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Chinese medicinal herbs for the common cold (Review)

Zhang X, Wu T, Zhang J, Yan Q, Xie L, Liu GJ

This is a reprint of a Cochrane review, prepared and maintained by The Cochrane Collaboration and published in The Cochrane Library

2009, Issue 4

http://www.thecochranelibrary.com

Chinese medicinal herbs for the common cold (Review)

Copyright 2009 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

T A B L E O F C O N T E N T S

HEADER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

PLAIN LANGUAGE SUMMARY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

BACKGROUND . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

OBJECTIVES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

METHODS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

AUTHORS’ CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

CHARACTERISTICS OF STUDIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34

DATA AND ANALYSES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

Analysis 1.1. Comparison 1 Chinese herbs versus controls, Outcome 1 Change of symptoms. . . . . . . . . 101

Analysis 1.2. Comparison 1 Chinese herbs versus controls, Outcome 2 Change of symptoms (Sanhan Jiere Houfuye). 104

Analysis 1.3. Comparison 1 Chinese herbs versus controls, Outcome 3 Recovery. . . . . . . . . . . . . . 105

Analysis 1.4. Comparison 1 Chinese herbs versus controls, Outcome 4 Improvement. . . . . . . . . . . . 106

Analysis 1.5. Comparison 1 Chinese herbs versus controls, Outcome 5 Partial improvement. . . . . . . . . . 107

Analysis 1.6. Comparison 1 Chinese herbs versus controls, Outcome 6 No improvement. . . . . . . . . . . 108

Analysis 1.7. Comparison 1 Chinese herbs versus controls, Outcome 7 Number of participants whose temperature

normalised at 24, 48, 72 hours after drug administration. . . . . . . . . . . . . . . . . . . . 108

Analysis 1.8. Comparison 1 Chinese herbs versus controls, Outcome 8 Time temperature started to abate. . . . . 109

Analysis 1.9. Comparison 1 Chinese herbs versus controls, Outcome 9 Average duration of fever time. . . . . . 110

Analysis 1.10. Comparison 1 Chinese herbs versus controls, Outcome 10 TCM signs (ITT analysis). . . . . . . 111

APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111

WHAT’S NEW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

HISTORY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

CONTRIBUTIONS OF AUTHORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

DECLARATIONS OF INTEREST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

SOURCES OF SUPPORT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112

DIFFERENCES BETWEEN PROTOCOL AND REVIEW . . . . . . . . . . . . . . . . . . . . . 113

NOTES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

INDEX TERMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

Chinese medicinal herbs for the common cold (Review) i

Copyright 2009 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

[Intervention Review]

Chinese medicinal herbs for the common cold

Xiaoge Zhang2, Taixiang Wu1, Jing Zhang3, Qiu Yan4, Lingxia Xie5, Guan Jian Liu1

1Chinese Cochrane Centre, Chinese EBM Centre,West China Hospital, Sichuan University, Chengdu, China. 2State Key Laboratory

ofOralDiseases,WestChina College of Stomatology, SichuanUniversity, Chengdu, China. 3Reproductive Endocrinology,Department

of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China. 4West China Medical

School, Sichuan University, Chengdu, China. 5Clinical Medicine, West China Secondary Hospital, Sichuan University, Chengdu,

China

Contact address: Taixiang Wu, Chinese Cochrane Centre, Chinese EBM Centre, West China Hospital, Sichuan University, No. 37,

Guo Xue Xiang, Chengdu, Sichuan, 610041, China. [email protected]. [email protected]. (Editorial group: Cochrane Acute

Respiratory Infections Group.)

Cochrane Database of Systematic Reviews, Issue 4, 2009 (Status in this issue: Unchanged)

Copyright 2009 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

DOI: 10.1002/14651858.CD004782.pub2

This version first published online: 24 January 2007 in Issue 1, 2007.

Last assessed as up-to-date: 21 July 2008. (Help document - Dates and Statuses explained)

This record should be cited as: Zhang X, Wu T, Zhang J, Yan Q, Xie L, Liu GJ. Chinese medicinal herbs for the common cold.

Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD004782. DOI: 10.1002/14651858.CD004782.pub2.

A B S T R A C T

Background

Chinese medicinal herbs are frequently used to treat the common cold in China. Until now, their efficacy has not been systematically

reviewed.

Objectives

To assess the effectiveness and safety of Chinese medicinal herbs for the common cold.

Search strategy

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, issue 2), which contains the

Cochrane Acute Respiratory Infections Group’s Specialised Register;MEDLINE (1966 toMay 2008); EMBASE (1980 toMay 2008);

AMED (1985 to May 2008); the Chinese Biomedical Database (CBMdisc) (1978 to May 2008); and China National Knowledge

Infrastructure (CNKI) (1994 to May 2008).

Selection criteria

Randomised controlled trials (RCTs) studying the efficacy of Chinese medicinal herb(s) for the treatment of the common cold.

Data collection and analysis

Four review authors telephoned the original trial authors of the RCTs identified by our searches to verify the randomisation procedure.

Two review authors extracted and analysed data from trials which met the inclusion criteria.

Main results

We found17 studies involving 3212 patients. Themethods of 15 studies were at high risk of bias. In only two studies was the risk of bias

low. Trials used “positive drugs”, of which the efficacy was not known, as controls. Different Chinese herbal preparations were tested in

nearly all trials. In only one trial was a Chinese herbal preparation tested twice. In seven trials, six herbal preparations were found to be

Chinese medicinal herbs for the common cold (Review) 1

Copyright 2009 The Cochrane Collaboration. Published by JohnWiley & Sons, Ltd.

more effective at enhancing recovery than the control preparations. In the other 10 studies, seven herbal preparations were not shown

to be significantly different from the control. One study did not describe the difference between the intervention and control groups.

Authors’ conclusions

Chinese herbal medicines may shorten the symptomatic phase in patients with the common cold. However, the lack of trials of low

enough risk of bias, or using a placebo or a drug clearly identified as a control, means that we are uncertain enough to be unable to

recommend any kind of Chinese medicinal herbs for the common cold.

P L A I N L A N G U A G E S U M M A R Y

Chinese medicinal herbs to treat the common cold

The common cold is the most widespread acute respiratory tract illness affecting all age groups. Many Chinese herbal medicines are

used to treat this illness in China. Although we included 17 trials, involving 3212 patients, in this review, the risk of bias was so high that

the evidence did not support using any Chinese herbal preparation(s) for the common cold. Well-designed clinical trials are required.

B A C K G R O U N D

Description of the condition

The common cold is the most widespread acute respiratory tract

illness across all age groups