[Evidence map analysis of clinical research on treatment of community-acquired pneumonia with Chinese patent medicines in recent ten years].

This study summarized clinical research on the application of Chinese patent medicines for the treatment of community-acquired pneumonia(CAP) through an evidence mapping method to elucidate the distribution of evidence and the current state of research in this field. Databases, including CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase, and Cochrane Library were searched, covering the period from January 2014 to August 2024. Randomized controlled trial(RCT), systematic review/Meta-analysis, and guideline/expert consensus of Chinese patent medicines for CAP in the past 10 years were included, and the characteristics of evidence distribution were presented by a combination of text and charts. A total of 243 publications were included, including 222 RCTs, 14 systematic reviews/Meta-analyses, 2 network Meta-analyses, and 5 guidelines/expert consensus. The overall number of publications in this field showed a fluctuating downward trend. Most of the included RCTs were small in size, with sample sizes ranging from 61 to 100 cases, and the common course of treatment was 7, 10, or 14 days. Traditional Chinese medicine(TCM) syndrome type was reported in only 47 publications. A total of 37 Chinese patent medicines were involved, with Tanreqing Injection receiving the highest level of attention. The combination of quinolones and β-lactams was the measure most commonly taken for intervention. There was a wide range of outcome indicators, with high attention paid to signs and symptoms, physical and chemical tests, and safety events. There were problems such as a lack of attention to the distinction between primary and secondary outcome indicators, insufficient attention to the indicators with TCM characteristics, a lack of uniformity and standardization for the names of outcome indicators, and less use of economic indicators. In terms of quality assessment, most RCTs were rated as "unknown risk of bias" due to unspecified allocation concealment or blinding. Most systematic reviews/Meta-analyses were of "very low quality", and the guidelines/expert consensus lacked standardization in the rigor of their development and application. The results showed that the quality of clinical research on Chinese patent medicines for CAP was generally low. In the future, the design of clinical protocols should be further optimized, and more large-sample, multicenter, long-term follow-up studies should be conducted. Moreover, a core set of outcome indicators with TCM characteristics should be established, and the quality of systematic review/Meta-analysis and guideline/expert consensus literature should be improved so that more high-quality evidence for the treatment of CAP with Chinese patent medicines will be provided.
Chronic respiratory disease
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Care/Management
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Authors

Huang Huang, Xie Xie, Yin Yin, Li Li, Wang Wang
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