Add-on effect of Chinese herbal medicine in the treatment of mild to moderate COVID-19: A systematic review and meta-analysis

Introduction Coronavirus disease 2019 (COVID-19) has emerged as a global pandemic since its outbreak in Wuhan, China. It is an urgent task to prevent and treat COVID-19 effectively early. In China’s experience combating the COVID-19 pandemic, Chinese herbal medicine (CHM) has played an indispensable role. A large number of epidemiological investigations have shown that mild to moderate COVID-19 accounts for the largest proportion of cases. It is of great importance to treat such COVID-19 cases, which can help control epidemic progression. Many trials have shown that CHM combined with conventional therapy in the treatment of mild to moderate COVID-19 was superior to conventional therapy alone. This review was designed to evaluate the add-on effect of CHM in the treatment of mild to moderate COVID-19. Methods Eight electronic databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, the Clinical Trials.gov website, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang Database and China Biology Medicine (CBM) were searched from December 2019 to March 2021 without language restrictions. Two reviewers searched and selected studies, and extracted data according to inclusion and exclusion criteria independently. Cochrane Risk of Bias (ROB) tool was used to assess the methodological quality of the included RCTs. Review Manager 5.3.0 software was used for statistical analysis. Results Twelve eligible RCTs including 1393 participants were included in this meta-analysis. Our meta-analyses found that lung CT parameters [RR = 1.26, 95% CI (1.15, 1.38), P<0.00001] and the clinical cure rate [RR = 1.26, 95%CI (1.16, 1.38), P<0.00001] of CHM combined with conventional therapy in the treatment of mild to moderate COVID-19 were better than those of conventional therapy. The rate of conversion to severe cases [RR = 0.48, 95%CI (0.32, 0.73), P = 0.0005], TCM symptom score of fever [MD = -0.62, 95%CI (-0.79, -0.45), P<0.00001], cough cases [RR = 1.43, 95%CI (1.16, 1.75), P = 0.0006], TCM symptom score of cough[MD = -1.07, 95%CI (-1.29, -0.85), P<0.00001], TCM symptom score of fatigue[MD = -0.66, 95%CI (-1.05, -0.28), P = 0.0007], and CRP[MD = -5.46, 95%CI (-8.19, -2.72), P<0.0001] of combination therapy was significantly lower than that of conventional therapy. The WBC count was significantly higher than that of conventional therapy[MD = 0.38, 95%CI (0.31, 0.44), P<0.00001]. Our meta-analysis results were robust through sensitivity analysis. Conclusion Chinese herbal medicine combined with conventional therapy may be effective and safe in the treatment of mild to moderate COVID-19. More high-quality RCTs are needed in the future.

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Adjuvant Therapy of Oral Chinese Herbal Medicine for Menopausal Depression: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2018/7420394 ◽

2018 ◽

Vol 2018 ◽

pp. 1-14 ◽

Cited By ~ 1

Author(s):

Jiju Wang ◽

Jian Liu ◽

Xiaojia Ni ◽

Guangning Nie ◽

Yuyan Zeng ◽

...

Keyword(s):

Herbal Medicine ◽

Adjuvant Therapy ◽

Chinese Herbal Medicine ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Cochrane Central Register ◽

Chinese Herbal ◽

The People ◽

Menopausal Depression

Objective. The aim of this meta-analysis was to evaluate the effectiveness of oral Chinese herbal medicine (OCHM) combined with pharmacotherapy for menopausal depression. Methods. The electronic databases were searched from their inception to December 25, 2016, comprising PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure (CNKI), Wanfang database, and Chinese Biomedical (CBM) database. Randomized controlled trials investigating the effectiveness of OCHM combined with pharmacotherapy for the people with menopausal depression were eligible. Risk of bias was evaluated according to the Cochrane handbook. Meta-analyses were performed to pool the effect size. Heterogeneity and publication bias were also examined. Results. Twenty-two RCTs with 1770 participants were included in the review. None of the studies used placebo as the control and the risk of bias was high in blinding the participants and personnel. Overall, the meta-analysis demonstrated that adjuvant therapy of OCHM was effective in reducing the Hamilton Rating Scale for Depression (HAMD) scores compared to pharmacotherapy (MD = −3.75; 95% CI = −5.22, −2.29; P < 0.00001). The meta-analysis also suggested that OCHM adjuvant therapy for menopausal depression was superior to pharmacotherapy in terms of response rate of reducing HAMD scores (RR = 1.17; 95% CI = 1.10, 1.25; I2 = 55%). Conclusions. OCHM may provide additional effectiveness to pharmacotherapy for the people with menopausal depression. RCTs including the placebo control were required to further determine the additional efficacy of OCHM for menopausal depression.

