Shengtao Cui, Xiaofei Xie, Jingjing Yang, Yao Xiao, Wei Wang
TCM used as an adjunct to conventional Western medical treatment may provide additional benefits in improving clinical outcomes and alleviating symptoms in children with post-infectious chronic cough. However, due to limitations in study quality and heterogeneity, further high-quality, well-designed studies are warranted to strengthen the evidence base.
BACKGROUND: Chronic cough following respiratory infection in children is often refractory to conventional therapies. However, the current clinical evidence regarding the efficacy of traditional Chinese medicine (TCM) remains inconclusive and lacks systematic synthesis, leaving clinicians without clear guidance. This study systematically evaluated the efficacy and safety of TCM for chronic cough following respiratory infection in children to support clinical decision-making.
METHODS: A systematic search was conducted in the Cochrane Library, PubMed, Embase, Web of Science, Wiley Online Library, China National Knowledge Infrastructure (CNKI), and Wanfang databases. Randomized controlled trials (RCTs) of TCM for chronic cough following respiratory infection in children were included. Meta-analyses were performed using RevMan 5.4 and Stata 16.0.
RESULTS: A total of 23 RCTs involving 2,126 children were included. Meta-analysis demonstrated that, compared with conventional Western medical treatment alone, TCM combined with conventional treatment significantly improved the overall clinical effectiveness rate [risk ratio (RR) =1.19, 95% confidence interval (CI) (1.15, 1.24), P<0.001], shortened the time to cough resolution [mean difference (MD) =-3.19, 95% CI (-4.42, -1.97), P<0.001] and the time to disappearance of pulmonary rales [MD =-2.00, 95% CI (-2.47, -1.54), P<0.001], and significantly reduced cough symptom scores [MD =-1.32, 95% CI (-1.69, -0.95), P<0.001]. For secondary outcomes, combined TCM therapy significantly reduced TCM syndrome scores, improved immune function indicators [immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG)], and decreased levels of inflammatory biomarkers [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and monocyte chemoattractant protein-4 (MCP-4)]. No statistically significant difference was observed between groups in the incidence of adverse events.
CONCLUSIONS: TCM used as an adjunct to conventional Western medical treatment may provide additional benefits in improving clinical outcomes and alleviating symptoms in children with post-infectious chronic cough. However, due to limitations in study quality and heterogeneity, further high-quality, well-designed studies are warranted to strengthen the evidence base.