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. 2022 Jul 4:13:923395.
doi: 10.3389/fphar.2022.923395. eCollection 2022.

Chinese Patent Medicine Shufeng Jiedu Capsules as an Adjuvant Therapy for Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Xiao-Wen Zhang  1 , Ru-Yu Xia  1 , Jia-Qi Gao  2 , Jin-Jun Liu  2 , De-Hao Xu  3 , Xun Li  1 , Xiao-Yang Hu  4 , Merlin Willcox  4 , Michael Moore  4 , Meng-Yuan Dai  5 , Jeanne Trill  4 , Yu-Tong Fei  1 , Jian-Ping Liu  1   6
Affiliations

Chinese Patent Medicine Shufeng Jiedu Capsules as an Adjuvant Therapy for Community-Acquired Pneumonia: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Xiao-Wen Zhang et al. Front Pharmacol. .

Abstract

Background: Shufeng Jiedu (SFJD) capsules can be used as adjunctive treatment for patients with community-acquired pneumonia, but the effectiveness and safety of SFJD are not clear. This review aims to evaluate the effectiveness and safety of SFJD based on randomized controlled trials (RCTs). Methods: A systematic review was conducted by searching PubMed, Embase, Scopus, Web of Science, CENTRAL, CNKI, VIP, CBM, Wanfang and trial registry platforms from their inception to March 2022. Two reviewers screened studies, extracted the data and assessed risk of bias independently. The data were pooled for meta-analysis or presented narratively. Results: Seventeen RCTs involving 1840 participants were included. All trials compared SFJD plus antibiotics to antibiotics, or combined with symptomatic treatment in both groups. The overall certainty of evidence was assessed as moderate to very low certainty. Compared with routine treatment (antibiotics alone or antibiotics plus symptomatic treatment), SFJD plus routine treatment showed beneficial effects in resolution of fever (MD -1.20 days, 95%CI -1.73 to -0.67; 10 RCTs; very low certainty), cough (MD -1.02 days, 95%CI -1.23 to -0.81; 9 RCTs; moderate certainty), phlegm (MD -1.46 days, 95%CI -2.84 to -0.08; 6 RCTs; very low certainty), pulmonary crepitations (MD -1.61 days, 95%CI -2.64 to -0.59; 8 RCTs; low certainty), shortness of breath (MD -2.80 days, 95%CI -2.88 to -2.72; 2 RCTs; low certainty) and chest pain (MD -2.85 days, 95%CI -3.01 to -2.69; 1 RCT; low certainty). There was no significant difference in pathogen clearance (1 RCT). No serious adverse events were reported, but 2.60% (5/192) patients reported nausea in the SFJD groups, 1.04% (2/192) participants in routine group, and no significant difference was identified. Conclusions: Current evidence suggests that adding SFJD may shorten the duration of symptom relief in community-acquired pneumonia for 1-2 days. The adverse events were minor and controllable, and no serious adverse events were reported. Well-reported trials and potential of reducing antibiotics were expected in the future studies.

Keywords: Chinese patent medicine; community-acquired pneumonia; meta-analysis; randomized controlled trial; shufeng jiedu capsules; systematic review.

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Conflict of interest statement

The authors declare that they have the following possible conflicts of interest. However, these conflicts of interest do not actually influence the design, analyses, and the reporting of this study. This work is supported by the project investigating the use of Chinese herbal medicine for the treatment of chronic obstructive pulmonary disease. The project is part of the “UK-China collaboration to tackle antimicrobial resistance”, funded by the UK and Chinese governments. This project is also in partnership with Anhui Jiren Pharmaceutical Co., Ltd., which manufactures SFJD, and they also contributed some funding. The handling editor MY declared a shared parent affiliation with the author MYD at the time of review.

Figures

FIGURE 1
FIGURE 1
PRISMA flow chart of literature searching and screening.
FIGURE 2
FIGURE 2
Risk of bias assessment for eligible studies. (A) Risk of bias summary; (B) Risk of bias graph.
FIGURE 3
FIGURE 3
Forest plot of resolution time (days) of fever stratified by age. Comparison: SFJD plus routine treatment vs. routine treatment. SFJD: Shufeng Jiedu capsule.
FIGURE 4
FIGURE 4
Forest plot of duration of cough (days) stratified by age. Comparison: SFJD plus routine treatment vs. routine treatment. SFJD: Shufeng Jiedu.
FIGURE 5
FIGURE 5
Forest plot of duration of pulmonary crepitations (days) stratified by age. Comparison: SFJD plus routine treatment vs. routine treatment. SFJD: Shufeng Jiedu.
FIGURE 6
FIGURE 6
Forest plot of white cell count stratified by age (×109/L). Comparison: SFJD plus routine treatment vs. routine treatment. SFJD: Shufeng Jiedu.
FIGURE 7
FIGURE 7
Forest plot of C-reactive protein stratified by age (mg/L). Comparison: SFJD plus routine treatment vs. routine treatment. SFJD: Shufeng Jiedu.
FIGURE 8
FIGURE 8
Funnel plot of comparison: SFJD plus routine treatment vs. routine treatment, outcome: duration of cough. SFJD: Shufeng Jiedu.
See this image and copyright information in PMC

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