WMD=-60.27, 95% CI; -70.58 to -49.96), higher CD4+ counts (cells/uL) (WMD=167.96, 95% CI;109.68 to 226.24), and shorter time to defervescence (days) (WMD= -1.06, 95%CI;-1.60 to-0.53).Conclusions: The experience of integrative TCM/WM in the treatment of SARS is encouraging. The use of TCM as an adjunctive therapy in the treatment of SARS should be further investigated (AU)

RESUMEN

Antecedentes: Los datos sobre la eficacia del tratamiento integrado de medicina tradicional china(MTC) y de tratamiento occidental (TO) para pacientes con SRAS son controvertidos. Los efectos del tratamiento MTC/TO no han sido completamente cuantificados. Objetivos: Evaluar sistemáticamente los efectos del tratamiento integrado de MTC con TO contra el TO solo en pacientes con SRAG, incorporando datos de estudios recientemente publicados. Métodos: se realizó un meta-análisis utilizando los estudios clínicos controlados aleatorizados y no aleatorizados que comparaban la eficacia del tratamiento integrado MTC/TO con el TO solo desde 2002 a 2006. Las medidas de resultados incluían tasa de mortalidad, tasa de cura, resolución de infiltrados pulmonares, uso de corticoides, y tiempo a la recuperación. Los efectos fueron presentados como riesgo relativo (RR), tasa de diferencia (TD) y diferencia media ponderada(DMP). Los efectos combinados se calcularon tanto por efectos fijos como por modelos de efecto aleatorio. Resultados: Se identificaron un total de 1678pacientes con diagnóstico de SARS, incluyendo866 pacientes de 16 estudios controlados aleatorizados y 812 pacientes de 8 estudios controlados no aleatorizados. No hubo diferencias detectadas en las tasad e mortalidad o tasa de cura entre los tratamientos. Comparados con los pacientes recibiendo TO solo, los pacientes que recibieron tratamiento integrado tenían más probabilidad de tener una resolución total o parcial del infiltrado pulmonar (TD=0.18, IC 95% 0.07 a0.30), menor dosis media diaria (mg) de corticoides (DMP=-60.27, IC 95% -70.58 a -49.96), mayor recuento CD4+ (células/uL) (DMP=167.96, IC95% 109.68 a 226.24), y menor tiempo a recuperación (días) (DMP= -1.06, IC 95% 1.60 a -0.53).Conclusiones: La experiencia del tratamiento integrado MTC/TO para el SRAS anima. El uso deMTC como coadyuvante en tratamiento de SRAS debería ser más investigado (AU)