저자 및 기관: 김관일 (경희대학교 대학원 임상한의학과), 신승원 (경희대학교 한의과대학), 이나라 (서울대학교 보건대학원), 이범준 (경희대학교한방병원 호흡기 알레르기·면역 조절 클리닉), 이준희 (경희대학교 한의과대학 사상의학교실), 이향숙 (침구경락융합연구센터)

발표 저널: Journal of Ethnopharmacology

원문 링크: https://pubmed.ncbi.nlm.nih.gov/26666732/

서지사항

Kim KI, Shin S, Lee N, Lee BJ, Lee J, Lee H. A traditional herbal medication, Maekmoondong-tang, for cough: A systematic review and meta-analysis. J Ethnopharmacol. 2016 Feb 3;178:144-54. doi: 10.1016/j.jep.2015.12.005.

Abstract

Ethnopharmacological relevance: Maekmoondong-tang (MMDT) is a traditional herbal medication widely used to improve cough in Korea, Japan, and China. It is composed of six herbs (Ophiopogonis Tuber, Pinelliae Tuber, Glycyrrhizae Radix, Zizyphi Fructus, Ginseng Radix, and Oryzae Semen).

Aim of the study: This study is aimed to systematically review the relevant randomised controlled trials (RCTs) to determine the effectiveness and safety of MMDT for cough.

Materials and methods: Electronic and hand-searching of 7 databases (Cochrane Library, MEDLINE, EMBASE, OASIS, RISS, CNKI and CiNii) was systematically conducted up to February 2015 for RCTs testing MMDT in patients with cough. The primary outcome was cough symptom improvement using cough diary, visual analog scale, or response rate. Risk of bias of the included trials was evaluated with the Cochrane risk of bias assessment tool. The dichotomous data were pooled to obtain a risk ratio (RR) of cough persisting after treatment, with 95% confidence intervals (CI).

Results: Nine RCTs involving 2453 participants were included. The methodological quality was largely poor for a majority of the studies. MMDT reduced the severity of cough by 74% compared with the conventional antitussive medications in various conditions (n=1145; RR of cough persisting after treatment=0.26; 95% CI, 0.19-0.34, I(2)=0%). The addition of MMDT to conventional medication in patients with postinfectious cough significantly alleviated symptoms up to day 5 but the effect was not maintained one week afterwards. For other diseases/conditions including chronic obstructive pulmonary disease, lung cancer surgery, and asthma, the evidence is inconsistent for MMDT/mMMDT for cough. Adverse events appear to be rare but the reporting was poor.

Conclusions: The current evidence from our systematic review and meta-analysis on MMDT for cough is inconclusive and we propose that rigorously designed, placebo-controlled trials of MMDT should be conducted to establish its place in management of cough.

Keywords: Bakumondo-to (TJ-29); Cough; Herbal medicine; Maekmoondong-tang; Mai-men-dong-tang; Systematic review.

Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

한글 요약

맥문동탕은 한의학에서 기침을 치료하는 처방으로 이용되어 왔다. 실제로 어느 정도의 기침 완화 효과가 있는지에 대하여 7개의 데이터베이스에서 검색한 맥문동탕 임상시험에 대하여 체계적 고찰과 메타분석을 수행하였다. 검색된 9개의 임상시험 (총 참여 환자 2453명)은 방법론적으로 우수하지는 않은 것으로 평가되었다. 또한 맥문동탕 단독 치료는 기존 치료에 비하여 기침의 심각도를 완화하는 효과가 어느 정도 나타났으나 병행 치료하였을 때 치료 종료 시점에서는 그 효과가 뚜렷하지 않았다. 만성 폐쇄성 폐질환이나 암 수술과 같은 기저 질환에 동반되는 기침에 대한 맥문동탕의 치료 효과 또한 통계적으로 유의하지는 않았다. 맥문동탕이 기침을 치료하는 효과에 대한 제대로 된 평가를 위해서는 좀 더 큰 규모의, 질적으로 우수하고 위약을 활용한 무작위배정 비교임상연구가 요구된다. 

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