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REVIEW ARTICLE

Clinical effectiveness of traditional Chinese medicine in modulating intestinal microbiota for pediatric Mycoplasma pneumoniae pneumonia: A systematic review and meta-analysis

Keke Li1 ,  Qinghe Zeng1 ,  Jianyi Liu2 ,  Yueyu Ma1 ,  Weiwei Liu2*
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1 Department of Chinese Paediatrics, Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
2 Department of Chinese Paediatrics, The Second Affiliated Hospital, Tianjin University of Traditional Chinese Medicine, Tianjin, China
EJMO, 8602 https://doi.org/10.36922/ejmo.8602
Submitted: 20 January 2025 | Revised: 24 February 2025 | Accepted: 4 March 2025 | Published: 24 March 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

This research aimed to perform a preliminary meta-analysis to comprehensively examine the effectiveness and safety of herbal medicines in modulating the intestinal microbiota of pediatric patients suffering from Mycoplasma pneumoniae pneumonia (MPP). A systematic search of seven databases was conducted in March 2024. The included randomized controlled trials were evaluated using the Risk of Bias (ROB) 2.0 tool, as recommended in the Cochrane Handbook. The analysis included a total of 11 studies, with a combined sample of 880 children. Traditional Chinese medicine (TCM) significantly enhanced the clinical outcomes of pediatric cases of MPP compared to Western medicine or symptomatic treatment. The meta-analysis results indicated that TCM significantly improved total clinical effectiveness (risk ratio = 1.19, 95% confidence interval [CI]: 1.13, 1.26), increased Bifidobacterium bifidum count (mean difference [MD] = 1.404, 95% CI: 1.180, 1.628), reduced serum interleukin-6 levels (MD = −4.665, 95% CI: −8.191, −1.139), and shortened the time required for rales to resolve (MD = −1.790, 95% CI: −1.951, −1.629) compared to the Western medicine group, with all differences being statistically significant at p < 0.05. Regarding safety, TCM modulation of the intestinal microbiota in treating pediatric mycoplasma pneumonia did not result in a higher incidence of adverse reactions, with the difference being statistically non-significant (p > 0.05). The ROB 2.0 assessment indicated potential bias, and the literature quality was moderate, necessitating future validation by higher-quality studies. The clinical effectiveness of intestinal microbiota-targeted TCM modulation in treating pediatric mycoplasma pneumonia was superior to Western medicine-only treatment, offering significant advantages in reducing inflammatory cell infiltration, shortening the time for rales to resolve, and demonstrating a better safety profile. However, future high-quality, large-scale clinical trials are needed to verify these findings.

Keywords
Intestinal microbiota
Mycoplasma pneumoniae
Traditional Chinese medicine
Systematic review
Meta-analysis
Clinical effectiveness of treatment
Funding
This research was supported by the Tianjin Municipal Education Commission Scientific Research Program Project (Natural Science) Key Project (No. 2021ZD024).
Conflict of interest
The authors declare that they have no relevant financial interests or personal relationships that could influence the objectivity of the research presented in this paper.
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