{"title":"[Evidence mapping of clinical research on traditional Chinese medicine in treatment of idiopathic pulmonary fibrosis].","authors":"Li-Li Xu, Dan-Yang Zang, Shu-Guang Yang, Ning-Xia Yu, Xue-Qing Yu","doi":"10.19540/j.cnki.cjcmm.20240821.501","DOIUrl":null,"url":null,"abstract":"<p><p>This study systematically retrieved the clinical studies in the treatment of idiopathic pulmonary fibrosis(IPF) with traditional Chinese medicine(TCM) and employed evidence mapping to summarize the overall research status and deficiencies of TCM in treating IPF. CNKI, VIP, SinoMed, Wanfang, PubMed, Web of Science, Cochrane Library, and EMbase were searched for the relevant studies published from inception to February 20, 2024. The distribution characteristics of the evidence were analyzed and presented through charts combined with words. A total of 323 studies were included, including 295 randomized controlled trials(RCTs) and 28 Meta-analysis. The number of publications in this field rose with fluctuations, yet the proportion of core papers was low, and the research lacked the attention of foreign researchers. There were scant cross-regional collaboration between researchers and insufficient attention from relevant departments. The included RCT generally had low quality, with small sample sizes, short treatment courses, and insufficient attention to acute exacerbation and complications of IPF. In addition, few studies employed TCM alone, and the TCM syndromes remained to be standardized. A considerable number of outcome indicators were involved in the publications, while the majority of them failed to emphasize the disparity between primary and secondary outcome indicators. There were diverse reference standards for the comprehensive indicators among the outcome indicators, and insufficient attention was paid to long-term prognosis and health economic indicators. The included Meta-analysis concluded that TCM had potential clinical efficacy in treating IPF. However, the methodological credibility grading and the GRADE grading results of outcome indicators were low. The results suggested that TCM demonstrated certain advantages in the treatment of IPF, while the quality of the included studies was not high. In the future, clinical research protocols should be standardized and registered. Multicenter, large-sample, and follow-up clinical studies should be conducted. The research reports should refer to relevant reporting standards to improve the quality and generate high-level evidence, thus providing a reference for the clinical application of TCM in the treatment of IPF.</p>","PeriodicalId":52437,"journal":{"name":"Zhongguo Zhongyao Zazhi","volume":"49 24","pages":"6803-6812"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Zhongguo Zhongyao Zazhi","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.19540/j.cnki.cjcmm.20240821.501","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Pharmacology, Toxicology and Pharmaceutics","Score":null,"Total":0}
引用次数: 0
Abstract
This study systematically retrieved the clinical studies in the treatment of idiopathic pulmonary fibrosis(IPF) with traditional Chinese medicine(TCM) and employed evidence mapping to summarize the overall research status and deficiencies of TCM in treating IPF. CNKI, VIP, SinoMed, Wanfang, PubMed, Web of Science, Cochrane Library, and EMbase were searched for the relevant studies published from inception to February 20, 2024. The distribution characteristics of the evidence were analyzed and presented through charts combined with words. A total of 323 studies were included, including 295 randomized controlled trials(RCTs) and 28 Meta-analysis. The number of publications in this field rose with fluctuations, yet the proportion of core papers was low, and the research lacked the attention of foreign researchers. There were scant cross-regional collaboration between researchers and insufficient attention from relevant departments. The included RCT generally had low quality, with small sample sizes, short treatment courses, and insufficient attention to acute exacerbation and complications of IPF. In addition, few studies employed TCM alone, and the TCM syndromes remained to be standardized. A considerable number of outcome indicators were involved in the publications, while the majority of them failed to emphasize the disparity between primary and secondary outcome indicators. There were diverse reference standards for the comprehensive indicators among the outcome indicators, and insufficient attention was paid to long-term prognosis and health economic indicators. The included Meta-analysis concluded that TCM had potential clinical efficacy in treating IPF. However, the methodological credibility grading and the GRADE grading results of outcome indicators were low. The results suggested that TCM demonstrated certain advantages in the treatment of IPF, while the quality of the included studies was not high. In the future, clinical research protocols should be standardized and registered. Multicenter, large-sample, and follow-up clinical studies should be conducted. The research reports should refer to relevant reporting standards to improve the quality and generate high-level evidence, thus providing a reference for the clinical application of TCM in the treatment of IPF.
本研究系统地检索了中医药治疗特发性肺纤维化(IPF)的临床研究,并采用证据图法对中医药治疗IPF的总体研究现状及不足进行了总结。检索中国知网、维普网、中国医学信息网、万方网、PubMed网、Web of Science网、Cochrane图书馆、EMbase网从建站到2024年2月20日发表的相关研究。通过图表与文字相结合的方式,分析了证据的分布特征。共纳入323项研究,包括295项随机对照试验(RCTs)和28项meta分析。该领域的论文发表量呈波动上升趋势,但核心论文占比较低,研究缺乏国外研究者的关注。研究人员之间的跨区域合作不足,相关部门的重视不足。纳入的RCT总体质量较低,样本量小,疗程短,对IPF急性加重和并发症关注不足。此外,单独使用中医的研究较少,中医证候也有待规范。出版物涉及相当数量的结果指标,但大多数出版物没有强调主要和次要结果指标之间的差异。结果指标中综合指标参考标准不一,对长期预后和健康经济指标重视不够。纳入meta分析的结论是中医药治疗IPF具有潜在的临床疗效。然而,结果指标的方法学可信度评分和GRADE评分结果较低。结果提示中药治疗IPF具有一定优势,但纳入的研究质量不高。在未来,临床研究方案应该标准化和注册。应进行多中心、大样本、随访的临床研究。研究报告应参照相关报告标准,提高报告质量,形成高水平证据,为中医治疗IPF的临床应用提供参考。