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Meta-Analysis
. 2024 Nov 8;103(45):e40465.
doi: 10.1097/MD.0000000000040465.

The impact of Tanreqing injection on mucus hypersecretion and cough in bronchiectasis: A meta-analysis of randomized controlled trials

Jinzhi Zhang  1 , Zi Yang  2 , Shasha Yuan  1 , Yuanyuan Duan  1 , Qing Miao  1
Affiliations
Meta-Analysis

The impact of Tanreqing injection on mucus hypersecretion and cough in bronchiectasis: A meta-analysis of randomized controlled trials

Jinzhi Zhang et al. Medicine (Baltimore). .

Abstract

Background: Bronchiectasis clinically manifests airway mucus hypersecretion as mucopurulent sputum production and chronic cough. In the past decade, Tanreqing injection (TRQ) has been often used in clinical practice as an add-on treatment for bronchiectasis in China. Several in vivo studies have indicated that TRQ is effective in improving sputum expectoration and cough in acute exacerbation of bronchiectasis but results of individual studies are inconsistent. Therefore, systematically and critically evaluating the effectiveness and safety of TRQ on mucus hypersecretion and cough in bronchiectasis is necessary.

Methods: Randomized controlled trials examining the treatment of bronchiectasis with TRQ were systematically searched from databases including PubMed, Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Vip Information Database, Wanfang data, and Chinese Biomedical Literature Database, based on a preregistered protocol and adhering to Cochrane methods. Pertinent data were taken out from the included studies and a methodological quality assessment was done. R language (version 4.4.1) was used to perform the meta-analysis.

Results: Twenty randomized controlled trials involving 1544 patients were analyzed. The results demonstrated that TRQ significantly improved mucus hypersecretion, shortened the duration of cough and phlegm, reduced symptom scores, and enhanced both forced expiratory volume in 1 second and forced vital capacity. Additionally, TRQ effectively lowered inflammatory markers, including C-reactive protein, procalcitonin, white blood cell count, neutrophil count, interleukin-6, and tumor necrosis factor-alpha. Moreover, TRQ increased the partial pressure of oxygen and decreased carbon dioxide pressure.

Conclusion: The findings suggest that TRQ positively impacts mucus hypersecretion and mucociliary clearance, leading to improvements in sputum production and cough during bronchiectasis exacerbations, without increasing the risk of adverse effects. TRQ may be considered a viable option for managing bronchiectasis and could serve as a novel mucus-modifying agent.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flowchart for selection of randomized controlled trials.
Figure 2.
Figure 2.
Risk of bias in the included studies.
Figure 3.
Figure 3.
Meta-analysis of cough and sputum disappearance time.
Figure 4.
Figure 4.
Meta-analysis of the time for defervescence.
Figure 5.
Figure 5.
Meta-analysis of the time for lung rales disappearance.
Figure 6.
Figure 6.
Meta-analysis of cough symptom score.
Figure 7.
Figure 7.
Meta-analysis of symptom score for sputum production.
Figure 8.
Figure 8.
Meta-analysis of dyspnea symptom score.
Figure 9.
Figure 9.
Meta-analysis of forced expiratory volume in 1 second.
Figure 10.
Figure 10.
Meta-analysis of forced vital capacity.
Figure 11.
Figure 11.
Meta-analysis of peak expiratory flow.
Figure 12.
Figure 12.
Meta-analysis of white blood cells.
Figure 13.
Figure 13.
Meta-analysis of C-reactive protein.
Figure 14.
Figure 14.
Meta-analysis of erythrocyte sedimentation rate.
Figure 15.
Figure 15.
Meta-analysis of neutrophil percentage.
Figure 16.
Figure 16.
Meta-analysis of procalcitonin.
Figure 17.
Figure 17.
Meta-analysis of interleukin-6.
Figure 18.
Figure 18.
Meta-analysis of tumor necrosis factor-alpha.
Figure 19.
Figure 19.
Meta-analysis of partial pressure of oxygen.
Figure 20.
Figure 20.
Meta-analysis of forced carbon dioxide pressure.
Figure 21.
Figure 21.
Funnel diagram of white blood cell count.
Figure 22.
Figure 22.
Funnel diagram of C-reactive protein.
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