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Yang L, Zhang X, Wang Z, Lin X, Zhang Y, Lu J, Wu L, Yao S, Jing W, Huang X, Wang P. Decoction regulating phytochemicals' micromorphology changes and anti-inflammation activity enhancements originated from herb medicine supermolecules. Chin Med 2024; 19:19. [PMID: 38279104 PMCID: PMC10811931 DOI: 10.1186/s13020-023-00864-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/21/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Mahuang Fuzi decoction (MGF) is composed of three herb medicines that has been clinically used to treat inflammatory diseases for a long history. At present, more and more active phytochemicals' aggregations have been found during the thermodynamic process of herb medicine decoction, and revealing the clinical efficacy of herb medicine through supramolecular strategies is the focus of current research. However, it is not clear whether decoction induced supermolecules' morphological changes to modify activity. METHODS Dynamic light scattering (DLS) and field emission scanning electron microscopy (FESEM) were used to analyze the micromorphology of MGF, MGF SA (MGF supermolecules), and MIX (physical mixture of MGF single decoction). The interaction and thermodynamic parameters of single herbs in a decoction were investigated by Isothermal titration calorimetry (ITC). The phytochemicals were systematically analyzed by ultra high performance liquid chromatography-Q Exactive hybrid quadrupole-orbitrap high-resolution accurate mass spectrometry (UHPLC-Q-Orbitrap HRMS). Under the safe dose on RAW264.7 cells, NO, IL-6 and TNF-α were determined by Enzyme-Linked ImmunoSorbent Assay (ELISA) method. NF-κB p65 translocation from the cytoplasm into the nucleus was examined using the immunofluorescence assay and the western blot, respectively. Furthermore, Metabolomics was used to discover potential biomarkers and the associated metabolic pathways of MGF SA treatment. RESULTS There were nanoscale aggregations in MGF, and the micromorphology of the extracted MGF SA consisted of uniform particles; while the MIX micromorphology had no uniformity. ITC showed that the interaction MH-GC and FZ-GC were a spontaneous exothermic reaction, indicating that their phytochemicals had the property of self-assembly. Though the micromorphology between MGF, MGF SA, and MIX was obviously different, UHPLC-Q-Orbitrap HRMS results displayed that the main phytochemicals of MGF and MIX had nearly the same components. Interestingly, MGF and MGF SA could significantly inhibit the production of NO, and had better inhibition effect on the expression of nuclear protein NF-κB p65 than MIX, among which MGF SA had the best effect. Further investigation indicated that the perturbance of metabolic profiling in RAW264.7 inflammatory cells was obviously reversed by MGF SA. CONCLUSIONS The decoction enriched the key active phytochemicals and regulated the formation of homogeneous nanoparticles in MGF SA. The supermolecules in MGF SA significantly enhanced its anti-inflammatory activity, primarily affecting the NF-κB signaling pathway and the biosynthesis and metabolism of arginine in RAW264.7 inflammatory cells. Current study displayed that co-decocting herbal medicine were beneficial to the treatment of diseases than the mixture of the single herbs' extraction.
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Affiliation(s)
- Luping Yang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Xiang Zhang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Zhijia Wang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Xiaoyu Lin
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Yaozhi Zhang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Jihui Lu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Linying Wu
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Shuchang Yao
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Wenguang Jing
- National Institutes for Food and Drug Control, Beijing, 100050, China.
| | - Xuemei Huang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China.
| | - Penglong Wang
- School of Chinese Pharmacy, Beijing University of Chinese Medicine, Beijing, 102488, China.
