Efficacy,Safety And Economy Of Shufeng Jiedu Capsule In The Treatment Of Acute Exacerbation Of Chronic Obstructive Pulmonary Disease And Community Acquired Pneumonia: A Systematic Review

Objective: The aim of this study is to assess the efficacy and safety of Shufeng Jiedu Capsule(SFJDC)by meta-analysis,and to evaluate the economy of Shufeng Jiedu Capsule by cost-effectiveness analysis in the treatment of Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and Community-acquired pneumonia(CAP),so as to provide scientific evidence for clinical decision-making and rational drug use.Methods: ShufengJiedu,Shufeng Jiedu + community acquired pneumonia,Shufeng Jiedu + chronic obstructive pulmonary disease,Pneumonia,CAP,AECOPD were used as the subject or key words to search CNKI,VIP,WANGFANG,CBM,Pub Med,MEDLINE and other databases respectively.Since SFJDC was approved in2009,randomized controlled trials of SFJDC in the treatment of AECOPD and CAP published from January 2009 to February 2021 were searched.The efficacy and safety of SFJDC are evaluated through meta-analysis in the treatment of AECOPD、CAP.And on the basis of meta-analysis,cost-effectiveness analysis was used to further evaluate its economy.Results: Clinical efficacy: Meta-analysis showed that the total effective rate(RR= 1.2,95% CI: 1.15,1.24,P < 0.00001),disappearance time of pulmonary rales(MD=-1.27,95% CI:-1.47,-1.07,P < 0.00001),high sensitivity C-reactive protein(MD=-5.64,95% CI:-6.87,-4.41,P < 0.00001),PCT of procalcitonin(MD =-0.24,P <0.00001)after SFJDC combined with conventional therapy were significantly higher than those in conventional therapy,After treatment,FEV1(SMD = 0.85,95% CI: 0.53,1.16,P < 0.00001),FEV1 / FVC(SMD = 1.53,95% CI: 0.91,2.16,P < 0.00001),Pa O2(MD = 6.00,95% CI: 3.58,8.42,P < 0.00001),CO2(MD =-3.99,95% CI:-6.99,-0.99,P = 0.009),FEV1 / FVC(SMD = 1.53,95% CI: 0.91,2.16,P < 0.00001),Pa O2(MD = 6.00,95% CI: 3.58,8.42,P < 0.00001),and CO2(MD =-3.99,95% CI:-6.99,-0.99,P = 0.009),Fe,Mean length of stay(MD =-2.02,95% CI:-3.47,-0.57,P = 0.006);Comparison of SFJDC combined with conventional treatment and conventional treatment for non-severe CAP: total effective rate(RR = 1.17,95% CI:1.12,1.22,P < 0.00001),disappearance time of fever(MD =-1.06,95% CI:-1.73,-0.39,P = 0.002),disappearance time of pulmonary rales(MD =-1.53,95% CI:-2.18,-0.87,P < 0.00001),disappearance time of expectoration and cough(MD =-1.28,95% CI:-2.38,-0.18,P = 0.02);MD =-1.08,95% CI:-1.31,-0.85,P < 0.00001),hs CRP after treatment(MD =-4.14,95% CI:-6.45,-1.84,P = 0.0004),PCT of procalcitonin after treatment(SMD =-5.19,95% CI:-7.14,-3.24,P < 0.00001),average length of stay(MD =-1.81,95% CI:-2.53,-1.10,P < 0.00001).Safety: SFJDC combined with conventional treatment compared with conventional treatment for AECOPD(RR = 0.76,95% CI: 0.49,1.18,P = 0.23),SFJDC combined with conventional treatment compared with conventional treatment for CAP(RR = 0.80,95% CI: 0.22,2.88,P = 0.73).Economy: The CER of hospitalized patients with AECOPD(215.80,463.03)and non hospitalized patients with AECOPD(16.12,17.85)were compared between SFJDC combined with routine treatment and routine treatment;SFJDC combined with conventional therapy was compared with conventional therapy in the treatment of non-severe CAP inpatients with CER(215.80,312.64).Conclusion:In terms of clinical efficacy,compared with conventional treatment,SFJDC combined with conventional treatment can eliminate the pulmonary rales of patients with AECOPD and CAP as soon as possible,significantly improve the lung ventilation and ventilation status of patients,reduce the levels of serum inflammatory factors CRP and PCT,inhibit airway inflammatory reaction,significantly improve the clinical symptoms of patients with AECOPD and CAP,and shorten the hospitalization time of patients.In terms of safety,there was no significant difference between SFJDC combined with conventional treatment and conventional treatment.In terms of economy,the cost-effectiveness analysis of the total effective rate of SFJDC combined with conventional and conventional treatment for AECOPD inpatients and non inpatients,and non-severe CAP inpatients found that the CER of SFJDC combined with conventional treatment group was less than that of conventional treatment group,which indicated that SFJDC combined with conventional treatment was more economical.Furthermore,the highest and lowest bid prices of SFJDC were used to analyze the cost-effectiveness of AECOPD and CAP by single factor sensitivity analysis.The results showed that the SFJDC combined with conventional treatment was more robust and had the advantage of pharmacoeconomic.