SUMMARY OBJECTIVE: The purpose of this study was to evaluate the efficacy of the use of four concomitant Chinese medicines with azithromycin in the treatment of mycoplasma pneumonia in children (MPC) by using network meta-analysis (NMA) and ranking them according to their performances. METHODS: There were a total of 130 randomly controlled trials of four different concomitant Chinese medicines with azithromycin for the treatment of MPC in many databases, and an NMA was conducted in them by using Stata (version 13.0) software to evaluate the odds ratio (OR) and sequence of the different combinations. The included studies were divided into two groups: control group (azithromycin alone) and observation group (one of four azithromycin combinations). RESULTS: A total of 13119 cases were included in this study, and the results showed that the pooled OR and 95% confidence interval (CI) of MPC improvement compared with azithromycin alone were 4.76 (3.18–7.14) for azithromycin and Reduning, 5.66 (4.50–7.12) for azithromycin and Tanreqing, 4.84 (3.35–7.01) for azithromycin and Xiyanping, and 4.58 (3.59–5.83) for azithromycin and Yanhuning, respectively. This study shows the significant efficacy of Chinese concomitant drug. The combination of azithromycin with Tanreqing is the best candidate of concomitant drug in terms of clinical efficacy. Its surface under the cumulative ranking (SUCRA) score was 85.5, while the SUCRA score for the azithromycin and Yanhuning combination was the worst, which is 48.4. CONCLUSIONS: The combination of azithromycin with Tanreqing is the most promising group among four combinations for the treatment of MPC.

RESUMO OBJETIVO Vários medicamentos chineses e ocidentais integrados podem ser benéficos para o tratamento da COVID-19. O objetivo deste estudo é avaliar a eficácia da tomografia computadorizada (TC) de pulmão de quatro medicamentos chineses e ocidentais integrados para o tratamento da COVID-19 usando uma meta-análise em rede (NMA). MÉTODOS Vários bancos de dados foram consultados para encontrar ensaios clínicos randomizados de quatro tipos diferentes de medicamentos chineses e ocidentais integrados para o tratamento da COVID-19. A NMA foi realizada nos dados usando o software Stata (13.0). O odds ratio (OR) foi calculado. Os estudos incluídos neste artigo foram divididos em um grupo de controle (medicina ocidental) e um grupo de observação (um dos quatro medicamentos chineses e ocidentais integrados). RESULTADOS 5 publicações elegíveis foram identificadas. Um total de 598 casos foram incluídos no estudo, e os resultados mostraram que os quatro tipos de medicamentos chineses e ocidentais integrados (tratamento sintomático e de suporte com Qingfei Touxie Fuzheng, Lianhua Qingke e Xuebijing) foram significativamente superiores (P <0,05) a somente cuidados sintomáticos e de suporte, exceto cuidados sintomáticos e de suporte com Lianhua Qingwen. A combinação de cuidados sintomáticos e de suporte com Lianhua Qingke teve a maior probabilidade de ser a intervenção clinicamente mais eficaz, com uma superfície abaixo da curva de classificação cumulativa (SUCRA) de 85,7. CONCLUSÕES Uma combinação de tratamento sintomático e de suporte com Lianhua Qingke é a melhor opção entre os quatro medicamentos integrados chineses e ocidentais considerados para o tratamento de COVID-19.

SUMMARY OBJECTIVE Various integrated Chinese and Western medicines might be beneficial for the treatment of Coronavirus disease 2019 (COVID-19). This study aims to evaluate the efficacy of lung computed tomography (CT) of four integrated Chinese and Western medicines in the treatment of COVID-19 using network meta-analysis (NMA). METHODS Multiple databases were consulted to find randomized controlled trials of four different types of integrated Chinese and Western medicines for the treatment of COVID-19. NMA was conducted on the data using Stata (13.0) software. The odds ratio (OR) was calculated. The studies included in this paper were divided into a control group (Western medicine) and an observation group (one of four integrated Chinese and Western medicines). RESULTS 5 eligible publications were identified. A total of 598 cases were included in the study, and the results showed that the four types of integrated Chinese and Western medicines (symptomatic and supportive care with Qingfei Touxie Fuzheng, Lianhua Qingke, and Xuebijing) were significantly superior (P < 0.05) to symptomatic and supportive care alone, except for symptomatic and supportive care with Lianhua Qingwen. The combination of symptomatic and supportive care with Lianhua Qingke had the highest probability of being the most clinically efficacious intervention, with a surface under the cumulative ranking (SUCRA) curve of 85.7. CONCLUSIONS A combination of symptomatic and supportive care with Lianhua Qingke is the best option among the four integrated Chinese and Western medicines considered for the treatment of COVID-19.