Nebulised Chinese herbal medicine for paediatric pneumonia: a meta-analysis

This study aimed to systematically evaluate the clinical efficacy and safety of nebulised Chinese herbal medicine as an adjunctive therapy for paediatric pneumonia.

A comprehensive search was conducted in the PubMed, Cochrane Library, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, VIP and Chinese Biomedical Literature electronic databases between inception and 1 November 2025. Randomised controlled trials (RCTs) investigating nebulised Chinese herbal medicine as an adjunctive treatment for paediatric pneumonia were included. Two reviewers independently performed literature selection and data extraction and assessed the methodological quality using the Cochrane risk-of-bias tool. Meta-analysis was performed using Stata 17.0 software, and publication bias was assessed using RevMan 5.4.

Seventeen RCTs involving 1,764 patients were included. The meta-analysis showed that, compared with conventional Western therapy alone, the combination with nebulised Chinese herbal medicine significantly improved the total clinical effective rate [odds ratio = 3.24, 95% CI: (2.24, 4.68), p < 0.001] and significantly shortened the resolution time of respiratory symptoms [standardised mean difference (SMD) = -1.10, 95% CI: (-1.56, -0.64), p < 0.001], fever resolution time [SMD = -1.01, 95% CI: (-1.59, -0.43), p = 0.0006] and hospital stay duration [SMD = -1.06, 95% CI: (-1.38, -0.73), p < 0.001].

Current evidence suggests that nebulised Chinese herbal medicine combined with conventional Western therapy can significantly improve clinical efficacy, accelerate symptom resolution and shorten the disease course in children with pneumonia. However, due to methodological limitations in the included studies, these findings warrant further validation in larger, rigorously designed trials.