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

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

doi:10.1186/s13020-022-00600-z

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

Chin Med. 2022 Jun 21;17(1):77. doi: 10.1186/s13020-022-00600-z.

Authors

Lu Li^#^{1

2

3

4

5}, Hongliang Xie^#^{1

2}, Ling Wang⁶, Aolin Zhang^{1

2}, Xuan Mou^{1

2}, Yifan Lin⁶, Hongli Ma⁷, Yu Wang⁷, Jian Li^{7

8}, Jingshu Gao⁷, Chi Chiu Wang^{4

9}, Ping Chung Leung⁵, Xiaohui Fan^{10

11}, Xiaoke Wu^{12

13}

Affiliations

¹ Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.
² Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China.
³ Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, Hangzhou, 310016, China.
⁴ Department of Obstetrics and Gynaecology, Li Ka Shing Institute of Health Sciences; School of Biomedical Sciences, Sichuan University-Chinese University of Hong Kong Joint Reproductive Medicine Laboratory, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China.
⁵ Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China.
⁶ Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, China.
⁷ Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.
⁸ Department of Obstetrics and Gynecology, Affiliated Hospital, Guizhou Medical University, Guiyang, 550000, China.
⁹ College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
¹⁰ Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China. [email protected].
¹¹ Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China. [email protected].
¹² Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China. [email protected].
¹³ Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, 150040, China. [email protected].

^# Contributed equally.

Abstract

Objective: To systematically review the clinical efficacy and safety of Chinese herbal medicine (CHM) with and without Western medicine (WM) for different severity of COVID-19.

Methods: CNKI, PubMed, Wanfang Database, ClinicalTrails.gov, Embase, ChiCTR and ICTRP were searched from 01 Jan, 2020 to 30 Jun, 2021. Two authors independently assessed all the randomized clinical trials (RCTs) for trial inclusion, data extraction and quality assessment. Meta-analysis was conducted using Review Manager software (RevMan 5.4.1). Evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Primary outcomes included total effectiveness rate. Secondary outcomes included improvements in symptom improvement and total adverse event rate. Different severity of COVID-19 patients was assessed in subgroup analysis. This study was registered with INPLASY, INPLASY202210072.

Results: 22 high quality RCTs involving 1789 participants were included. There were no trial used CHM alone nor compare placebo or no treatment. Compared with WM, combined CHM and WM (CHM-WM) treatment showed higher total effectiveness rate, lower symptom scores of fever, cough, fatigue, dry throat and pharyngalgia, shorter mean time to viral conversion, better Computerized Tomography (CT) image and blood results, fewer total adverse events and worse conditions (P < 0.05). Subgroup analysis showed that the total effectiveness rate of combined CHM-WM group was significantly higher than WM group, especially for mild and moderate patients. No significant differences in mortality and adverse events were found between combined CHM-WM and WM treatment. No serious adverse events and long-term outcomes were reported.

Conclusion: Current evidence supported the therapeutic effects and safety of combined CHM-WM treatment on COVID-19, especially for patients with mild and moderate symptoms. Long-term effects of therapy are worthy in further study.

Keywords: Combined Chinese Herbal Medicine-Western Medicine therapy; Corona Virus Disease 2019 severity; Meta-analysis; Systematic review.

Publication types

Review

Abstract

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