Insights into add-on effectiveness of Chinese herbal formulae in COVID-19: An overview of systematic reviews

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine Pub Date : 2025-04-01 DOI:10.1016/j.eujim.2025.102440

Bo Li , Yi-Ying Wang , Le-yan Hu , Jie Lian , Shuai Dong , Guo-dong Li , Jia-xin Wang , Zheng Li , Hui-juan Cao

{"title":"Insights into add-on effectiveness of Chinese herbal formulae in COVID-19: An overview of systematic reviews","authors":"Bo Li , Yi-Ying Wang , Le-yan Hu , Jie Lian , Shuai Dong , Guo-dong Li , Jia-xin Wang , Zheng Li , Hui-juan Cao","doi":"10.1016/j.eujim.2025.102440","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Coronavirus Disease 2019 (COVID-19) has rapidly spread worldwide, overwhelming healthcare systems. Numerous clinical trials have explored the efficacy of Chinese herbal formulae (CHFs) in treating COVID-19, resulting in a surge of systematic reviews (SRs). This review critically evaluates the additive effectiveness of CHFs for COVID-19, aiming to provide a robust foundation for high-quality research and integrated therapeutic strategies.</div></div><div><h3>Methods</h3><div>This PRISMA-compliant review was registered on PROSPERO. We included SRs assessed oral CHFs combined with guideline recommended Standard Treatment (ST), versus ST in patients with COVID-19 patients. Primary outcomes included clinical improvement (e.g., days without ventilator support) and deterioration (e.g., new need for oxygen therapy). PubMed, Cochrane Library, Embase, Sinomed, CNKI, Wanfang, and VIP were searched from inception to July 1, 2024, for SRs (Cochrane/non-Cochrane) of RCTs reporting predefined outcomes. Secondary meta-analyses were conducted using RevMan 5.3, with methodological quality and evidence certainty assessed via AMSTAR-II and GRADE.</div></div><div><h3>Results</h3><div>Eight SRs (6860 cases) were included. Meta-analyses showed that CHF combined with ST outperformed ST alone in reducing all-cause mortality (RR = 0.27, 95 %CI [0.08–0.96], <em>P</em> = 0.04), adverse events (RR = 0.34, 95 %CI [0.20–0.59], <em>P</em> < 0.0001), severe case conversion (RR = 0.33, 95 %CI [0.17–0.66], <em>P</em> = 0.002), and improving pulmonary imaging (RR = 1.28, 95 %CI [1.12–1.46], <em>P</em> = 0.0003). No significant differences were observed in clinical symptom recovery rates (cough) or recovery times (cough and fatigue). Bubble plots suggested weak to moderate effects of specific CHFs (e.g., <em>Buzhongyiqi Decoction, Maxingshigan-Weijing Decoction</em>) on viral clearance, severe case conversion, adverse events, and pulmonary imaging.</div></div><div><h3>Conclusion</h3><div>Comprehensive analyses indicated that CHFs showed good add-on effect in treating COVID-19. However, it is important to note that the overall quality of evidence in these studies is generally low, and further high-quality clinical trials are needed to validate these findings.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"75 ","pages":"Article 102440"},"PeriodicalIF":1.9000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Integrative Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1876382025000125","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Coronavirus Disease 2019 (COVID-19) has rapidly spread worldwide, overwhelming healthcare systems. Numerous clinical trials have explored the efficacy of Chinese herbal formulae (CHFs) in treating COVID-19, resulting in a surge of systematic reviews (SRs). This review critically evaluates the additive effectiveness of CHFs for COVID-19, aiming to provide a robust foundation for high-quality research and integrated therapeutic strategies.

Methods

This PRISMA-compliant review was registered on PROSPERO. We included SRs assessed oral CHFs combined with guideline recommended Standard Treatment (ST), versus ST in patients with COVID-19 patients. Primary outcomes included clinical improvement (e.g., days without ventilator support) and deterioration (e.g., new need for oxygen therapy). PubMed, Cochrane Library, Embase, Sinomed, CNKI, Wanfang, and VIP were searched from inception to July 1, 2024, for SRs (Cochrane/non-Cochrane) of RCTs reporting predefined outcomes. Secondary meta-analyses were conducted using RevMan 5.3, with methodological quality and evidence certainty assessed via AMSTAR-II and GRADE.

Results

Eight SRs (6860 cases) were included. Meta-analyses showed that CHF combined with ST outperformed ST alone in reducing all-cause mortality (RR = 0.27, 95 %CI [0.08–0.96], P = 0.04), adverse events (RR = 0.34, 95 %CI [0.20–0.59], P < 0.0001), severe case conversion (RR = 0.33, 95 %CI [0.17–0.66], P = 0.002), and improving pulmonary imaging (RR = 1.28, 95 %CI [1.12–1.46], P = 0.0003). No significant differences were observed in clinical symptom recovery rates (cough) or recovery times (cough and fatigue). Bubble plots suggested weak to moderate effects of specific CHFs (e.g., Buzhongyiqi Decoction, Maxingshigan-Weijing Decoction) on viral clearance, severe case conversion, adverse events, and pulmonary imaging.

Conclusion

Comprehensive analyses indicated that CHFs showed good add-on effect in treating COVID-19. However, it is important to note that the overall quality of evidence in these studies is generally low, and further high-quality clinical trials are needed to validate these findings.

查看原文本刊更多论文

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

4.70

自引率

4.00%

发文量

102

审稿时长

33 days

期刊介绍： The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.