Traditional Chinese medicine Injections (TCMIs) seem to provide positive benefits for elderly patients with community-acquired pneumonia (CAP); however, the level of certainty regarding current evidence is low. CAP is a common, serious type of respiratory infection, especially prevalent in older persons, where its consequences are known to contribute to high morbidity rates, slow recovery, and mortality. A recent study was conducted by Yang H. and colleagues, published in the journal of Medicine.
The main aim of the study was to rigorously and comprehensively provide high-quality evidence regarding the effectiveness and safety of traditional Chinese medicine injections in the treatment of CAP among older people. The proposed evidence-mapping review involved randomized controlled trials (RCTs) and meta-analyses, and systematic reviews of the effectiveness of TCMIs in treating CAP in older people. An electronic literature search was performed in eight databases: PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, VIP, Wanfang, and SinoMed. The search was performed from the beginning of the databases to December 19th, 2024. The risk of bias in the RCT studies was determined using the Cochrane risk of bias approach, and evidence bubble charts were employed to present the evidence points of studies.
The evidence map consisted of 165 RCTs and one meta-analysis, with the oldest trial published in 2001. All trials took place in China, with RCTs accounting for 99% of extant trial data. Tanreqing Injection represented the most commonly evaluated type of TCMI. In trials, treatment duration varied between 7-13 days. Patients encompassed older adults with CAP, hospitalized and treated with TCMIs, both alone or combined with conventional medications. The two primary outcomes included clinical effectiveness rate, resolution of symptoms, followed by alleviation of respiratory symptoms, and total recovery. Trial results, along with meta-analyses, indicated a statistically significant positive impact of TCMI administration on elderly patients with CAP.
Key findings
• 99% of included studies were randomized controlled trials
• Tanreqing Injection was the most frequently evaluated TCMI
• Median treatment duration: 7–13 days
• Primary outcomes: clinical effectiveness rate and symptom resolution time
• Overall findings: consistent reports of improved clinical efficacy and faster symptom relief with TCMIs.
• Despite these favorable findings, the overall certainty of evidence was rated as low due to methodological limitations.
The traditional Chinese medicine injection has a prominent potential for enhanced clinical efficacy and symptomatic relief in elderly patients with community-acquired pneumonia. More high-quality clinical trials must be conducted to incorporate TCMIs in treatment strategies for CAP among the elderly.
Reference:
Yang, Hao MDa,b,c; Wang, Jun MDa,b,c; Zhang, Kang MDa,b,c; Xie, Kai MDa,b,c; Ji, Wenshuai MDa,b,c; Wang, Haifeng PhDa,b,c,*. Efficacy and safety of traditional Chinese medicine injections for older adults with community-acquired pneumonia: An evidence map. Medicine 104(52):p e46849, December 26, 2025. | DOI: 10.1097/MD.0000000000046849
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