Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children: An overview of systematic reviews

Si Zhang, Xuan Zhang, Yuehua Cui, Juan Huang, Fei Fan, Simeng Wang, Fei Han*

*Corresponding author for this work

Research output: Contribution to journalJournal articlepeer-review


Objective: To summarize the characteristics and evaluate the quality of the methodology andevidence within systematic reviews (SRs) of Chinese herbalmedicine (CHM) for Mycoplasma pneumoniae pneumonia (MPP)in children.

Methods: SRs of randomized controlled trials were searchedusing PubMed, the Cochrane Library, Embase, the Chinese NationalKnowledge Infrastructure Databases (CNKI), the Chinese Scientific JournalsDatabase (VIP), Wanfang, and the SinoMed Database. SRs on the use of CHM aloneor in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM. Twoinvestigators independently assessed methodological quality, reportingcharacteristics, and evidence quality using the A Measurement Tool to AssessSystematic Reviews (AMSTAR) 2, the Preferred Reporting Items for SystematicReviews and Meta-Analyses (PRISMA) 2020, and the Grading of Recommendations,Assessment, Development, and Evaluation (GRADE) criteria. The primaryindicators were the total effective rate, fever subsidence time, and coughdisappearance time. The secondary outcomes were pulmonary rale disappearancetime, average hospitalization time, lung X-ray infiltrate disappearance time,immunological indices, and inflammatory cytokine levels.

Results: Twelve relevant SRs were included; 75 % (9/12) wereassessed as very low quality, and 25 % (3/12) were rated as low qualityusing the AMSTAR 2 criteria. According to the PRISMA 2020 checklist, theaverage SR score was 20.3 out of a 27 point maximum. In all SRs, CHMdemonstrated improvement in symptoms and signs among children with MPP. Theevidence quality using the GRADE criteria ranged from “very low”(>50 %) to “moderate” (<5 %). The most common downgradingfactor was imprecision, followed by publication bias and inconsistency.

Conclusion: This overview highlights the limited quality of themethodology and evidence of the included SRs. Although the included studiesshowed the beneficial effects of CHM on MPP in children, it was difficult todraw firm conclusions owing to methodological flaws.

Original languageEnglish
Number of pages9
JournalJournal of Traditional Chinese Medical Sciences
Publication statusE-pub ahead of print - 9 Dec 2023

Scopus Subject Areas

  • Complementary and alternative medicine

User-Defined Keywords

  • Children
  • Chinese herbal medicine
  • Mycoplasma pneumoniae pneumonia
  • Overview
  • Systematic review


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