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Huang M, Liu YY, Xiong K, Yang FW, Jin XY, Wang ZQ, Zhang JH, Zhang BL. The role and advantage of traditional Chinese medicine in the prevention and treatment of COVID-19. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:407-412. [PMID: 37625946 DOI: 10.1016/j.joim.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/04/2023] [Indexed: 08/27/2023]
Abstract
The global coronavirus disease 2019 (COVID-19) pandemic has had a massive impact on global social and economic development and human health. By combining traditional Chinese medicine (TCM) with modern medicine, the Chinese government has protected public health by supporting all phases of COVID-19 prevention and treatment, including community prevention, clinical treatment, control of disease progression, and promotion of recovery. Modern medicine focuses on viruses, while TCM focuses on differential diagnosis of patterns associated with viral infection of the body and recommends the use of TCM decoctions for differential treatment. This differential diagnosis and treatment approach, with its profoundly empirical nature and holistic view, endows TCM with an accessibility advantage and high application value for dealing with COVID-19. Here, we summarize the advantage of and evidence for TCM use in COVID-19 prevention and treatment to draw attention to the scientific value and accessibility advantage of TCM and to promote the use of TCM in response to public health emergencies. Please cite this article as: Huang M, Liu YY, Xiong K, Yang FW, Jin XY, Wang ZQ, Zhang JH, Zhang BL. The role and advantage of traditional Chinese medicine in the prevention and treatment of COVID-19. J Integr Med. 2023; 21(5): 407-412.
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Affiliation(s)
- Ming Huang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yao-Yuan Liu
- Department of Cardiology, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300193, China
| | - Ke Xiong
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Feng-Wen Yang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Xin-Yao Jin
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Zhao-Qi Wang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jun-Hua Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; State Drug Administration Key Laboratory of Evidence-based Evaluation of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301600, China
| | - Bo-Li Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China.
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Zhong L, Tian L, Ng CYJ, Leung C, Yang X, Liong C, Chen H, Wong R, Ng BFL, Lin Z, Feng Y, Bian Z. Persistent clinical symptoms and their association with CM syndromes in post-COVID-19 rehabilitation patients in Hong Kong. Heliyon 2023; 9:e19410. [PMID: 37810093 PMCID: PMC10558494 DOI: 10.1016/j.heliyon.2023.e19410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 10/10/2023] Open
Abstract
Background Heterogeneous clinical conditions were observed in individuals who had recovered from COVID-19 and some symptoms were found to persist for an extended period post-COVID. Given the non-specific nature of the symptoms, Chinese medicine (CM) is advantageous in providing holistic medical assessment for individuals experiencing persisting problems. Chinese medicine is a type of treatment that involves prescribing regimens based on CM Syndromes diagnosed by CM practitioners. However, inadequate research on CM elements behind the practice has faced scrutiny. Methods This study analysed 1058 CM medical records from 150 post-COVID-19 individuals via a semi-text-mining approach. A logistic model with MCMCglmm was then utilised to analyse the associations between the indicated factors and identified conditions. Calculations were performed using R Studio and related libraries. Results With the semi-text-mining approach, three common CM Syndromes (Qi and Yin Deficiency, Lung and Spleen Deficiency, Qi Deficiency of both Spleen and Lung) and nine clinical conditions (fatigue, poor sleep, dry mouth, shortness of breath, cough, headache, tiredness, sweating, coughing phlegm) were identified in the CM clinical records. Analysis via MCMCglmm revealed that the occurrence of persisting clinical conditions was significantly associated with female gender, existing chronic conditions (hypertension, high cholesterol, and diabetes mellitus), and the three persisting CM Syndromes. The current study triangulated the findings from our previous observational study, further showing that patients with certain post-COVID CM Syndromes had significantly increased log-odds of having persisting clinical conditions. Furthermore, this study elucidated that the presence of chronic conditions in the patients would also significantly increase the log-odds of having persistent post-COVID clinical conditions. Conclusion This study provided insights on mining text-based CM clinical records to identify persistent post-COVID clinical conditions and the factors associated with their occurrence. Future studies could examine the integration of integrating exercise modules, such as health qigong Liuzijue, into multidisciplinary rehabilitation programmes.
