Efficacy of traditional Chinese medicine in treating severe pneumonia: A meta-analysis and systematic review
Clinical Snapshot
PICO Framework
| P — Population | Patients with severe pneumonia |
| I — Intervention | Traditional Chinese medicine (TCM) as adjunctive therapy combined with conventional treatment |
| C — Comparator | Conventional treatment alone |
| O — Outcomes | Clinical effective rate, TCM symptoms, inflammatory markers (WBC, CRP), severity scores (CPIS, APACHE II), arterial blood gas indices (PaO2), pulmonary function (FEV1), complications, mortality, immune function (CD4+ T lymphocytes) |
Bottom Line
This meta-analysis of 34 RCTs suggests that traditional Chinese medicine as adjunctive therapy may improve clinical outcomes in severe pneumonia, including reduced mortality, improved inflammatory markers, and better pulmonary function. However, the evidence quality is uncertain due to limited methodological details, lack of effect size reporting, and unclear risk of bias assessment. The authors acknowledge the need for higher-quality studies. Given the heterogeneity of TCM interventions and potential cultural specificity of outcomes, these findings require cautious interpretation. Australian clinicians should await more robust evidence before considering TCM integration, particularly given current TGA regulatory frameworks and the critical nature of severe pneumonia management.
Key Findings
P Value: P < 0.05 for all reported outcomes
Effect Size: Not reported in abstract
Primary Outcome: Overall clinical effective rate significantly improved with TCM adjunctive therapy
Nnt Or Sensitivity: Not calculable from available data
Confidence Interval: Not reported in abstract
Clinical Application
Limited by availability of qualified TCM practitioners and standardized TCM protocols Limited applicability in Australia due to TGA regulations on complementary medicines and lack of TCM integration in standard pneumonia care pathways Patients with severe pneumonia, particularly in settings where TCM expertise is available
Abstract
BACKGROUND: Severe pneumonia (SP) is a critical respiratory disease characterized by its severity and high mortality rate. Traditional Chinese medicine (TCM) has gradually been used as an adjunctive therapy in clinical treatment of SP, yet its efficacy and safety lack systematic evidence. This study aims to analyze, evaluate, and compare current research evidence on TCM adjunctive therapy for SP, providing a basis for clinical treatment of this condition. METHODS: A systematic search was conducted on both English and Chinese online databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP) to identify relevant papers published from inception to November 2023. High-quality randomized controlled tests (RCTs) were selected for analysis. Outcome measures related to SP were extracted from the literature. Statistical analysis was performed using RevMan 5.3 (Cochrane) software to assess heterogeneity among included studies, calculate mean differences, odds ratios, and their 95% confidence intervals, and detect publication bias. RESULTS: A total of 34 RCTs met the inclusion criteria. Comparative analysis revealed that integrating TCM with conventional treatment significantly improves the overall clinical effective rate(P < .05). Specifically, it markedly alleviates TCM symptoms (P < .05). Additionally, TCM adjunctive therapy reduces levels of inflammatory markers including white blood cells, C-reactive protein (P < .05), and decreases Clinical Pulmonary Infection Score and Acute Physiology and Chronic Health Evaluation II scores compared to conventional treatment alone (P < .05). Compared to conventional treatment alone, TCM adjunctive therapy also enhances arterial blood gas indices (PaO2) (P < .05) and pulmonary function (forced expiratory volume in 1 second) (P < .05). Complication rates and mortality are lower in the TCM adjunctive therapy group(P < .05). Moreover, TCM treatment significantly boosts immune function (cluster of differentiation 4+ T lymphocyte) (P < .05). CONCLUSION: Integrating TCM with conventional treatment shows advantages in the efficacy of SP treatment, clinical symptoms management, inflammatory markers, and severity grading. Compared to conventional treatment alone, TCM adjunctive therapy improves immune function, pulmonary function, complication rates. However, future research should focus on large-scale, high-quality RCTs to further validate the effectiveness and safety of TCM adjunctive therapy for SP.
References
- 1.Zhou, A., Lin, H., Chen, Z., Luo, L., Ye, X., & Li, L. (2026). Efficacy of traditional Chinese medicine in treating severe pneumonia: A meta-analysis and systematic review. Medicine, 105(21), e48983. https://doi.org/10.1097/MD.0000000000048983
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