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Chinese herbal medicine for functional dyspepsia: a network meta-analysis of prokinetic-controlled randomised trials

Chinese Medicine ◽

10.1186/s13020-021-00556-6 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Leonard Ho ◽

Claire C. W. Zhong ◽

Charlene H. L. Wong ◽

Justin C. Y. Wu ◽

Karina K. H. Chan ◽

...

Keyword(s):

Herbal Medicine ◽

Adverse Events ◽

Beneficial Effect ◽

Chinese Herbal Medicine ◽

Comparative Effectiveness ◽

Meta Analysis ◽

Random Effect ◽

Chinese Herbal ◽

Meta Analyses

Abstract Background Prokinetic is the first-line conventional treatment for functional dyspepsia (FD) in Asia despite potential adverse events. Chinese herbal medicine (CHM) may be an effective and safe substitution. This network meta-analysis (NMA) aimed to evaluate the comparative effectiveness of different CHM formulae for FD against prokinetics. Methods Seven international and Chinese databases were searched from their inception to July 2020 for randomised controlled trials (RCTs) on CHM versus prokinetics. Data from each RCT were first pooled using random-effect pairwise meta-analyses and illustrated as risk difference (RD) or standardised mean difference (SMD) with 95% confidence interval (CI). Random-effect NMAs were then performed to evaluate the comparative effectiveness of CHM formulae and displayed as RD with 95% CI or SMD with 95% credible interval (CrI). The GRADE partially contextualised framework was applied for NMA result interpretation. Results Twenty-six unique CHM formulae were identified from twenty-eight RCTs of mediocre quality. Pairwise meta-analyses indicated that CHM was superior to prokinetics in alleviating global symptoms at 4-week follow-up (pooled RD: 0.14; 95% CI: 0.10–0.19), even after trim and fill adjustment for publication bias. NMAs demonstrated that Modified Zhi Zhu Decoction may have a moderate beneficial effect on alleviating global symptoms at 4-week follow-up (RD: 0.28; 95% CI: − 0.03 to 0.75). Xiao Pi Kuan Wei Decoction may have a large beneficial effect on alleviating postprandial fullness (SMD: − 2.14; 95% CI: − 2.76 to 0.70), early satiety (SMD: − 3.90; 95% CI: − 0.68 to − 0.42), and epigastric pain (SMD: − 1.23; 95% CI: − 1.66 to − 0.29). No serious adverse events were reported. Conclusion Modified Zhi Zhu Decoction and Xiao Pi Kuan Wei Decoction may be considered as an alternative for patients unresponsive to prokinetics. Confirmatory head-to-head trials should be conducted to investigate their comparative effectiveness against prokinetics.

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Add-On Effect of Honeysuckle in the Treatment of Coronavirus Disease 2019: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.708636 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xu-Qin Du ◽

Li-Peng Shi ◽

Wen-Fu Cao ◽

Zhi-Wei Chen ◽

Biao Zuo ◽

...

