AUTHOR=Guo Jian-Ning , Bai Xue , Zhang Hong-Xian , Zhang Ning , Liang Jun-Ming , Guo Zi-Yi , Cui Xia 

TITLE=Efficacy and safety of Chinese herbal medicine for pneumonia convalescence in children: A systematic review and meta-analysis

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.956736

DOI=10.3389/fphar.2022.956736

ISSN=1663-9812

ABSTRACT=Background: Chinese herbal medicine (CHM) has advantages in treating sequela symptoms of pediatric pneumonia convalescence. Hence, this study aims to evaluate the efficacy and safety of CHM using a meta-analysis approach.
Methods: The randomized controlled trials (RCTs) that meet the search strategy were selected from seven databases from the inception date to December 17, 2021. Based on the Cochrane handbook, the quality of the selected studies was assessed using the risk of bias. Data were expressed as relative risk (RR) or mean difference (MD) and with 95% confidence interval (CI). Subgroup analyses and Sensitivity analyses were performed. The Grading Recommendation Assessment, Development, and Evaluation (GRADE) method was used to assess the evidence certainty. 
Result: 20 RCTs with 2241 participants were identified using the search criteria. CHMs included danshen injection, liujunzi decoction, qingfeitongluo decoction, yiqihuoxue decoction, yupingfeng granule, xiaoerfeike granule, sha sheng mai dong decoction, etc. Results indicated that CHM combined with western medicine (WM) or CHM alone improved the total clinical effective rate (RR = 1.22, 95% CI: 1.15 to 1.29), reduced cough relief time (MD = -2.16, 95% CI -2.46 to -1.85), lung rales disappearance time (MD= -1.82, 95% CI -2.17 to -1.47), and length of hospital stay (MD=-2.01, 95% CI -3.81 to -0.22) in the treatment of pneumonia convalescence in children. However, there was no significant statistical difference regarding the incidence of adverse reactions (RR=0.57, 95% CI 0.23 to 1.43). 
Conclusion: CHM combined with WM or CHM alone was found to improve the total clinical effective rate, alleviate clinical symptoms, and reduce hospital stays. Meanwhile, with a favourable safety profile. However, the selected RCTs were of low research quality. Therefore, more high-quality RCTs evidence should be performed to validate our findings.