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Affiliation(s)
- Linda Zhong
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Liang Tian
- Department of Physics and Institute of Computational and Theoretical Studies, Hong Kong Baptist University, Hong Kong
| | - Chester Yan Jie Ng
- School of Biological Sciences, Nanyang Technological University, Singapore
| | - Choryin Leung
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong
| | - Xian Yang
- Alliance Manchester Business School, The University of Manchester, Singapore
| | - Ching Liong
- School of Chinese Medicine, The Chinese University of Hong Kong
| | - Haiyong Chen
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong
| | - Rowena Wong
- Chinese Medicine Department, Hospital Authority, Hong Kong
| | - Bacon FL. Ng
- Chinese Medicine Department, Hospital Authority, Hong Kong
| | - Z.X. Lin
- School of Chinese Medicine, The Chinese University of Hong Kong
| | - Y.B. Feng
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong
| | - Z.X. Bian
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong
| | - for COVID-19 Research Team
- School of Chinese Medicine, Hong Kong Baptist University, Hong Kong
- Department of Physics and Institute of Computational and Theoretical Studies, Hong Kong Baptist University, Hong Kong
- School of Biological Sciences, Nanyang Technological University, Singapore
- Alliance Manchester Business School, The University of Manchester, Singapore
- School of Chinese Medicine, The Chinese University of Hong Kong
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong
- Chinese Medicine Department, Hospital Authority, Hong Kong
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Tong L, Ma Z, Zhou Y, Yang S, Yang Y, Luo J, Huang J, Wang F. Combination of Chinese herbal medicine and conventional western medicine for coronavirus disease 2019: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1175827. [PMID: 37529247 PMCID: PMC10387529 DOI: 10.3389/fmed.2023.1175827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/29/2023] [Indexed: 08/03/2023] Open
Abstract
Objective This 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. Methods We 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. Results Our 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. Conclusions Potentially, 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 registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=293963.
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Panahi Y, Gorabi AM, Talaei S, Beiraghdar F, Akbarzadeh A, Tarhriz V, Mellatyar H. An overview on the treatments and prevention against COVID-19. Virol J 2023; 20:23. [PMID: 36755327 PMCID: PMC9906607 DOI: 10.1186/s12985-023-01973-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 01/14/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to plague the world. While COVID-19 is asymptomatic in most individuals, it can cause symptoms like pneumonia, ARDS (acute respiratory distress syndrome), and death in others. Although humans are currently being vaccinated with several COVID-19 candidate vaccines in many countries, however, the world still is relying on hygiene measures, social distancing, and approved drugs. RESULT There are many potential therapeutic agents to pharmacologically fight COVID-19: antiviral molecules, recombinant soluble angiotensin-converting enzyme 2 (ACE2), monoclonal antibodies, vaccines, corticosteroids, interferon therapies, and herbal agents. By an understanding of the SARS-CoV-2 structure and its infection mechanisms, several vaccine candidates are under development and some are currently in various phases of clinical trials. CONCLUSION This review describes potential therapeutic agents, including antiviral agents, biologic agents, anti-inflammatory agents, and herbal agents in the treatment of COVID-19 patients. In addition to reviewing the vaccine candidates that entered phases 4, 3, and 2/3 clinical trials, this review also discusses the various platforms that are used to develop the vaccine COVID-19.
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Affiliation(s)
- Yunes Panahi
- grid.411705.60000 0001 0166 0922Pharmacotherapy Department, Faculty of Pharmacy, Bagyattallah University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- grid.411705.60000 0001 0166 0922Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sona Talaei
- grid.449862.50000 0004 0518 4224Department of Basic Sciences, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Fatemeh Beiraghdar
- grid.411521.20000 0000 9975 294XNephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abolfazl Akbarzadeh
- grid.412888.f0000 0001 2174 8913Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahideh Tarhriz
- grid.412888.f0000 0001 2174 8913Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Mellatyar
- grid.411705.60000 0001 0166 0922Pharmacotherapy Department, Faculty of Pharmacy, Bagyattallah University of Medical Sciences, Tehran, Iran
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Li L, Wu Y, Wang J, Yan H, Lu J, Wang Y, Zhang B, Zhang J, Yang J, Wang X, Zhang M, Li Y, Miao L, Zhang H. Potential Treatment of COVID-19 with Traditional Chinese Medicine: What Herbs Can Help Win the Battle with SARS-CoV-2? ENGINEERING (BEIJING, CHINA) 2022; 19:139-152. [PMID: 34729244 PMCID: PMC8552808 DOI: 10.1016/j.eng.2021.08.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/28/2021] [Accepted: 08/03/2021] [Indexed: 05/05/2023]
Abstract
Traditional Chinese medicine (TCM) has been successfully applied worldwide in the treatment of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the pharmacological mechanisms underlying this success remain unclear. Hence, the aim of this review is to combine pharmacological assays based on the theory of TCM in order to elucidate the potential signaling pathways, targets, active compounds, and formulas of herbs that are involved in the TCM treatment of COVID-19, which exhibits combatting viral infections, immune regulation, and amelioration of lung injury and fibrosis. Extensive reports on target screening are elucidated using virtual prediction via docking analysis or network pharmacology based on existing data. The results of these reports indicate that an intricate regulatory mechanism is involved in the pathogenesis of COVID-19. Therefore, more pharmacological research on the natural herbs used in TCM should be conducted in order to determine the association between TCM and COVID-19 and account for the observed therapeutic effects of TCM against COVID-19.
