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

IF 1.7 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

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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.

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新型冠状病毒肺炎中草药方剂附加疗效研究：系统综述

2019冠状病毒病（COVID-19）在全球迅速蔓延，使医疗保健系统不堪重负。大量临床试验探索了中药方剂治疗新冠肺炎的疗效，导致系统评价（SRs）激增。本综述严格评估了CHFs对COVID-19的附加有效性，旨在为高质量的研究和综合治疗策略提供坚实的基础。方法本综述符合prisma标准，在PROSPERO注册。我们纳入了评估口服CHFs联合指南推荐的标准治疗（ST）的SRs，以及COVID-19患者的ST。主要结局包括临床改善（例如，无需呼吸机支持的天数）和恶化（例如，需要新的氧气治疗）。检索PubMed、Cochrane Library、Embase、中国医学信息网、中国知网、万方网和维普网，从建库到2024年7月1日，检索报告预定义结果的随机对照试验的sr （Cochrane/非Cochrane）。使用RevMan 5.3进行二级荟萃分析，通过AMSTAR-II和GRADE评估方法学质量和证据确定性。结果共纳入8例SRs（6860例）。meta分析显示，CHF联合ST在降低全因死亡率（RR = 0.27, 95% CI [0.08-0.96], P = 0.04）和不良事件(RR = 0.34, 95% CI [0.20-0.59], P <；0.0001)、重症转化（RR = 0.33, 95% CI [0.17-0.66], P = 0.002）和改善肺部影像学（RR = 1.28, 95% CI [1.12-1.46], P = 0.0003）。临床症状恢复率（咳嗽）或恢复时间（咳嗽和疲劳）无显著差异。气泡图显示，特定CHFs（如补中益气汤、麻星石肝胃经汤）对病毒清除、重症病例转化、不良事件和肺部影像学的影响弱至中等。结论综合分析表明，CHFs治疗COVID-19具有良好的附加效果。然而，值得注意的是，这些研究的总体证据质量普遍较低，需要进一步的高质量临床试验来验证这些发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.