Keyword(s):

Herbal Medicine ◽

Combination Therapy ◽

Symptom Score ◽

Chinese Herbal Medicine ◽

Conventional Therapy ◽

Clinical Cure ◽

Clinical Cure Rate ◽

Cochrane Library ◽

Cure Rate ◽

Chinese Herbal

Background: The outbreak of coronavirus disease 2019 (COVID-19) has rapidly spread to become a global emergency since December 2019. Chinese herbal medicine plays an important role in the treatment of COVID-19. Chinese herbal medicine honeysuckle is an extremely used traditional edible and medicinal herb. Many trials suggest that honeysuckle has obtained a good curative effect for COVID-19; however, no systematic evaluation on the clinical efficacy of honeysuckle in the treatment of COVID-19 is reported. This study aimed to evaluate the efficacy and safety of Chinese herbal medicine honeysuckle in the treatment of COVID-19.Methods: Seven electronic databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database, and China Biology Medicine) were searched to identify randomized controlled trials (RCTs) of honeysuckle for adult patients (aged ≥ 18 years) with COVID-19. The Cochrane Risk of Bias Tool was applied to assess the methodological quality of trials. Review Manager 5.3 software was used for data analysis.Results: Overall, nine RCTs involving 1,286 patients were enrolled. Our meta-analyses found that combination therapy of honeysuckle and conventional therapy was more effective than conventional therapy alone in lung computed tomography (CT) [relative risk (RR) = 1.24, 95% confidence interval (95%CI) (1.12, 1.37), P < 0.0001], clinical cure rate [RR = 1.21, 95%CI (1.12, 1.31), P < 0.00001], and rate of conversion to severe cases [RR = 0.50, 95%CI (0.33, 0.76), P = 0.001]. Besides, combination therapy can improve the symptom score of fever, cough reduction rate, symptom score of cough, and inflammatory biomarkers (white blood cell (WBC) count; C-reactive protein (CRP)) (P < 0.05).Conclusion: Honeysuckle combined with conventional therapy may be beneficial for the treatment of COVID-19 in improving lung CT, clinical cure rate, clinical symptoms, and laboratory indicators and reducing the rate of conversion to severe cases. Besides, combination therapy did not increase adverse drug events. More high-quality RCTs are needed in the future.

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Chinese herbal medicine for postpartum constipation: a protocol of systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2018-023941 ◽

2019 ◽

Vol 9 (1) ◽

pp. e023941 ◽

Cited By ~ 1

Author(s):

Jingbo Zhai ◽

Yan Li ◽

Jingyi Lin ◽

Shuo Dong ◽

Jinhua Si ◽

...

Keyword(s):

Systematic Review ◽

Herbal Medicine ◽

Chinese Herbal Medicine ◽

Meta Analysis ◽

Random Effect Model ◽

Gastrointestinal Symptoms ◽

Publication Date ◽

Cochrane Central Register ◽

Chinese Herbal ◽

Effect Model

IntroductionConstipation is one of the most common gastrointestinal symptoms in postpartum mothers. The choice of treatments for postpartum constipation remains a challenging clinical problem. Chinese herbal medicine has become increasingly popular as an alternative therapy for constipation. This systematic review aims to evaluate the efficacy and safety of Chinese herbal medicine for postpartum constipation.Methods and analysisWe will search PubMed (1946 to present), EMBASE (1974 to present), Cochrane Central Register of Controlled Trials (all years), Web of Science (1900 to present), Chinese Biomedical Literatures Database (1978 to present), China National Knowledge Infrastructure (1979 to present) and WANFANG data (1998 to present) to identify any eligible study. No restriction will be put on the language, publication date or status of the study. The primary outcome will be the spontaneous bowel movement. Secondary outcomes will be stool consistency, quality of life, transit time, relief of constipation symptoms and adverse events. We will perform the meta-analysis when more than one trial examines the same intervention and outcomes with comparable methods in similar populations. If the heterogeneity is not significant statistically (p>0.10 or I2<50%), the fixed-effect model will be built to estimate the overall intervention effects. Otherwise, the random-effect model will be used to provide more conservative results.Ethics and disseminationNo ethical issues are foreseen because no primary data will be collected. The results will be published in a peer-reviewed scientific journal.PROSPERO registration numberCRD42018093741

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Chinese herbal medicine for functional dyspepsia: systematic review of systematic reviews

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284818785573 ◽

2018 ◽

Vol 11 ◽

pp. 175628481878557 ◽

Cited By ~ 8

Author(s):

Michael H. K. Chu ◽

Irene X. Y. Wu ◽

Robin S. T. Ho ◽

Charlene H. L. Wong ◽

Anthony L. Zhang ◽

...

