Treatment Of Asthmatic Children With Traditional Chinese Medicine Or Combine Traditional Chinese And Western Medicine: A Systematic Review

[Background] Childhood asthma is a common and frequently occurring disease in pediatrics clinical. It recurrently attacks, severely interfering with the development of the children. According to West Medicine, the prevalent treatment for childhood asthma is to administer glucocorticosteroid combining with prolonged actionβ₂-receptor agonist (LABA). However, taking in glucocorticosteroid for long time has many side effects. It will interfere with the development of the children, cause alalia and mogiarthria, induce Candida infection in oral cavity, and so on. In past and present medical literature, it has reported that the Traditional Chinese Medicine (TCM) does well for the childhood asthma. TCM has accumulated abundant clinic experience and conducted much helpful exploration in the treatment of childhood asthma. However, there are few reports systematic evaluating the effectiveness of TCM treating childhood asthma. Consequently, it is deficient of evidence to confirm the effectiveness and dominance of TCM treating childhood asthma. To apply Evidence Based Medicine (EBM) to systematic analyze the research status and exiting problems as well as results, will help us to correctly evaluate the effectiveness and applying perspective of TCM treating childhood asthma, provide clue and thinking for future research, promote the communication of TCM with west medicine and lead it to the whole world.[Objectives] To apply EBM and systematic review to evaluate the clinical research quality, analyze the status quo in the aspect of scientific research design and effectiveness evaluation and exiting problems, appraise the overall research level and objectively assess the effectiveness as well as safety of TCM treating childhood asthma.[Methods] Searched for the Databases of CBM Disc (1979-2007) and CJFD (1994-2007), all literatures of random control trial concerning the TCM or TCM combined with west medicine treating childhood asthma were evaluated. According with the principles and methods of clinical epidemiology/ technology, we instituted the《Table of systematic evaluation and information collection concerning TCM treating childhood asthma》, including: important principles of clinical scientific research and concrete questions concerning childhood asthma, such as general state of health, inclusion or exclusion criteria, sample size, interclass equilibration, randomness, blindness, statistics method selection, standardization of study factors, criterion judging curative effect, analysis of loss of follow-up/withdraw cases, record and analysis of adverse effect, conclusion deduction and its rationality, and so on. Calculate the percentages in various conditions and evaluate its quality. On the base of the calculation, apply software Revman to conduct Meta analysis. At last, adopt Graphing of Funnel Plots to analyze the publication bias.[Results] Altogether, 105 literatures were found and evaluated. 21 adopted the diagnosis criteria combined TCM with west medicine, accounting for 20.0%; 92 adopted the west medicine diagnosis criteria, accounting for 91.14%. 15 defined the inclusion criteria, accounting for 14.29%; 10 didn' t define the inclusion criteria, accounting for 9. 52%. 7 defined the exclusion criteria, accounting for 6.66%; 80 didn' t define the inclusion as well as exclusion criteria, accounting for 76.19%. Only 12 were satisfied with complete random, as a whole, the quality of randomness was low. Most studies compared the interclass equilibration, but only involving in age, sex, time of onset, course of disease, and so on. Still another 9 didn' t compare the interclass equilibration. It was not rigorous for sample research and there wasn' t a study conducting estimation of sample size at anticipation. There was also not record or illustration concerning the cases screening, nor allocation delitescence. Blindness was seldom applying and only one applied single blind method. 30 studies didn' t mention the concrete statistics method, accounting for 30.48%, as a result, it was difficult to judge if the curative effect assessing index was correct. 25 studies applied wrong statistics method, accounting for 23.81%. 105 studies didn' t define the cases of withdraw and lost to follow-up as well as excluded, nor analyze intention treatment. Of the 105 studies, 72 didn' t record the follow-up, accounting for 68. 57%. 79 studies drew conclusion according to the statistical inference, accounting for 75.24%; 13 didn' t accord to the statistical inference, accounting for 12.38%; while 43 didn' t extrapolate the result, accounting for 40.95%.[Conclusion] According to the result of Meta-analysis, it is effective for TCM treating childhood asthma. However, the effectiveness couldn' t be excluded from error because the research methods were low quality. Results of low research quality were shown that much deficiency existed in the studies concerning TCM treating childhood asthma at present. It was mainly embodied in the ignoring of the technology applying and unreliable research results. A rigorously designed large sample size, multi-centre, randomized, controlled and Placebo parallel clinical trial is needed to confirm the effectiveness of TCM treating childhood asthma.