Clinical Effect Of External Treatment Of TCM On Cough After Infection Systematic Evaluation And Meta Analysis

【Objective】Systematic evaluation and Meta analysis were conducted to explore the clinical efficacy of external treatment of TCM in the treatment of post-infection cough(PIC),so as to provide research evidence for clinical decision making in the treatment of post-infection cough.【Method】Computer retrieval includes CNKI,Wan Fang Data,CBM,VIP.Embase database,PubMed database,Cochrane Library;The retrieval starts and ends from the date of database construction to November 30,2018.Collect the RCT of PIC with external treatment of TCM,use NoteExpress software to screen the literatures preliminarily,then strictly screen the literatures according to the inclusion and exclusion criteria,and evaluate the literatures according to the modified Jadad scoring scale and bias risk assessment tool,and use RevMan5.3 software for integrated analysis.【Result】A total of 41 eligible RCT literatures were included,of which only one was of quality,with a total of 4235 patients.The results showed:(1)The total effective rate of RR(relative risk)was 1.41,95%ci[0.90,2.23],Z = 1.49,P > 0.005.The recurrence rates of the two groups were RR = 0.92,95%ci [0.40,2.10],Z = 0.20,P > 0.05.The disappearance time of cough symptoms was WMD =-0.33,95%ci [-3.34,3.29],Z = 0.02,P > 0.05.(2)Compared with western medicine,the total effective rate of external treatment of TCM was 1.08,95%ci [0.99,1.18],Z = 1.76,P >0.05.The RR of adverse reactions was 0.26,95%ci [0.12,0.56],Z = 3.48,P < 0.05.(3)Comparison between external treatment combined with TCM and single TCM: total effective rate RR = 1.16,95%ci [1.11,1.21],Z = 6.44,P < 0.00001;LCQ integral WMD = 3.75,95% CI [-0.26,7.76],Z = 1.83,P >0.05;The WMD of cough was-0.54,95% CI [-0.87,-0.21],Z = 3.2,P <0.05.The WMD of expectoration was-0.68,95%CI[-0.97,-0.39],Z=4.63,P<0.00001;WMD =-0.32,95% CI [-0.60,-0.04],Z = 2.21,P < 0.05 for itchy throat;TCM syndrome total score was WMD=-0.91,95%CI[-1.19,-0.64],Z=6.51,P<0.00001;Cough VAS score of WMD = 0.96,95% CI [1.65,0.26],Z = 2.7,P < 0.05;WMD=-39.48,95%CI[-40.68,-32.28],Z=64.59,P<0.00001 for the concentration integral of substance P in induced sputum supernatant.The RR of recurrence rate was 0.67,95%ci[0.18,2.47],Z=0.61,P>0.05.Relieve cough time RR = 1.82,95% CI [2.57,1.08],Z = 4.81,P < 0.00001;Cough disappearance time of WMD = 2.48,95%CI [3.99,0.98],Z = 3.23,P < 0.05;The RR of adverse reactions was 0.50,95%ci [0.18,1.42],Z=1.30,P>0.05.(4)Comparison between TCM external treatment combined with TCM and western medicine: total effective rate RR=1.38,95%ci [1.18,1.62],Z=3.97,P<0.00001;Cough WMD = 0.57,95% CI[1.25,0.10],Z = 1.67,P > 0.05;Coughing up phlegm WMD = 0.55,95% CI[1.34,0.24],Z = 1.36,P > 0.05;Pharyngeal itching WMD = 0.58,95% CI[0.74,0.42],Z = 7.13,P < 0.00001;Cough VAS score WMD = 1.09,95% CI[1.41,0.78],Z = 6.81,P < 0.00001;The RR of adverse reactions was 0.11,95%ci [0.04,0.28],Z=4.47,P<0.00001.(5)Compared with western medicine,the total effective rate of external treatment of traditional Chinese medicine in children was 1.25,95% CI [1.12,1.41],Z = 3.78,P < 0.05.(6)Comparison of external treatment combined with western medicine and western medicine in children: total effective rate RR = 1.96,95%ci [1.76,2.20],Z = 11.86,P < 0.00001.【Conclusion】The clinical efficacy of external treatment of TCM in thetreatment of post-infection cough is definite,but the methodological quality of the included RCT literature is low,and the sample size is small,which cannot provide a strong evidence-based medicine basis.More large samples,multi-center and high-quality RCT are still needed for further evidence.