ABSTRACT
Background: Acupoint application of herbal medicine (AAHM) has been widely used in China. At present, there is no systematic review of AAHM versus placebo in the treatment of asthma. This systematic review aims to assess the efficacy of AAHM for asthma. Methods: Searches were conducted in five English databases and four Chinese databases from their inceptions until December 2020. Randomized double-blind placebo-controlled trials were screened, and included studies evaluated routine pharmacotherapy (RP) plus AAHM versus RP plus placebo or AAHM versus placebo. The Cochrane risk of bias tool and Grading of Recommendations Assessment, Development and Evaluation (GRADE) were performed to evaluate the methodological quality and quality of evidence separately. Results: Sixteen studies involving 1,730 participants were included in this review. Compared with placebo plus RP, participants receiving long-term AAHM plus RP showed improvement in asthma quality of life questionnaire (AQLQ) with moderate-quality evidence (MD 6.53 points, 95% CI 2.70 to 10.36). Low-quality evidence indicated that AAHM plus RP was associated with improved FEV1 (%) compared with placebo plus RP, whether long- or short-term use (MD 11.80%, 95% CI 2.84 to 20.76; MD 10.57%, 95% CI 8.40 to 12.74; respectively). Moderate-quality evidence showed that participants receiving short-term AAHM were associated with a higher AQLQ score (MD 6.57 points, 95% CI 3.76 to 9.38) and a lower frequency of acute exacerbations (MD -1.84, 95% CI -2.32 to -1.36) compared with placebo. Low-quality evidence also indicated that AAHM was associated with improved FEV1 (L) compared with placebo, whether long- or short-term use (MD 0.35 litres, 95% CI 0.03 to 0.67; MD 0.66 litres, 95% CI 0.59 to 0.73; respectively). Conclusions: Moderate-quality evidence is promising that AAHM can improve the quality of life and reduce acute exacerbations in patients with asthma. AAHM also shows a positive role in improving lung function, but the evidence is so indefinite due to low quality.
ABSTRACT
Dingchuan decoction (DCD) is a traditional Chinese prescription for asthma that remains popular today. To systematically evaluate the effect of DCD on lung function, clinical effectiveness rate, and safety in children with asthma, significant databases were searched for randomized controlled trials from their inception to September 9, 2019. Randomized controlled trials assessing the effect of DCD on lung function and clinical effectiveness rate in children with asthma were included in this meta-analysis. The methodological quality of the included trials was assessed using the Cochrane risk of bias tool. RevMan 5.3 was used for data analysis. Fourteen studies with 1,384 children were reviewed. FEV1 improvement rate (mean difference [MD] 12.50, 95% confidence interval [CI] 8.72-16.29), PEF improvement rate (MD 14.28, 95% CI 11.08-17.49), and clinical effectiveness rate (relative risk 1.19, 95% CI 1.14-1.25) significantly increased in the DCD group when compared to simple conventional medication. Four trials suggest that DCD is safe for children. In conclusion, the use of DCD combined with conventional medication improves lung function and clinical effectiveness rate better than simple conventional medication. However, the selected trials lack blinding and large-scale studies. Therefore, to better manage DCD in clinical practice, more randomized controlled trials and large-scale studies are required for further evaluation.
