Effectiveness and safety of traditional Chinese herbs in children with cough variant asthma: a systematic review and Meta-analysis

OBJECTIVE: To systematically investigate the clinical effectiveness and safety of traditional Chinese herbs(TCHs) as an alternative to conventional medicine(CM) in children with cough variant asthma(CVA).METHODS: Randomized controlled trial(RCT) studies that were published from their inceptions to March 31, 2020, were identified from the electronic databases of China National Knowledge Infrastructure, Wangfang, Pub Med, and Cochrane Central Library. The primary outcome of the review was the total effective rate(TER), and the secondary outcomes were immunoglobulin E(Ig E), peak expiratory flow(PEF), adverse drug reactions, and relapse rates of interventions.RESULTS: For the Meta-analysis, 13 studies involving 992 children with CVA were included. In terms of TER and Ig E, the experimental interventions of TCH, when compared with the control interventions of CM, on pediatric CVA were found to be significantly effective(P < 0.0001), whereas for spirometry, PEF was not significantly improved in the TCH group(P = 0.48). The incident rates of adverse drug reaction and relapse were found to be significantly lower in the TCH group than those in the CM group(P = 0.02 and P < 0.0001, respectively).CONCLUSION: Compared with CM therapy, the effects of TCH therapy on pediatric CVA were significantly beneficial in terms of TER and Ig E, but not for PEF, and the methodological quality of included studies was poor. Therefore, the results should be interpreted with caution. More randomized controlled trials with rigorous experimental methodologies are required for objectivity in the future.