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Affiliation(s)
- Lin Li
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yuzheng Wu
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Laboratory of Pharmacology of TCM Formulae Co-Constructed by the Province-Ministry, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jiabao Wang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Huimin Yan
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jia Lu
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yu Wang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Boli Zhang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Junhua Zhang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jian Yang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Xiaoying Wang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Min Zhang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yue Li
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Lin Miao
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Han Zhang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Key Laboratory of Pharmacology of Traditional Chinese Medical Formulae, Ministry of Education, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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Liu Y, Xia K, Liu S, Wang W, Li G. Ginseng as a Key Immune Response Modulator in Chinese Medicine: From Antipandemic History to COVID-19 Management. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 51:19-34. [PMID: 36419254 DOI: 10.1142/s0192415x23500027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The cytokine storm plays an indispensable role in the severe and critical illness and death of the COVID-19 vulnerable population. Thus, suppressing the cytokine storm is of great significance. Ginseng is a traditional Chinese herb originally used for improving physiological conditions and ameliorating disease. Common throughout the history of ancient Chinese medicine is utilizing ginseng as a major ingredient to successfully fight various pandemics, and the most famous decoction is Renshen Baidu powder. In recent years, ginseng has been observed to provide preventive and therapeutic benefits in the treatment of various conditions by suppressing hyper-inflammation, inhibiting virus intrusion, and balancing the host's immunity. This paper summarizes the ancient Chinese medicine books' recordings of, the clinical practice of, and the laboratory exploration of ginseng for the treatment of pandemics and COVID-19. Ginseng and its active ingredients were found to downregulate inflammatory cytokines, upregulate anti-inflammatory cytokines, stimulate the secretion of the antiviral cytokine IFN-[Formula: see text], prevent viral entry and replication, and improve viral clearance. Furthermore, ginseng modulates both natural and acquired immunity during viral infection. Collectively, we propose that ginseng can act as a key immune response modulator against the cytokine storm of COVID-19. This paper may provide a new approach to discover specific medications using ginseng to combat COVID-19.
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Affiliation(s)
- Yanyi Liu
- Department of Respiratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China.,Beijing University of Chinese Medicine, Beijing 100029, P. R. China
| | - Kun Xia
- Department of Respiratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Shixu Liu
- Department of Respiratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Wei Wang
- Department of Respiratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
| | - Guangxi Li
- Department of Respiratory, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, P. R. China
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Li M, Zhu H, Liu Y, Lu Y, Sun M, Zhang Y, Shi J, Shi N, Li L, Yang K, Sun X, Liu J, Ge L, Huang L. Role of Traditional Chinese Medicine in Treating Severe or Critical COVID-19: A Systematic Review of Randomized Controlled Trials and Observational Studies. Front Pharmacol 2022; 13:926189. [PMID: 35910363 PMCID: PMC9336221 DOI: 10.3389/fphar.2022.926189] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) continues to spread globally. Due to the higher risk of mortality, the treatment of severe or critical patients is a top priority. Traditional Chinese medicine (TCM) treatment has played an extremely important role in the fight against COVID-19 in China; a timely evidence summary on TCM in managing COVID-19 is crucial to update the knowledge of healthcare for better clinical management of COVID-19. This study aimed to assess the effects and safety of TCM treatments for severe/critical COVID-19 patients by systematically collecting and synthesizing evidence from randomized controlled trials (RCTs) and observational studies (e.g., cohort).Methods: We searched nine databases up to 19th March 2022 and the reference lists of relevant publications. Pairs of reviewers independently screened studies, extracted data of interest, and assessed risk of bias. We performed qualitative systematic analysis with visual presentation of results and compared the direction and distribution of effect estimates for each patient’s important outcome. We performed sensitivity analyses to observe the robustness of results by restricting analysis to studies with low risk of bias.Results: The search yielded 217,761 records, and 21 studies (6 RCTs and 15 observational studies) proved eligible. A total of 21 studies enrolled 12,981 severe/critical COVID-19 patients with a mean age of 57.21 years and a mean proportion of men of 47.91%. Compared with usual supportive treatments, the effect estimates of TCM treatments were consistent in direction, illustrating that TCM treatments could reduce the risk of mortality, rate of conversion to critical cases, and mechanical ventilation, and showed significant advantages in shortening the length of hospital stay, time to viral clearance, and symptom resolution. The results were similar when we restricted analyses to low-risk-bias studies. No serious adverse events were reported with TCM treatments, and no significant differences were observed between groups.Conclusion: Encouraging evidence suggests that TCM presents substantial advantages in treating severe/critical COVID-19 patients. TCM has a safety profile that is comparable to that of conventional treatment alone. TCMs have played an important role in China’s prevention and treatment of COVID-19, which sets an example of using traditional medicine in preventing and treating COVID-19 worldwide.
