Chinese medicinal herbs for acute bronchitis

Background Acute bronchitis is one of the most common diagnoses made by primary-care physicians. It is traditionally treated with antibiotics (although the evidence for their effectiveness is weak and modest at best), and other even less effective treatments. Chinese medicinal herbs have also been used as a treatment. Objectives This review aimed to summarise the existing evidence on the comparative effectiveness and safety of Chinese medicinal herbs for treating uncomplicated acute bronchitis. Search strategy We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, Issue 1), which includes the Cochrane Acute Respiratory Infections Group's specialised register; MEDLINE (1966 to March Week 1, 2007); EMBASE (1988 to January 2007); The Chinese Cochrane Centre's Controlled Trials Register (up to January 2007); and the Chinese Biomedical Database (CBM) (1980 to January 2007). Selection criteria Randomised controlled trials (RCTs) comparing Chinese medicinal herbs with placebo, antibiotics or other Western medicines for the treatment of uncomplicated acute bronchitis. Data collection and analysis At least two review authors independently extracted data and assessed trial quality. Main results No studies met the inclusion criteria for this review. One study with 300 participants but uncertain randomisation was analysed. The study showed that treatment with the Chinese medicinal herb Huoke granules leads to a shorter duration of cough, fever and sputum compared to using penicillin and Xiaoer Shangfeng Zhike tangjiang syrup. However, the study also lacked allocation concealment and blinding. There was a high possibility of conflict of interest as the Huoke granules were made by the trial author's hospital. Authors' conclusions There is insufficient quality data to recommend the routine use of Chinese herbs for acute bronchitis. Study-design limitations of the individual studies meant that no conclusion about the benefits of Chinese herbs could be taken. In addition, the safety of Chinese herbs is unknown due to the lack of toxicological evidence on these Chinese herbs, though adverse events were reported in some case reports.