Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis

ObjectiveTo evaluate the efficacy and safety of Modified Xuanbai Chengqi Decoction as an adjunctive therapy for severe pneumonia (SP) and to explore its clinical rationale.MethodsA comprehensive search was performed in CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed, and Embase, covering database...

Full description

Saved in:
Bibliographic Details
Main Authors: Yifu Tie, Han Liu, Tong Zhang, Tianwei Meng, Qun Liang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1573025/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849710046099800064
author Yifu Tie
Han Liu
Tong Zhang
Tianwei Meng
Qun Liang
author_facet Yifu Tie
Han Liu
Tong Zhang
Tianwei Meng
Qun Liang
author_sort Yifu Tie
collection DOAJ
description ObjectiveTo evaluate the efficacy and safety of Modified Xuanbai Chengqi Decoction as an adjunctive therapy for severe pneumonia (SP) and to explore its clinical rationale.MethodsA comprehensive search was performed in CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed, and Embase, covering database inception to November 2024. Randomized controlled trials that investigated the combination of Modified Xuanbai Chengqi Decoction with standard therapy for severe pneumonia were included. Quality evaluation, meta-analysis, and bias assessments were performed with Review Manager 5.4, using risk ratios and mean differences (MD), both with 95% confidence intervals to estimate effects.ResultsA total of 14 RCTs involving 1,061 participants met the inclusion criteria. Meta-analysis indicated that adjunctive treatment with the decoction achieved better overall response rates [RR = 1.21, 95% CI (1.14, 1.28), P < 0.00001] and demonstrated significant reductions in interleukin-6 (IL-6, MD = −15.07, 95% CI (−17.31, −12.83), P < 0.00001), interleukin-13 (IL-13, MD = −7.30, 95% CI (−7.82, −6.79), P < 0.00001), and tumour necrosis factor-α (TNF-α, MD = −0.56, 95% CI (−0.64, −0.48), P < 0.00001), high-sensitivity C-reactive protein (hs-CRP, MD = −2.09, 95% CI (−2.47, −1.71), P < 0.00001), procalcitonin (PCT, MD = −2.04, 95% CI (−2.55, −1.53), P < 0.00001), arterial blood gas lactate (LaC, MD = −2.28, 95% CI (−2.45, −2.11), P < 0.00001), mechanical ventilation time (MD = −120.03, 95% CI (−130.14, −109.92), P < 0.00001), clinical pulmonary infection score (CPIS, MD = −2.71, 95% CI (−3.95, −1.82), P < 0.00001), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (MD = −7.41, 95% CI (−7.54, −7.28), P < 0.00001), and ICU transfer rate [RR = 22.88, 95% CI (6.68, 78.32), P < 0.00001].ConclusionModified Xuanbai Chengqi Decoction appears advantageous as an adjunct for SP treatment, but the evidence remains insufficient to support widespread application owing to the low quality of the included research. Future studies should incorporate higher-quality RCTs and assess drug safety and cost-effectiveness in a rigorous manner.
format Article
id doaj-art-2b90bcbbd0f34e3799559f33468fba8a
institution DOAJ
issn 1663-9812
language English
publishDate 2025-04-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Pharmacology
spelling doaj-art-2b90bcbbd0f34e3799559f33468fba8a2025-08-20T03:15:04ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-04-011610.3389/fphar.2025.15730251573025Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysisYifu Tie0Han Liu1Tong Zhang2Tianwei Meng3Qun Liang4Heilongjiang University of Chinese Medicine, Harbin, ChinaInstitute for Global Health, University College London, London, United KingdomHeilongjiang University of Chinese Medicine, Harbin, ChinaHeilongjiang University of Chinese Medicine, Harbin, ChinaCritical Care Medicine, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, ChinaObjectiveTo evaluate the efficacy and safety of Modified Xuanbai Chengqi Decoction as an adjunctive therapy for