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Affiliation(s)
- Mengting Li
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
| | - Hongfei Zhu
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yafei Liu
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yao Lu
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
| | - Minyao Sun
- Evidence Based Nursing Centre, School of Nursing, Lanzhou University, Lanzhou, China
| | - Yuqing Zhang
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- CEBIM (Center for Evidence Based Integrative Medicine)-Clarity Collaboration, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- Nottingham Ningbo GRADE Center, The University of Nottingham Ningbo, Ningbo, China
| | - Jiaheng Shi
- China Center for Evidence Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- Department of Emergency, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Nannan Shi
- China Center for Evidence Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ling Li
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
| | - Xin Sun
- Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xin Sun, ; Jie Liu, ; Long Ge, ; Luqi Huang,
| | - Jie Liu
- China Center for Evidence Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- Department of Oncology, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Xin Sun, ; Jie Liu, ; Long Ge, ; Luqi Huang,
| | - Long Ge
- Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China
- WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China
- Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China
- *Correspondence: Xin Sun, ; Jie Liu, ; Long Ge, ; Luqi Huang,
| | - Luqi Huang
- China Center for Evidence Based Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- National Resource Center for Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Xin Sun, ; Jie Liu, ; Long Ge, ; Luqi Huang,
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Li L, Xie H, Wang L, Zhang A, Mou X, Lin Y, Ma H, Wang Y, Li J, Gao J, Wang CC, Leung PC, Fan X, Wu X. 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; 17:77. [PMID: 35729581 PMCID: PMC9210065 DOI: 10.1186/s13020-022-00600-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/26/2022] [Indexed: 11/10/2022] Open
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.
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Affiliation(s)
- Lu Li
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.,Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China.,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.,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.,Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Hongliang Xie
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.,Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China
| | - Ling Wang
- Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Aolin Zhang
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.,Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China
| | - Xuan Mou
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China.,Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China
| | - Yifan Lin
- Hangzhou TCM Hospital of Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Hongli Ma
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Yu Wang
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Jian Li
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China.,Department of Obstetrics and Gynecology, Affiliated Hospital, Guizhou Medical University, Guiyang, 550000, China
| | - Jingshu Gao
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China
| | - Chi Chiu Wang
- 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.,College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Ping Chung Leung
- Institute of Chinese Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Xiaohui Fan
- Pharmaceutical Informatics Institute, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China. .,Innovation Center in Zhejiang University, State Key Laboratory of Component-Based Chinese Medicine, Hangzhou, 310058, China.
| | - Xiaoke Wu
- Department of Obstetrics and Gynecology, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, 150040, China. .,Heilongjiang Provincial Hospital, Harbin Institute of Technology, Harbin, 150040, China.
