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TCM decoctions combined with conventional treatment improve FEV1 and PEF in pediatric asthmaTraditional herbal decoctions may improve lung function in children with asthma

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Key Takeaway
Note that TCM decoctions may improve lung function in pediatric asthma, but evidence is currently of low certainty.

This network meta-analysis evaluated the efficacy of various Traditional Chinese Medicine (TCM) decoctions when combined with conventional biomedical treatment (CBT) for pediatric asthma patients. The analysis included 2,068 participants across multiple trials to assess lung function and inflammatory markers.

The study found that Qing Qi Hua Tan Tang plus CBT significantly improved FEV1 compared to CBT alone (MD 1.20; 95% CrI [1.10, 1.40]). Additionally, Ma Xing Shi Gan Tang combined with CBT significantly increased peak expiratory flow (PEF) compared to CBT alone (MD 12.00; 95% CrI [8.00, 17.00]). No statistically significant differences were observed for IgE levels across the decoctions.

The authors note several limitations, including a high or unclear risk of bias in all included studies and concerns regarding blinding and allocation concealment. Furthermore, it was difficult to ensure the comparability of different TCM decoctions. Consequently, these findings are characterized as preliminary, hypothesis-generating, and exploratory. Clinical application should be approached with caution due to the low certainty of evidence.

How this fits prior evidence

This finding addresses a gap in adjunctive therapies for pediatric asthma by evaluating TCM decoctions. While previous coverage identified oral bacterial lysates as an adjunctive therapy to reduce wheezing and infection rates in children with asthma, this meta-analysis provides preliminary data on specific TCM decoctions like Qing Qi Hua Tan Tang and Ma Xing Shi Gan Tang to improve FEV1 and PEF.

Managing asthma in children is a constant challenge for families. While standard medical treatments are the foundation of care, some researchers are looking into whether adding herbal decoctions—traditional medicines brewed as teas—can provide extra support for a child's breathing.

A review of data from over 2,000 pediatric patients found that combining certain decoctions with standard treatment improved lung function. Specifically, one mixture called Qing Qi Hua Tan Tang showed better results in measuring air volume, while another called Ma Xing Shi Gan Tang helped increase peak flow. However, these findings did not change levels of IgE, a marker often linked to allergies.

It is important to keep these results in perspective. The study notes that the evidence is preliminary and has some limitations, such as potential biases in the original trials. Because the data is still being explored, these findings are meant to help doctors think about new options rather than replace current standards of care.

What this means for you:
Adding specific herbal decoctions to standard treatment may improve lung function in children with asthma.

Common questions

Which specific herbal mixtures showed the most promise?

Two specific decoctions showed positive results. Qing Qi Hua Tan Tang was found to significantly improve forced expiratory volume (FEV1) when added to standard treatment. Another mixture, Ma Xing Shi Gan Tang, significantly increased peak expiratory flow (PEF) in children compared to those receiving standard treatment alone.

Is this a proven treatment for my child's asthma?

The findings are currently considered preliminary and exploratory. Because the original studies had some risks of bias and lacked certain controls, these results are intended to generate new ideas for research rather than serving as a confirmed medical recommendation.

Did these herbal treatments affect allergy markers like IgE?

No, the study found that none of the tested decoctions showed statistically significant differences in IgE levels. This means while they may help with lung function, they did not change this specific marker associated with allergic responses.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
ObjectiveThis study aimed to explore the potential comparative effectiveness of various traditional Chinese medicine (TCM) decoctions plus conventional biomedical treatment (CBT) versus CBT alone in pediatric asthma using a Bayesian network meta-analysis (NMA).MethodsSeven databases were systematically searched for randomized controlled trials (RCTs) published up to 24 March 2025 that evaluated TCM decoctions in the treatment of pediatric asthma. The Bayesian NMA was conducted using R 4.4.1 and Stata 15.1. Risk of bias was assessed using the Cochrane tool (Review Manager 5.4.1), and interventions were tentatively ranked by surface under the cumulative ranking curve (SUCRA).ResultsA total of 21 RCTs involving 2,068 patients and 9 distinct TCM decoctions were included. The risk of bias was high or unclear in all studies included, with particular concerns regarding allocation concealment and blinding. Compared with CBT alone, Qing Qi Hua Tan Tang (QQHTT) + CBT significantly improved forced expiratory volume in one second (FEV1) (mean difference [MD] 1.20; 95% credible interval [CrI] [1.10, 1.40]). Ma Xing Shi Gan Tang (MXSGT) + CBT significantly increased peak expiratory flow (PEF) (MD 12.00; 95% CrI [8.00, 17.00]). According to SUCRA, QQHTT + CBT (SUCRA = 99.9%) and MXSGT + CBT (SUCRA = 97.1%) ranked highest for FEV1 and PEF.ConclusionSensitivity analyses confirmed the stability of the results regarding FVC and IgG, with Ma Xing Shi Gan Tang He Su Ting Wan (MXSGTHSTW) + CBT and Xiao Qing Long Tang (XQLT) + CBT which was ranked first in all analyses. For FEV1, the top-ranked interventions (QQHTT, Da Qing Long Tang [DQLT], MXSGTHSTW) remained in the top three across all analyses, with minor changes in ranking attributable to differences in inclusion criteria across studies. For PEF, the rankings in sensitivity analysis 1 were influenced by a reduction in the number of eligible treatments. For IgE, no decoction showed statistically significant differences, and the rankings were sensitive to the conditions of the analysis. Although QQHTT and MXSGT demonstrated statistical advantages in this NMA, serious methodological limitations exist in the included studies, particularly the lack of blinding and allocation concealment. Moreover, the inability to fully ensure the comparability of TCM decoctions means that these findings should be regarded as preliminary, hypothesis-generating and exploratory.Systematic Review Registrationidentifier CRD420251120217.
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