Intervention Review

Pelargonium sidoides extract for acute respiratory tract infections

  1. Antje Timmer1,*,
  2. Judith Günther2,
  3. Gerta Rücker3,
  4. Edith Motschall4,
  5. Gerd Antes3,
  6. Winfried V Kern5

Editorial Group: Cochrane Acute Respiratory Infections Group

Published Online: 8 JUL 2009

Assessed as up-to-date: 8 DEC 2007

DOI: 10.1002/14651858.CD006323.pub2

Database Title

Additional Information

How to Cite

Timmer A, Günther J, Rücker G, Motschall E, Antes G, Kern WV. Pelargonium sidoides extract for acute respiratory tract infections. Cochrane Database of Systematic Reviews 2008, Issue 3. Art. No.: CD006323. DOI: 10.1002/14651858.CD006323.pub2.

Author Information

  1. 1

    Helmholtz Zentrum München Research Center for Health and Environment, Institute of Epidemiology, München, Germany

  2. 2

    Pharmafacts GmbH - Research and Consulting in Drug Care, Freiburg, Germany

  3. 3

    German Cochrane Center, Department of Medical Biometry and Statistics, Freiburg, Germany

  4. 4

    University Medical Center, Institite of Medical Biometry and Medical Informatics, Freiburg, Germany

  5. 5

    Center for Infectious Diseases and Travel Medicine, University Hospital, Department of Medicine, Freiburg, Germany

*Antje Timmer, Institute of Epidemiology, Helmholtz Zentrum München Research Center for Health and Environment, Ingolstädter Landstrasse 1, München, 85764, Germany. antje.timmer@helmholtz-muenchen.de.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 8 JUL 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Pelargonium sidoides (P. sidoides), also known as Umckaloabo, is a herbal remedy thought to be effective in the treatment of acute respiratory infections (ARIs).

Objectives

To assess the efficacy and safety of P. sidoides for the treatment of ARIs in children and adults.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, issue 4) which includes the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1966 to November 2007); EMBASE (1974 to December 2007); and other electronic databases.

Selection criteria

Randomized controlled trials (RCTs) examining the efficacy of P. sidoides preparations in ARIs compared to placebo, no treatment or any other treatment. Complete resolution of all symptoms was defined as a primary outcome.

Data collection and analysis

Three review authors (AT, JG, WK) independently extracted and quality scored the data. Separate analyses were performed by age group and disease entity. Heterogeneity was examined using the I-square (I2) statistic. Pooled relative risks (RR) were calculated using a fixed-effect model if heterogeneity was absent (I2 < 5%; P > 0.1), or a random-effects model in the presence of heterogeneity. If heterogeneity was substantial (I2 > 50%; P < 0.10), a pooled effect was not calculated.

Main results

Three trials (746 patients) of efficacy in acute bronchitis in adults showed substantial heterogeneity for all relevant outcomes. and three trials (819 children) were similarly inconsistent for acute bronchitis in children. Type of preparation was a potential cause of heterogeneity (not effective in tablet form).

One unpublished study in patients with sinusitis (n = 103 adults) showed significant treatment effects (complete resolution at day 21; RR 0.43, 95% CI 0.30, 0.62). One study in the common cold demonstrating efficacy after 10 days, but not five days.

Four trials were excluded because of excessive risk of bias. There were no valid data for the treatment of other acute respiratory tract infections. Adverse events were more common with P. sidoides, but none were serious.

Authors' conclusions

P. sidoides may be effective in alleviating symptoms of acute rhinosinusitis and the common cold in adults, but doubt exists. It may be effective in relieving symptoms in acute bronchitis in adults and children, and sinusitis in adults. Reliable data on treatment for other ARIs were not identified.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Pelargonium sidoides (Umckaloabo) for treating acute respiratory tract infections

Umckaloabo is a herbal extract derived from the plant Pelargonium sidoides (P. sidoides) and is available in both tablet and liquid forms. The extract is used for the treatment of acute respiratory tract infections (ARIs) where antibiotic use is unnecessary. In the light of inappropriate antibiotic use and increasing drug resistance rates worldwide, the need for an alternative, effective remedy for these medical conditions is crucial.