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10
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Ang L, Song E, Hu XY, Lee HW, Chen Y, Lee MS. Herbal Medicine Intervention for the Treatment of COVID-19: A Living Systematic Review and Cumulative Meta-Analysis. Front Pharmacol 2022; 13:906764. [PMID: 35795550 PMCID: PMC9251500 DOI: 10.3389/fphar.2022.906764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/23/2022] [Indexed: 11/24/2022] Open
Abstract
Background: Integrative herbal medicine has been reported to have beneficial effects in the treatment of coronavirus disease 2019 (COVID-19). Aim: To compile up-to-date evidence of the benefits and risks of herbal medicine for the treatment of COVID-19 symptoms. Methods: Eleven databases, including PubMed, Cochrane Register of Controlled Trials (CENTRAL), Embase, Allied and Complementary Medicine Database (AMED), Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Chinese Science and Technique Journals Database (VIP), Research Information Service System (RISS), Korean Medical database (KMBase), Korean Association of Medical Journal database (KoreaMed), and OASIS database, were searched from 15 June, 2020, until 28 March 2022. Randomized controlled trials (RCTs), published in any language, reporting the efficacy and safety outcomes of herbal medicine in patients of all ages with a PCR-confirmed diagnosis of COVID-19 were included in this analysis. Data extraction and quality assessments were performed independently. Results: Random-effects meta-analyses showed evidence of favorable effects of treatment with herbal medicine when added to standard treatment, versus standard treatment alone, on the total effective rate (p = 0.0001), time to remission from fever (p < 0.00001), rate of remission from coughing (p < 0.0001), fatigue (p = 0.02), sputum production (p = 0.004), improvement of manifestations observed on chest computed tomography scans (p < 0.00001), incidence of progression to severe COVID-19 (p = 0.003), all-cause mortality (p = 0.003), time to a negative COVID-19 coronavirus test (p < 0.0001), and duration of hospital stay (p = 0.0003). There was no evidence of a difference between herbal medicine added to standard treatment, versus standard treatment alone, on the rate of remission from symptoms such as a fever, sore throat, nasal congestion and discharge, diarrhea, dry throat, chills, and the rate of conversion to a negative COVID-19 coronavirus test. Meta-analysis showed no evidence of a significant difference in adverse events between the two groups. There was an unclear risk of bias across the RCTs included in this analysis, indicating that most studies had methodological limitations. Conclusion: Current evidence suggests that herbal medicine added to standard treatment has potential benefits in the treatment of COVID-19 symptoms but the certainty of evidence was low.
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Affiliation(s)
- Lin Ang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Eunhye Song
- Global Cooperation Center, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Xiao-Yang Hu
- School of Primary Care, Population Sciences and Medical Education, Aldermoor Health Centre, University of Southampton, Southampton, United Kingdom
| | - Hye Won Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Yaolong Chen
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou University, Lanzhou, China
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, South Korea
- *Correspondence: Myeong Soo Lee,
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11
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Yang Z, Liu Y, Wang L, Lin S, Dai X, Yan H, Ge Z, Ren Q, Wang H, Zhu F, Wang S. Traditional Chinese medicine against COVID-19: Role of the gut microbiota. Biomed Pharmacother 2022; 149:112787. [PMID: 35279010 PMCID: PMC8901378 DOI: 10.1016/j.biopha.2022.112787] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and it has become a public health concern worldwide. In addition to respiratory symptoms, some COVID‑19 patients also show various gastrointestinal symptoms and even consider gastrointestinal symptoms to be the first manifestation. A large amount of evidence has shown that SARS-CoV-2 infection could disrupt the gut microbiota balance, and disorders of the gut microbiota could aggravate the condition of COVID-19 patients. Therefore, maintaining the gut microbiota balance is expected to become a potential new therapeutic target for treating COVID-19. Traditional Chinese medicine (TCM) has significant effects in all stages of the prevention and treatment of COVID-19. It can adjust the gut microbiota and is an ideal intestinal microecological regulator. This review summarizes the advantages and clinical efficacy of TCM in the treatment of COVID-19 and expounds on the relationship between TCM and the gut microbiota, the relationship between COVID-19 and the gut microbiota, the mechanism of gut microbiota disorders induced by SARS-CoV-2, the relationship between cytokine storms and the gut microbiota, and the role and mechanism of TCM in preventing and treating COVID-19 by regulating the gut microbiota to provide new research ideas for TCM in the prevention and treatment of COVID-19.
