The efficacy and safety of combined chinese herbal medicine and western medicine therapy for COVID-19: a systematic review and meta-analysis

Li, Lü; Xie, Hongliang; Zhang, Aolin; Mou, Xuan; Lin, Yifan; Ma, Hongli; Wang, Yu; Li, Jian; Gao, Jingshu; Wang, Chi Chiu; Leung, Ping Chung; Fan, Xiaohui; Wu, Xiaoke

doi:10.1186/s13020-022-00600-z

Cited by 16 publications

(15 citation statements)

References 64 publications

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“…Relevant systematic reviews concerning CHM efficacy assessment have been published, but with limitations ( 22 – 29 ). Some articles incorporated non-RCTs (e.g., observational studies), or pooled the data from non-RCTs and RCTs together ( 22 , 23 ).…”

Section: Introductionmentioning

confidence: 99%

“…Many articles didn't assess the certainty of evidence ( 23 – 25 , 27 , 28 ). Some failed to address the risk of bias for each outcome due to the inappropriate use of Cochrane Risk of Bias Tool 2.0 (RoB2) ( 22 , 26 , 29 ). A previous systematic review has only pooled the outcomes with low risk of bias, which could lead to omission of evidence ( 30 ).…”

Section: Introductionmentioning

confidence: 99%

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Combination of Chinese herbal medicine and conventional western medicine for coronavirus disease 2019: a systematic review and meta-analysis

Tong

Zhou

et al. 2023

Front. Med.

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ObjectiveThis study aimed to assess the efficacy and safety of Chinese herbal medicine (CHM) plus conventional western medicine (CWM) in comparison with CWM against COVID-19.MethodsWe searched eight electronic databases and three trial registers spanning from January 1, 2020 to May 18, 2023. We included randomized controlled trials (RCTs) comparing the effectiveness and safety of CHM plus CWM and CWM against COVID-19 in our study. The Cochrane Risk of Bias tool 2.0 (RoB2) was applied to evaluate the methodological quality of the included RCTs. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was employed to assess the certainty of evidence. Statistical analysis was implemented in R version 4.1.2.ResultsOur study included 50 RCTs involving 11,624 patients. In comparison with sole CWM, CHM plus CWM against COVID-19 significantly enhanced clinical effective rate (RR = 1.18, 95% CI [1.13, 1.22]), improved chest image (RR = 1.19, 95% CI [1.11, 1.28]), inhibited clinical deterioration (RR = 0.45, 95% CI [0.33, 0.60]), lowered mortality (RR = 0.53, 95% CI [0.40, 0.70]), and reduced the total score of TCM syndrome (SMD = −1.24, 95% CI [−1.82, −0.66]). SARS-CoV-2 nucleic acid conversion time (MD = −2.66, 95% CI [−3.88, −1.44]), duration of hospitalization (MD = −2.36, 95% CI [−3.89, −0.82]), and clinical symptom (fever, cough, fatigue, and shortness of breath) recovery times were shorter in CHM plus CWM groups than in CWM groups. Further, CHM plus CWM treatment was more conducive for some laboratory indicators returning to normal levels. No statistical difference was found in the incidence of total adverse reactions between the two groups (RR = 0.97, 95% CI [0.88, 1.07]). We assessed the risk of bias for 246 outcomes, and categorized 55 into “low risk”, 151 into “some concerns”, and 40 into “high risk”. Overall, the certainty of the evidence ranged from moderate to very low.ConclusionsPotentially, CHM listed in this study, as an adjunctive therapy, combining with CWM is an effective and safe therapy mode for COVID-19. However, more high-quality RCTs are needed to draw more accurate conclusions.Clinical trial registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=293963.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combination of Chinese herbal medicine and conventional western medicine for coronavirus disease 2019: a systematic review and meta-analysis

Tong

Zhou

et al. 2023

Front. Med.