We reviewed eight randomized clinical trials with acceptable methodologies. Two trials showed that P. sidoides was effective in relieving all symptoms, and in particular cough and sputum production in adults with acute bronchitis. However, a third study showed that the preparation was only effective for treating sputum reduction. Similarly, P. sidoides was effective in resolving symptoms of acute bronchitis in two out of three pediatric studies. In acute sinusitis and the common cold P. sidoides was effective in resolving all symptoms including headaches and nasal discharge in adults when taken for an extended time period. Adverse events were more common with P. sidoides, but none were severe .

There is limited evidence for the effectiveness of P. sidoides in the treatment of ARIs. The herbal preparation may be effective in relieving symptoms in acute bronchitis in adults and children, and sinusitis in adults.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

老鸛草(Pelargonium Sidoides)萃取物用於治療急性呼吸道感染

老鸛草(Pelargonium Sidoides)，或稱為 Umckaloabo，被認為是一個對治療急性呼吸道感染(ARIs)有效的中草藥。

目標

此為評估老鸛草對兒童及成人之急性呼吸道感染治療的效果和安全性。

搜尋策略

我們的資料搜尋包括考科藍註冊中心之對照試驗(簡稱CENTRAL)(考科藍圖書館 2007年第3期)， 其中包括了考科藍急性呼吸道感染組的專門登記冊; MEDLINE(1966年至2007年11月)，醫學文摘庫(1974年至2007年12月)，以及其他電子資料庫。

選擇標準

在急性呼吸道感染，將老鸛草的療效與安慰劑，不治療或其他治療以隨機對照試驗(RCTs)相比。以所有的症狀完全解除做為一個主要結果。

資料收集與分析

三位作者(AT, JG, WK)各自獨立擷取資料並評估臨床實驗報告之可信度。按年齡和疾病實體分組各自分析。變異性分析使用I平方(I2)的統計方法。如果沒有變異性(I2 < 50％; P> 0.10)，會使用固定效應模型計算出匯集相對危險度(RR)。若有變異性，則使用隨機效應模型。如果有顯著變異性(I2 > 50％; P < 0.10)，匯集效果將不計算。

主要結論

3個關於治療成人之急性支氣管炎療效實驗(共746名病人)由各個型態個體組成。另外三個實驗(共819兒童)由與前者相同類型之急性支氣管炎兒童組成。個體組成之型態為造成整體實驗組成變異性的主因(藥丸形式並無效果)。一個未公開的研究對鼻竇炎之患者(共103位成年人)發現有顯著治療效果(第21天起疾病完全治癒，RR:0.43，95％信賴區間為 0.30至0.62)。另一項研究証明在感冒後10天可以看出療效，但在五天時仍未有顯著療效。有4個實驗因有顯著偏差的風險而被排除。對於其他急性呼吸道感染目前沒有有效的數據證明。老鸛草的使用常見一些副作用但都不是很嚴重。

作者結論

老鸛草對成人可以有效緩解急性鼻竇炎及感冒症狀的成年人，這是無庸置疑的。它也可以有效緩解成人和兒童的急性支氣管炎及成人鼻竇炎的症狀。至於其他急性呼吸道感染目前無可靠的實驗數據。

翻譯人

本摘要由臺灣大學附設醫院林敬凱翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

老鸛草(又名UMCKALOABO)用於急性呼吸道感染之治療：Umckaloabo是從被稱為老鸛草之中藥所提練出來的萃取物(P. sidoides)，它有做成藥丸和液體兩種劑型。這種提鍊物主要用於用於當急性呼吸道感染(ARIs)卻暫時還不需要使用抗生素的時機。因抗生素的不當使用，全世界正面臨整體致病菌對抗生素的耐藥率增加，我們需要對此一情況提出另一種改進方案來改變整體醫療情況。我們共擷取8篇隨機臨床實驗與合適的方法。其中兩項實驗聲稱老鸛草確實可有效緩解成人因急性支氣管炎之所有症狀，尤其是咳嗽和咳痰。但是，第三項實驗表示，老鸛草製劑只能減少痰量。同樣可見在另外2篇小而的研究，老鸛草可有效解決急性支氣管炎的所有症狀。就急性鼻竇炎和感冒方面，延長老鸛草之治療時間可有效解決成人之所有的症狀包括頭痛及流鼻水。使用老鸛草所產生的不良反應相當常見但都不嚴重。老鸛草在治療急性呼吸道感染上的證據有限。此中藥製劑，可能對成人和兒童因急性支氣管炎，或成人之鼻竇炎其症狀緩解有效。

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