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Affiliation(s)
- Zhihua Yang
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yangxi Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
| | - Lin Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
| | - Shanshan Lin
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
| | - Xiangdong Dai
- State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Haifeng Yan
- The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan 450000, China
| | - Zhao Ge
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
| | - Qiuan Ren
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China; First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
| | - Hui Wang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China
| | - Feng Zhu
- Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Shuping Wang
- Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin 300162, China.
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Resveratrol Treats UVB-Induced Photoaging by Anti-MMP Expression, through Anti-Inflammatory, Antioxidant, and Antiapoptotic Properties, and Treats Photoaging by Upregulating VEGF-B Expression. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6037303. [PMID: 35028009 PMCID: PMC8752231 DOI: 10.1155/2022/6037303] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 11/02/2021] [Indexed: 01/02/2023]
Abstract
UVB exposure is one of the primary factors responsible for the development of photoaging, and the aim of this study was to investigate the mechanism involved in the photoprotective properties of resveratrol (RES) in UVB-induced photoaging. Photoaging models of Hacat cells and ICR mice were established by UVB irradiation. The effect of RES on cell viability was then assessed using the MTT assay. The effect of RES on reactive oxygen species (ROS) production was detected through a fluorescent probe assay. The effect of RES on oxidized glutathione (GSSH) content, and superoxide dismutase (SOD) activity in photoaging Hacat cells, were measured separately, using kits. An enzyme-linked immunosorbent assay (ELISA) was used to measure the effect of RES on IL-6 secretion. The effect of VEGF-B on RES photoprotection was examined through the RT-qPCR method, after silencing VEGF-B through siRNA transfection. For animal experiments, the relative water content of the skin of ICR mice was determined using the Corneometer CM825 skin moisture tester. Starting from the third week of the study, the back skin of photoaging ICR mice was photographed weekly using the TIVI700 camera, and the depth of skin wrinkles in photoaging ICR mice was also analyzed. The thickness of the epidermis in photoaging ICR mice was assessed by the hematoxylin-eosin (HE) staining method. The content of collagen fibers in the skin dermis of photoaging ICR mice was measured by the Masson trichrome staining method. The content of collagen III in the dermis of the skin in photoaging ICR mice was measured through immunohistochemistry (IHC) techniques. The effect of RES on the mRNA expression levels of MMP-1, MMP-9, HO-1, GPX-4, IL-6, TNF-α, VEGF-B, caspase9, and caspase3 in photoaging Hacat cells, and that of MMP-3, Nrf2, HO-1, NQO1, SOD1, GPX-4, caspase9, caspase3, and IL-6 in the skin of photoaging ICR mice, was measured by RT-qPCR. The effects of RES on caspase3, Nrf2 (intranuclear), COX-2, P-ERK1/2, ERK1/2, P-P38MAPK, and P38MAPK in photoaging Hacat cells, and on MMP-9, caspase3, COX-2, P-JNK, P-ERK1/2, and P-P38MAPK protein expression in the skin of photoaging ICR mice, were assayed by the WB method. The results of this study, therefore, show that RES has a protective effect against UVB-induced photoaging in both Hacat cells and ICR mice. Its mechanism of action may include reducing the expression of MMPs and the secretion of collagen and inflammatory factors by inhibiting the ROS-mediated MAPK and COX-2 signaling pathways, balancing oxidative stress in the skin of Hacat cells and ICR mice by promoting the Nrf2 signaling pathway, inducing antiapoptotic effects by inhibiting caspase activation, and exerting antioxidant and antiapoptotic effects by targeting the VEGF-B, demonstrating its photoprotective effects against UVB irradiation-induced photoaging.
