A systematic review and meta-analysis of effect evaluation of traditional Chinese medicine in treating acute respiratory distress syndrome

Background: It was to systematically evaluate the effects of traditional Chinese medicine (TCM) in the treatment of acute respiratory distress syndrome (ARDS), and provide a theoretical basis for the clinical treatment of ARDS.Methods: English databases of PubMed, Embase, Medline, Spring, Cochrane Library, and Web of Science were searched, and the randomized controlled trial literatures on the treatment of ARDS patients with TCM published from January 1, 2001 to December 31, 2020 were screened.Then, Cochrane Handbook 5.0.2 was employed to evaluate the risk of bias in the included literatures, and Review Manager 5.3 was utilized for meta-analysis.Results: A total of 16 studies met the requirements and were included, with a total of 1,460 participants.The meta-analysis results showed that the mortality rate of patients in the observation group was remarkably reduced after treatment with TCM [mean deviation (MD) =0.51; 95% confidence interval (CI): 0.32-0.84;Z=2.69; P=0.007].The effective rate of clinical treatment was improved (MD =2.64; 95% CI: 1.79-3.90;Z=4.90; P<0.00001).Arterial partial pressure of oxygen (PaO 2 ) increased remarkably (MD =12.29; 95% CI: 8.88-15.71;Z=7.05; P<0.00001).The oxygenation index (PaO 2 /FiO 2 ) increased remarkably (MD =50.70;Z=5.54; P<0.00001).Interleukin-6 (IL-6) levels were remarkably reduced (MD =-8.32; 95% CI: -11.48 to -5.17; Z=5.17; P<0.00001).The level of C-reactive protein (CRP) decreased remarkably (MD =-9.23; 95% CI: -14.23 to -4.24; Z=3.62; P=0.0003).Compared with the control group, the above 8 analysis indicators showed statistically considerable differences.However, difference of partial pressure of carbon dioxide (PaCO 2 ) level (MD =-0.16; 95% CI: -2.97-2.65;Z=0.11; P=0.91) was not obvious between groups.Discussion: The treatment of ARDS with TCM can reduce the mortality rate of patients, improves the effective rate of clinical treatment, reduces the average mechanical ventilation time, increases the levels of PaO 2 , PaO 2 /FiO 2 , and reduces the levels of IL-6, tumor necrosis factor α (TNF-α), and CRP.The use of TCM has a significant treatment effect on ARDS.