[Systematic review and meta-analysis on the integrative traditional Chinese and Western medicine in treating SARS].

Liu, Jian-ping; Manheimer, Eric; Shi, Yi

OBJECTIVE To systematically evaluate the effects of Chinese herbal medicine in treating severe acute respiratory syndrome (SARS). METHODS Electronic and manual searches was conducted to identify randomised controlled trials (RCTs) for comparing the effects of integrative traditional Chinese and Western medicine versus the effects of Western medicine alone in treating SARS. Methodological quality of trials was assessed in terms of generation of allocation sequence, allocation concealment, blinding, and intention-to-treat. Exploring analysis was carried out on the non-randomized clinical controlled studies. Two authors collected data independently and evaluated quality and results. The data were quantified by Meta-analysis. RESULTS Eight RCTs (488 SARS patients) were included. The methodological quality was generally low. Results of Meta-analysis showed that the integrative therapy could significantly reduce the mortality (relative risk 0.32 [95% CI 0.12 - 0.91]) and the occurrence of fungal infection in patients who received hormone (glucocorticoid) therapy (0.35: 0.14 - 0.90), shorten the duration of fever (weighted mean difference -0.83 day; -1.30 - -0.35) and symptom relieving time (-1.23; -2.09 - -0.37), reduce the persistent time of chest radiograph abnormalities (- 2.61; -3.74 - -1.49). But it showed no significant difference on quality of life or glucocorticoid dosage. Conclusion The integrative therapy may have beneficial effects in lowering mortality, reducing complications, shortening the duration of symptoms and fever existence and lessening pulmonary inflammation in SARS patients. The evidence is insufficient to come to the affirmative conclusion due to the low methodological quality of the included trials.