severe pneumonia (SP) and to explore its clinical rationale.MethodsA comprehensive search was performed in CNKI, Wanfang, VIP, CBM, Cochrane Library, PubMed, and Embase, covering database inception to November 2024. Randomized controlled trials that investigated the combination of Modified Xuanbai Chengqi Decoction with standard therapy for severe pneumonia were included. Quality evaluation, meta-analysis, and bias assessments were performed with Review Manager 5.4, using risk ratios and mean differences (MD), both with 95% confidence intervals to estimate effects.ResultsA total of 14 RCTs involving 1,061 participants met the inclusion criteria. Meta-analysis indicated that adjunctive treatment with the decoction achieved better overall response rates [RR = 1.21, 95% CI (1.14, 1.28), P < 0.00001] and demonstrated significant reductions in interleukin-6 (IL-6, MD = −15.07, 95% CI (−17.31, −12.83), P < 0.00001), interleukin-13 (IL-13, MD = −7.30, 95% CI (−7.82, −6.79), P < 0.00001), and tumour necrosis factor-α (TNF-α, MD = −0.56, 95% CI (−0.64, −0.48), P < 0.00001), high-sensitivity C-reactive protein (hs-CRP, MD = −2.09, 95% CI (−2.47, −1.71), P < 0.00001), procalcitonin (PCT, MD = −2.04, 95% CI (−2.55, −1.53), P < 0.00001), arterial blood gas lactate (LaC, MD = −2.28, 95% CI (−2.45, −2.11), P < 0.00001), mechanical ventilation time (MD = −120.03, 95% CI (−130.14, −109.92), P < 0.00001), clinical pulmonary infection score (CPIS, MD = −2.71, 95% CI (−3.95, −1.82), P < 0.00001), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (MD = −7.41, 95% CI (−7.54, −7.28), P < 0.00001), and ICU transfer rate [RR = 22.88, 95% CI (6.68, 78.32), P < 0.00001].ConclusionModified Xuanbai Chengqi Decoction appears advantageous as an adjunct for SP treatment, but the evidence remains insufficient to support widespread application owing to the low quality of the included research. Future studies should incorporate higher-quality RCTs and assess drug safety and cost-effectiveness in a rigorous manner.https://www.frontiersin.org/articles/10.3389/fphar.2025.1573025/fullsevere pneumoniapneumoniameta-analysistraditional Chinese medicinesymptom complex
spellingShingle Yifu Tie
Han Liu
Tong Zhang
Tianwei Meng
Qun Liang
Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis
Frontiers in Pharmacology
severe pneumonia
pneumonia
meta-analysis
traditional Chinese medicine
symptom complex
title Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis
title_full Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis
title_fullStr Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis
title_full_unstemmed Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis
title_short Efficacy and safety of modified Xuanbai Chengqi Decoction as an adjunctive treatment for severe pneumonia: a systematic review and meta-analysis
title_sort efficacy and safety of modified xuanbai chengqi decoction as an adjunctive treatment for severe pneumonia a systematic review and meta analysis
topic severe pneumonia
pneumonia
meta-analysis
traditional Chinese medicine
symptom complex
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1573025/full
work_keys_str_mv AT yifutie efficacyandsafetyofmodifiedxuanbaichengqidecoctionasanadjunctivetreatmentforseverepneumoniaasystematicreviewandmetaanalysis
AT hanliu efficacyandsafetyofmodifiedxuanbaichengqidecoctionasanadjunctivetreatmentforseverepneumoniaasystematicreviewandmetaanalysis
AT tongzhang efficacyandsafetyofmodifiedxuanbaichengqidecoctionasanadjunctivetreatmentforseverepneumoniaasystematicreviewandmetaanalysis
AT tianweimeng efficacyandsafetyofmodifiedxuanbaichengqidecoctionasanadjunctivetreatmentforseverepneumoniaasystematicreviewandmetaanalysis
AT qunliang efficacyandsafetyofmodifiedxuanbaichengqidecoctionasanadjunctivetreatmentforseverepneumoniaasystematicreviewandmetaanalysis