ABSTRACT
Objective: To evaluate the efficacy and safety of Shegan Mahuang Decoction in the treatment of acute attack of bronchial asthma, and provide the support of evidence-based medicine for clinical treatment of bronchial asthma. Methods: The databases such as CNKI and PubMed were searched by computer, and RCT meeting the inclusion criteria was extracted. Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of included literatures, and Stata14.0 was used for Meta analysis. The outcome indicators included effective rate, pulmonary function (FEV1 / FVC and / or FEV1%), TCM symptoms score and adverse reactions. Finally, TSA 0.9 was used for trial sequential analysis. Results: A total of 20 articles were included in the study. The effective rate [RR = 1.18, 95% CI (1.14, 1.23), P = 0.00] in the trial group was significantly better than that in the control group. Subgroup analysis showed that the effective rate in the trial group with a course of treatment≤7 d[RR = 1.17, 95% CI (1.11, 1.24), P = 0.00] and 7-15 d[RR = 1.17, 95% CI (1.10, 1.24), P = 0.00] was significantly better than that in the control group. According to funnel chart and Begg's test, there was no published bias. The trial sequential analysis showed that the evidence of the effect was reliable. FEV1/FVC, the indexes of pulmonary function test, in the trial group were [SMD=1.17, 95%CI (0.44,1.90), P = 0.00] was significantly better than the control group, and FEV1% [SMD = 1.38, 95% CI (0.24, 2.52), P = 0.018] was also significantly better than the control group. The TCM syndrome score [WMD = -2.79, 95% CI (-3.39, -2.18), P = 0.00] in the trial group was significantly lower than the control group. The indicators of pulmonary function and TCM syndrome score were not reversed after sensitivity analysis, and the results were relatively stable. Serious adverse reactions were not reported in all studies. Conclusion Shegan Mahuang Decoction combined with conventional western medicine has more advantages in the treatment of acute attack of bronchial asthma than conventional western medicine alone. However, due to the limitations of this study, depth evaluation of its efficacy and safety needs more high quality RCTs in the future.