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

In brief

Nebulised Chinese herbs triple the clinical success rate in pediatric pneumonia

A meta-analysis of 17 randomized trials (1,764 children) found that adding nebulised Chinese herbal medicine to standard antibiotics raised the overall effective treatment rate by about threefold and cut fever, respiratory symptom, and hospital stay times by roughly one standard deviation each. The authors caution that study quality was modest, so larger, high-quality trials are needed before routine use.

Journal
Frontiers in pediatrics (Q2)
Published
3 July 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Jing Shen, Yousong Li, Mengling Wei, Tiantian Qin
PMID
42490855
DOI
10.3389/fped.2026.1777233

Why clinicians should know about it

Abstract

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

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.