Abstract:
OBJECTIVE To evaluate the benefits and harms of tetrandrine adjuvant treatment of silicosis.
METHODS The inclusion criterion was the RCT of tetrandrine plus the conventional therapy for silicosis. Systematically searched involving databases from their inception to January 1, 2021. Data were summarized using risk ratio(RR) or mean difference(MD), both with their 95% confidence intervals(CI). RevMan5.3 was used for data analyses. The GRADEpro online system was used to evaluate the quality level of current evidence.
RESULTS Twenty-one RCTs were totally included, involving 1 700 patients. The pooled results showed clinical total effective rate in tetrandrine plus the conventional therapy group was higher than the conventional therapy group alone(RR 1.31, 95%CI1.11, 1.55,
n=7,
I2=79%) or Xifei Ning plus the conventional therapy group(RR 1.23, 95%CI1.10, 1.36,
n=4,
I2=37%); the forced vital capacity(FCV), forced expiratory volume in one second(FEV1), and FVC/FEV1 in tetrandrine plus the conventional therapy group were higher than the conventional therapy group alone(MD 0.1, 95%CI0.02, 0.17,
n=4,
I2=48%), (MD 0.05, 95%CI0.00, 0.09,
n=5,
I2=64%) and (MD 4.74, 95%CI2.32, 7.16,
n=4,
I2=58%). The FCV and FEV1 in tetrandrine plus the conventional therapy group was higher than Xifei Ning plus the conventional therapy group (MD 0.09, 95%CI0.08, 0.1,
n=2,
I2=0%) and (MD 0.23, 95%CI0.14, 0.31,
n=4,
I2=0%). The improvement on SGRQ score was significant in tetrandrine plus the conventional therapy group(
P < 0.05). The improvement on clinical symptoms(such as cough, chest pain, suffocation) was significant in tetrandrine plus the conventional therapy group(
P < 0.05). The adverse reactions in treatment group could be recovered after according treatment without significant differences compared with control group. At present, the certainty of relevant efficacy evidence was mainly downgraded to "low" or "very low".
CONCLUSION The effectiveness of tetrandrine plus the conventional therapy for silicosis seemed to be better than the conventional therapy alone. Application of tetrandrine plus the conventional therapy couldn't increase the occurrence of adverse events. However, rigorously designed well-reported studies are warranted to confirm the findings.
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