ZHOU Xiaowen 1 , HUANG Suihe 2 , CAI Jianxiong 3 , HUANG Zhen 2 , XIE Qianwen 3 , XIE Qingfeng 2 , SUN Liangsheng 2 , YANG Zhimin 3 , WU Darong 3 , YAN Fang 2,4
  • 1. The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, P. R. China;
  • 2. Classical Traditional Chinese Medicine Ward, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510145, P. R. China;
  • 3. State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, P. R. China;
  • 4. Li Ke and Qi Yu-ru Academic Experience Inheritance Studio, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510145, P. R. China;
WU Darong, Email: darongwu@gzucm.edu.cn; YAN Fang, Email: yanf@gzucm.edu.cn
Pneumonia; Chinese medicine; Integrated Chinese and Western medicine; Retrospective cohort study
10.7507/1672-2531.202405051
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Objective To compare the clinical effectiveness of Chinese medicine and integrated Chinese medicine and antimicrobial drugs in the treatment of pneumonia. Methods The electronic medical record (EMR) of patients with pneumonia who admitted to the Classical Department of Chinese Medicine of Guangdong Hospital of Traditional Chinese Medicine from November 29, 2012 to June 17, 2022 were retrospectively collected. The patients were divided into two groups according to whether they were treated with antimicrobial drugs on the basis of Chinese medicine treatment. The non-exposed group was the traditional Chinese medicine group, and the exposed group was the integrated Chinese medicine and antimicrobial drugs group. Propensity score matching method was used to balance possible confounding factors. COX regression analysis was performed on the matched cohort to compare death rates among the groups, and Kaplan-Meier curve was drawn to evaluate the survival probability during hospitalization. The proportion of maximum oxygen concentration and duration of fever remission were compared between the two groups. Results This study included a total of 898 cases, with the majority (over 95%) falling within the range of mild to moderate severity. After propensity score matching,180 patients were remained in each group, among which the baseline characteristics were comparable. The primary outcome indicators showed that the risk of death during hospitalization was same in the integrated Chinese medicine and antimicrobial drugs group and in the Chinese medicine group (HR=1.52, 95%CI 0.36 to 6.39, P=0.566), the subgroup analysis is consistent with the overall trend of the results, and the differences were not statistically significant. The results indicate that during the hospitalization, the overall and subgroup mortality rates were similar between the two groups. The treatment effectiveness on the disappearance of major symptoms such as fever, cough, sputum production, fatigue, shortness of breath, and chest pain were comparable in both groups. The secondary outcome indicators showed that there was no statistical significance in the comparison of the proportion of maximum oxygen therapy concentration and the stable duration of fever remission between the two groups. Conclusion In the treatment of patients with mainly mild to moderate pneumonia, the effectiveness of the Chinese medicine group and the integrated Chinese medicine and antimicrobial drugs group in the hospitalization mortality, the disappearance of major symptoms, the proportion of maximum oxygen therapy concentration and the stable duration of fever remission are similar. Chinese medicine has a positive significance in reducing the use of antimicrobials in patients with pneumonia.