Keyword(s):

Systematic Review ◽

Herbal Medicine ◽

Functional Dyspepsia ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Chinese Herbal Medicine ◽

Meta Analysis ◽

Chinese Herbal ◽

Dyspeptic Symptoms ◽

Meta Analyses

Background: Pharmacotherapy, including prokinetics and proton pump inhibitors for functional dyspepsia (FD) have limited effectiveness, and their safety has been recently questioned. Chinese herbal medicine (CHM) could be considered as an alternative. A systematic review (SR) of SRs was performed to evaluate the potential effectiveness and safety of CHM. Method: We conducted a comprehensive literature search for SRs with meta-analyses in eight international and Chinese databases. Pooled effect estimation from each meta-analysis was extracted. The AMSTAR instrument was used to assess the methodological quality of the included SRs. Results: A total of 14 SRs of mediocre quality assessing various CHMs, alone or in combination with conventional pharmacotherapy, were included. Meta-analyses showed that CHM was more effective than prokinetic agents for the alleviation of global dyspeptic symptoms. Three specific CHM formulae appeared to show superior results in the alleviation of global dyspeptic symptoms, including Si Ni San, modified Xiao Yao San and Xiang Sha Liu Jun Zi decoction. No significant difference in the occurrence of adverse events in using CHM or pharmacotherapy was reported. Conclusion: CHM can be considered as an alternative for the treatment of FD symptoms when prokinetic agents and proton pump inhibitors are contraindicated. Future trial design should focus on measuring changes in individual dyspeptic symptoms and differentiate the effectiveness of different CHM for postprandial distress syndrome and epigastric pain syndrome. A network meta-analysis approach should be used to explore the most promising CHM formula for FD treatment in the future.

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Traditional Chinese herbal medicine for treating novel coronavirus (COVID-19) pneumonia: protocol for a systematic review and meta-analysis

10.21203/rs.2.23447/v2 ◽

2020 ◽

Author(s):

Yuxi Li ◽

Xiaobo Liu ◽

Liuxue Guo ◽

Juan Li ◽

Dongling Zhong ◽

...

Keyword(s):

Systematic Review ◽

Herbal Medicine ◽

Chinese Herbal Medicine ◽

Meta Analysis ◽

Biomedical Literature ◽

World Health ◽

Cochrane Central Register ◽

Traditional Chinese Herbal Medicine ◽

Chinese Herbal ◽

Novel Coronavirus

Abstract Background A new type of coronavirus, novel coronavirus (COVID-19), is causing an increasing number of cases of pneumonia and was declared a Public Health Emergency of International Concern by the World Health Organization on 30 January 2020. The virus first appeared in Wuhan, China in late December 2019 and traditional Chinese herbal medicine is being used for its treatment. This systematic review and meta-analysis will assess studies of the effects of traditional Chinese herbal medicine in COVID-19 pneumonia. Methods We will search electronic databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP) and Wanfang database using keywords related to COVID-19 and traditional Chinese herbal medicine. Reference lists of relevant trials and reviews will be searched. We will manually search grey literature, such as conference proceedings and academic degree dissertations, and trial registries. Two independent reviewers will screen studies (XL and DZ), extract data (YL and LG) and evaluate risk of bias (YL and DZ). Data analysis will be conducted using Review Manager software (version 5.3.5) and R software (version 3.6.1). Statistical heterogeneity will be assessed using a standard Chi-square test with a significance level of P < 0.10. Biases associated with study size (e.g. publication bias) will be investigated using funnel plots, the Egger 's test and Begg 's test and Trim and Fill analysis. Discussion This study will provide a high-quality synthesis of the effects of traditional Chinese herbal medicine for COVID-19. The use of traditional Chinese herbal medicine for treatment or prevention of these novel viral infections affecting the pneumonia will be investigated. Systematic review registration PROSPERO registration number: CRD42020168004

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