Table_10_The add-on effect of Shufeng Jiedu capsule for treating COVID-19: A systematic review and meta-analysis.DOCX

IntroductionShufeng Jiedu capsule (SFJD) is a commonly used Chinese patent medicine in China. Some studies have reported that SFJD has therapeutic effects in patients diagnosed with COVID-19. This systematic review aimed to critically evaluate the efficacy and safety of SFJD combined with western medicine (WM) for treating COVID-19.
MethodsA literature search by using WHO COVID-19 database, PubMed, Embase, Cochrane Library, the Web of Science, CKNI, Wanfang, VIP, SinoMed, and clinical trial registries was conducted, up to 1 August 2022. Randomized controlled trials (RCTs), non-RCTs, cohort studies and case series of SFJD combined with WM for COVID-19 were included. Literature screening, data extraction, and quality assessment were performed independently by two reviewers in line with the same criteria. We used the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) to assess the certainty of evidence. Meta-analyses were performed with Revman 5.3 if possible. The descriptive analysis was conducted when the studies could not be meta-analyzed.
ResultsTotally 10 studies with 1,083 patients were included. Their methodological quality were moderate. The results demonstrated that compared to WM group, SFJD + WM group remarkably increased the nucleic acid negative conversion rate (RR = 1.40, 95%CI: 1.07–1.84), total effective rate (RR = 1.18, 95%CI: 1.07–1.31), cure rate (RR = 4.06, 95%CI: 2.19–7.53), and the chest CT improvement rate (RR = 1.19, 95%CI: 1.08–1.31), shorten nucleic acid negative conversion time (MD = −0.70, 95%CI: −1.14 to −0.26), reduced the clinical symptom disappearance time (fever, diarrhea, cough, fatigue, pharyngalgia, nasal congestion, and rhinorrhea), as well as improved the levels of laboratory outcomes (CRP, IL-6, Lym, and Neu). Additionally, the incidence of adverse reactions did not exhibit any statistically significant difference between SFJD + WM group and WM group.
ConclusionSFJD combined with WM seems more effective than WM alone for the treatment of COVID-19. However, more well-designed RCTs still are warranted.
Systematic review registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022306307].

## 引言
疏风解毒胶囊（Shufeng Jiedu Capsule, SFJD）是我国临床常用的中成药。已有研究报道，该药物对新型冠状病毒肺炎（COVID-19）确诊患者具有治疗作用。本系统综述旨在严格评价疏风解毒胶囊联合西药（Western Medicine, WM）治疗COVID-19的有效性与安全性。

## 方法
本研究检索了截至2022年8月1日的WHO COVID-19数据库、PubMed、Embase、Cochrane图书馆、Web of Science、中国知网（CKNI）、万方数据、维普资讯、中国生物医学文献服务系统（SinoMed）及临床试验注册平台。纳入的研究类型包括疏风解毒胶囊联合西药治疗COVID-19的随机对照试验（Randomized Controlled Trials, RCTs）、非随机对照试验、队列研究及病例系列。由2名评价者按照统一标准独立完成文献筛选、数据提取与质量评价。本研究采用推荐分级的评估、制定与评价（Grading of Recommendations, Assessment, Development, and Evaluations, GRADE）工具对证据确定性进行评估。若条件允许，采用RevMan 5.3软件进行Meta分析；若无法进行Meta分析，则采用描述性分析。

## 结果
本研究共纳入10项研究，涉及1083例患者，其方法学质量为中等水平。结果显示，相较于单纯西药治疗组，疏风解毒胶囊联合西药治疗组可显著提高核酸转阴率（相对风险（Relative Risk, RR）=1.40，95%置信区间（95% Confidence Interval, 95%CI）：1.07~1.84）、总有效率（RR=1.18，95%CI：1.07~1.31）、治愈率（RR=4.06，95%CI：2.19~7.53）及胸部CT改善率（RR=1.19，95%CI：1.08~1.31）；缩短核酸转阴时间（均差（Mean Difference, MD）=-0.70，95%CI：-1.14~-0.26），缩短发热、腹泻、咳嗽、乏力、咽痛、鼻塞、流涕等临床症状消失时间，并改善实验室指标水平（C反应蛋白（C-reactive protein, CRP）、白细胞介素6（Interleukin-6, IL-6）、淋巴细胞计数（Lymphocyte, Lym）、中性粒细胞计数（Neutrophil, Neu））。此外，疏风解毒胶囊联合西药组与单纯西药组的不良反应发生率差异无统计学意义。

## 结论
疏风解毒胶囊联合西药治疗COVID-19的效果似乎优于单纯西药治疗，但仍需开展更多设计严谨的随机对照试验。

## 系统综述注册信息
注册平台：https://www.crd.york.ac.uk/PROSPERO/，注册编号：CRD42022306307。