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“…Firstly, the overall quality of RCTs studies included in this review was generally poor, a finding commonly reported in previous systematic reviews involving TCM for other conditions [ 147 – 150 ]. Among 82 included trials, none of them were completely in compliance with CONSORT-CHM guideline.…”

Section: Discussionmentioning

confidence: 96%

Efficacy and safety of traditional Chinese medicine for cancer-related fatigue: a systematic literature review of randomized controlled trials

Yang,

Li,

Chau

et al. 2023

Chin Med

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Background Cancer-related fatigue (CRF) is an extremely common and long-term condition that affects the physical and mental health of oncology patients. While the treatment for CRF with western medicine and non-pharmacological therapy remains uncertain and challenging, traditional Chinese medicine (TCM) has become a trending option for the patients. Based on the findings from randomized controlled trials (RCTs), this study aims to identify and evaluate the evidence about the efficacy and safety of TCM for CRF. Methods A systematic literature search was conducted according to the PRISMA literature research guidelines. Seven electronic databases including PubMed, the Cochrane Library, Embase, Web of Science, Scopus, China National Knowledge Infrastructure (CNKI) and Wanfang database were searched to identify RCTs which investigated TCM in the treatment of CRF published since inception to December 2022. RCTs comparing TCM with no treatment, placebo, or pharmacological interventions were considered eligible for this review. The Consolidated Standards of Reporting Trials Statement extensions for Chinese herbal medicine Formulas (CONSORT-CHM) and the Cochrane Collaboration’s Risk of Bias tool were used in this review to evaluate the quality and the risk of bias of all included trials. Results A total of 82 RCTs were included in this review, regardless of whether they were published in English or Chinese. After data extraction and results evaluation, 78 trials demonstrated overall efficacy in using TCM for CRF patients compared with the control group, in which 33 trials showed that the efficacy rate was statistically significant (p < 0.05 or p < 0.01). TCM was also shown to be beneficial in improving the scores of relevant scales (e.g., PFS, QoL, TCM syndrome score, other fatigue scales etc.) or physical tests indicators (e.g., cytokines, blood test etc.). The most common herbs found in Chinese medicine were Astragali Radix, Ginseng Radix and Codonopsis Radix. Some TCM products, such as Kangai Injection, Buzhong Yiqi Decoction and Shenqi Fuzheng Injection could provide a reference for medication in this review. A range of non-serious, reversible adverse effects associated with the use of TCM was also reported. However, the result of evaluation showed that none of the trials fully met all the CONSORT-CHM criteria, the quality of included trials was generally poor and the risk of bias was mostly uncertain. Conclusion There is some evidence supporting the efficacy and safety of TCM in managing CRF in this systematic review. However, no clear conclusion can be made due to the inadequate reporting of efficacy and adverse reactions. In view of some concerns about the existing evidence after the evaluation, it is essential to standardize the comprehensive identification and efficacy measurement standards, improve the quality of RCTs and conduct more multicomponent therapies to provide an updated reference for CRF patients medication in the future. The protocol of this systematic review has been registered on PROSPERO (CRD42023413625). [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023413625].

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“…Other WMs, such as lopinavir/ritonavir and favipiravir, also have similar concerns [13,29]. In contrast to WM, TCM has unique features, including multi-target, multi-pathway approach and multi-component, which are beneficial for anti-inflammatory, organ protection, broadspectrum antiviral, and immune regulation [30,31]. Thus, compared with WM, TCM is associated with fewer side effects.…”

Section: Discussion About Tcm and Wmmentioning

confidence: 99%

Five traditional Chinese medicine formulations for addressing COVID-19

Zhang

2024

TMBLS

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Covid-19 has spread worldwide, with its initial outbreak occurring in China. The Chinese government employed not only Western medicine but also traditional Chinese medicine (TCM) in their response. TCM, due to its potential to enhance human immunity, was considered a valuable tool in prevention. Furthermore, the analysis of TCM recipes has shed light on their efficacy. Some of the five recipes, including LHQW, XFBD and LCDD, have been found to have the capacity to enhance the patients’ immunity responses. Furthermore, specific formulations like LHQW, XFBD, and HSBD have the capability to disrupt the attachment of COVID-19 to host cells by impeding its interaction with the ACE2 receptor. It is worth noting that Western medicine (WM) has limitations, thus, leading to the exploration of a combined approach involving both TCM and WM. Clinical observations have demonstrated that the treatment combining TCM and WM is more effective compared to treatments with either approach isolation. However, further research is needed to identify more favorable treatment strategies.

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The efficacy and safety of combined chinese herbal medicine and western medicine therapy for COVID-19: a systematic review and meta-analysis

Cited by 16 publications

References 64 publications

Combination of Chinese herbal medicine and conventional western medicine for coronavirus disease 2019: a systematic review and meta-analysis

Combination of Chinese herbal medicine and conventional western medicine for coronavirus disease 2019: a systematic review and meta-analysis

Efficacy and safety of traditional Chinese medicine for cancer-related fatigue: a systematic literature review of randomized controlled trials

Five traditional Chinese medicine formulations for addressing COVID-19

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