Efficacy of Tanreqing injection for cough caused by acute trachea-bronchitis disease: A systematic review and meta-analysis of randomized trials

Article type
Authors
Ma N1, Pan B1, Yang K1
1Centre for Evidence-Based Medicine, School of Basic Medical Science,Lanzhou University, Lanzhou, Gansu, China; Centre for Evidence-Based Social Science/Center for Health Technology Assessment, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
Abstract
"Background: Tanreqing injection (TRQI), known for anti-inflammatory properties, is widely used in China to treat cough caused by acute trachea-bronchitis disease (ATB).
Objective: To investigate the clinical efficacy and safety of TRQI with and without WM for cough caused by ATB.
Methods: We systematically searched eight databases, including CENTRAL, Embase, PubMed, Science Direct, Wiley, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang, from inception to August 2023 for randomized clinical trials (RCTs) on TRQI for cough caused by ATB. We carried out random-effects meta-analysis using Review Manager 5.4 and assessed the certainty of evidence utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Results: A total of 2872 citations were identified by our search, of which 26 eligible RCTs enrolled 2731 participants. Low to moderate certainty evidence showed that when compared with WM, TRQI plus WM treatment was associated with a favorable effect on the time for cough symptom to disappear (MD -2.21d, 95% CI -2.64 to -1.78), time to improve cough and sputum production (MD -0.68d, 95% CI -0.83 to -0.53), symptom disappearance rate (RR 1.37, 95% CI 1.20 to 1.55), forced vital capacity, and forced expiratory volume in one second (MD 0.38 L, 95% CI 0.26 to 0.50; MD 2.92%, 95% CI 1.29 to 4.56, respectively). In terms of AEs, there was no association between TRQI plus WM and WM (RR 0.55, 95% CI 0.14 to 2.21). Very low certainty evidence showed that TRQI alone was associated with reduced time to improve cough and sputum (MD -0.14d, 95% CI -0.26 to -0.02) and increased symptom disappearance rate (RR 1.89, 95% CI 1.24 to 2.88; low certainty evidence) compared to WM.
Conclusions: The overall efficacy of TRQI or WM for ATB cough is better than that of WM, and TRQI also effectively improve symptoms in patients with similar adverse events. However, due to the lack of methodological rigor of included studies, the present findings should be interpreted with caution. We advocate better high-quality and convincing clinical studies to be performed to prove the effectiveness and safety of TRQIs."