Meta-analysis Of Modified Qianjinweijing Decoction Combined With Western Medicine In The Treatment Of Severe Pneumonia

Objective:Through literature collection,the effectiveness and safety of modified Qianjin Weigan decoction combined with western medicine in the treatment of severe pneumonia were systematically evaluated by the method of evidence-based medicine.Methods:By using the computer retrieval method,we systematically and comprehensively searched CNKI,Wanfang,VIP,PubMed and other relevant databases,collected and established the database until December 2020,and applied Qianjin Weigan decoction combined with western medicine to treat severe pneumonia(severe)According to the inclusion and exclusion criteria,the literatures were strictly screened.After extracting the effective data,Revman 5.4 software was used to conduct a meta-analysis on the clinical efficacy of Qianjin Weigan decoction combined with western medicine in the treatment of sp.Results:A total of 11 articles were included,including 491 cases in the experimental group and 490 Cases in the control group.Meta analysis results showed that:in terms of clinical total effective rate,the modified Qianjin Weigan decoction combined with western medicine group was better than the simple western medicine group[or=3.25,95%CI(1.75,6.02),P<0.00001],the difference was statistically significant.Modified Qianjin Weigan decoction combined with western medicine in the treatment of SP,oxygen index[MD=30.73,95%CI(23.91,37.55),P<0.00001],C-reactive protein(CRP)[MD=-10.80,95%CI(-15.49,-6.11),P<0.00001],procalcitonin(PCT)[SMD=-3.34,95%CI(-15.49,-6.11),P<0.00001]CI(-4.44,-2.25),P<0.00001],CD4+CD25+regulatory T cells(CD4+CD25+Tregs)results[MD =-1.84,95%CI(-2.19,-1.48),P<0.00001],APACHE II score[MD=-2.41,95%CI(-3.34,-1.48),P<0.00001],CPIs score[MD=-1.01,95%CI(-1.88,-0.14),P=0.02],Murray lung injury score[MD=-1.69,95%CI(-3.34,-1.48),P<0.00001]CI(-3.21,-0.18),P=0.03]and body temperature[MD=-0.82,95%CI(1.21,-0.44),P<0.00001],the results were better than that of Western medicine group,the difference was statistically significant.In sensitivity analysis,the results showed no significant change after the large heterogeneity studies were eliminated one by one,suggesting that the sensitivity was low and the study was more robust.In terms of publication bias,taking the total effective rate and C-reactive protein as examples,the funnel chart was used to analyze the publication bias of 11 included articles.The results suggested that there might be potential publication bias.In terms of safety,the incidence of adverse reactions[or=0.63,95%CI(0.32,1.24),P=0.18],there was no significant difference between the experimental group and the control group.Conclusion:The results show that Qianjin Weigan decoction combined with western medicine in the treatment of severe pneumonia can significantly improve the total effective rate of clinical treatment,improve respiratory function,reduce the expression of related immune factors and inhibit inflammatory factors,which is worthy of clinical application.Due to the lack of reported data of adverse reactions in the study,although the safety evaluation has been carried out,its safety needs to be further studied.Due to the general quality of the included studies,small sample size,and publication bias results show potential publication bias,which affect the credibility of the above results,the strength of evidence of the results of this study is limited.In the future,large sample,multi center,high-quality randomized controlled trials are still needed to confirm the effectiveness of modified Qianjin Weigan decoction combined with western medicine in the treatment of severe pneumonia.