Chinese herbal medicines in the treatment of acute respiratory infections:a review of randomised and controlled clinical trials

Objective: To review clinical trials of Chinese herbal medicines (CHMs) in the management of acute respiratory infections (ARIs). Data sources: MEDLINE, the Cumulative Index to Nursing and Allied Health Li terature, the Cochrane Library and three Chinese medical journals available in Australia. Study selection: Studies in which a control group was used in comparing CHM s with a placebo or "Western medicine" (usually antibiotics) for treating A RIs were included. Data synthesis: 27 of 46 studies identified in the search of the databases and the Chinese journals fulfilled the inclusion criteria. Twenty-six of th ese were published in Chinese, and one in English. Twenty were randomised c ontrolled trials and seven were "controlled clinical trials". Although most of the studies reported that CHMs are better than antibiotics for the trea tment of ARIs, the quality of the studies was generally poor when evaluated for patient allocation, treatment description, outcome measurement and dat a analysis. Conclusions: Because the trial methodology of these studies was often inade quate or insufficiently documented, it is difficult to recommend the use of CHMs in ARIs. However, Shuang Huang Lian does appear to be useful for trea ting lower respiratory tract infections. More rigorous evaluation of CHMs i s needed, as they are becoming popular treatments in many countries, includ ing Australia.