Comparative efficacy and safety of antiviral traditional Chinese medicine injections for viral pneumonia: a systematic review and network meta-analysis

Viral pneumonia (VP) is becoming a persistent and pervasive burden of disease. Traditional Chinese medicine Injections (TCMIs) have been proved effective in the treatment of patients with VP, which are now widely used in China. The evidence of TCMIs for VP is evolving rapidly. This study aims to assess the comparative efficacy and safety of TCMIs to provide more evidence and sights for the treatment selection of VP. Seven databases were searched from their inception up to 16 March 2022. Only randomized controlled trials (RCTs) are included to compare the efficacy and safety of antiviral TCMIs for the treatment of viral pneumonia. Clinical efficacy and rate of adverse events were considered as primary outcomes. A total of 76 RCTs with eight TCMIs comprising 7925 patients were included in the NMA. According to NMA, Reduning Injection combined with conventional antiviral drugs (CAD) produced superior effects in the effective outcomes and reduced the adverse event incidence rate of VP. This study indicated that TCMIs combined with CAD was more effective and safer than CAD monotherapy and compared different TCMIs therapies, which provided guidance and reference for the selection of clinical treatment medication.病毒性肺炎（Viral Pneumonia, VP）正成为一种持续且广泛存在的疾病负担。中药注射剂（Traditional Chinese Medicine Injections, TCMIs）已被证实对病毒性肺炎患者具有确切治疗效果，目前在国内应用广泛。针对病毒性肺炎的中药注射剂相关研究证据正快速更新。本研究旨在评估各类中药注射剂的相对疗效与安全性，以期为病毒性肺炎的临床治疗选择提供更多证据与参考视角。本研究检索了自建库至2022年3月16日的7个数据库，仅纳入对比抗病毒类中药注射剂治疗病毒性肺炎的疗效与安全性的随机对照试验（Randomized Controlled Trials, RCTs），将临床疗效与不良事件发生率设为主要结局指标。本次网络Meta分析（Network Meta-Analysis, NMA）共纳入76项随机对照试验，涉及8种中药注射剂，合计7925例患者。网络Meta分析结果显示，热毒宁注射液联合常规抗病毒药物（Conventional Antiviral Drugs, CAD）在病毒性肺炎的临床有效结局中疗效更优，且可降低不良事件发生率。本研究表明，中药注射剂联合常规抗病毒药物的治疗方案相较于单纯常规抗病毒药物治疗，疗效更优且安全性更高；同时本研究还对比了不同中药注射剂治疗方案的效果，可为病毒性肺炎的临床用药选择提供指导与参考。