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Li J, Yang Y, Xiong B, Lu J, Zhou Y, Li C, Hu X. The immunomodulatory effects of Qushi Jianpi Hewei Decoction (QJHD) for patients with COVID-19 by metagenomics and transcriptomic sequencing. PHARMACOLOGICAL RESEARCH - MODERN CHINESE MEDICINE 2022. [PMCID: PMC8759103 DOI: 10.1016/j.prmcm.2022.100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ethnopharmacological relevance Several studies have confirmed that intestinal microflora dysbiosis correlates with the severity of COVID-19 patients. Clinical meta-analysis and our data show that the circulating miRNAs like miRNA-146 and the levels of serum cytokines in the peripheral blood are closely related to mild to moderate COVID-19 patients. Despite the widespread use of traditional herbal medicine for COVID-19 in China, the mechanisms remain largely uncovered. Aim of the study We conducted an observational case-control study to verify the efficacy and safety of traditional Chinese herbal medicine Qushi Jianpi Hewei Decoction (QJHD) for mild to moderate COVID-19 patients, and investigated the potential biomolecular mechanisms through metagenomics and transcriptomic sequencing methods. Materials and methods QJHD was given orally twice a day individually for 14 to 28 days. A total of 10 patients were enrolled in the study and given QJHD. We observed advantages in clinical cure time rate, and the relief of gastrointestinal symptoms as compared with reports in the literature. The metagenomics sequencing data of fecal microflora and transcriptomic sequencing data of blood cell in patients with SARS-Cov-2 infection patients were selected compared to the healthy control donors. Results No serious adverse events were reported. Meanwhile, the transcriptome analysis showed a decrease of the hsa-miR-21-5p expression in peripheral blood without QJHD. The species composition analysis showed an increase in the expression of Faecalibacterium prausnitzii in the intestinal tract; The interleukin-10 (IL-10) expression also in COVID-19 patient decreased in peripheral blood compared with healthy control donors. And we found an improvement in these parameters in patients taking QJHD. Conclusions Our findings show that QJHD could improve clinical outcomes of mild to moderate COVID-19 patients, probably through beneficial immunomodulatory effects by regulating Faecalibacterium prausnitzii in the intestinal tract and hsa-miR-21 and IL-10 expression in peripheral blood. (chictr.org.cn, ChiCTR2000030305)
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Bouare N, Minta DK, Dabo A, Gerard C. COVID-19: A pluralistic and integrated approach for efficient management of the pandemic. World J Virol 2022; 11:20-39. [PMID: 35117969 PMCID: PMC8788213 DOI: 10.5501/wjv.v11.i1.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/10/2021] [Accepted: 12/28/2021] [Indexed: 02/06/2023] Open
Abstract
The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which triggered the ongoing pandemic, was first discovered in China in late 2019. SARS-CoV-2 is a respiratory virus responsible for coronavirus disease 2019 (COVID-19) that often manifests as a pneumonic syndrome. In the context of the pandemic, there are mixed views on the data provided by epidemiologists and the information collected by hospital clinicians about their patients. In addition, the literature reports a large proportion of patients free of pneumonia vs a small percentage of patients with severe pneumonia among confirmed COVID-19 cases. This raises the issue of the complexity of the work required to control or contain the pandemic. We believe that an integrative and pluralistic approach will help to put the analyses into perspective and reinforce collaboration and creativity in the fight against this major scourge. This paper proposes a comprehensive and integrative approach to COVID-19 research, prevention, control, and treatment to better address the pandemic. Thus, this literature review applies a pluralistic approach to fight the pandemic.
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Affiliation(s)
- Nouhoum Bouare
- Biomedical Sciences Researcher, National Institute of Public Health, Bamako 1771, Mali
| | | | - Abdoulaye Dabo
- Department Epidemiology & Infectiology Disease, Faculty Medicine & Dentistry, CNRST/Univ Bamako, Bamako 3052, Mali
| | - Christiane Gerard
- Formerly Responsible for the Blood Bank, CHU-Liège, University of Liège, Liège 4000, Belgium
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Shi S, Wang F, Yao H, Kou S, Li W, Chen B, Wu Y, Wang X, Pei C, Huang D, Wang Y, Zhang P, He Y, Wang Z. Oral Chinese Herbal Medicine on Immune Responses During Coronavirus Disease 2019: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2022; 8:685734. [PMID: 35127733 PMCID: PMC8814103 DOI: 10.3389/fmed.2021.685734] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 12/07/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Cellular immune responses including lymphocyte functions and immune effector cells are critical for the control of coronavirus infection. Chinese herbal medicine (CHM) potentially has a therapeutic effect for treatment of coronavirus disease 2019 (COVID-19). Nevertheless, there are limited clinical practice suggestions on immunogenicity of the CHM against SARS-CoV-2. To assess the effect of oral CHM on immunogenicity and whether oral CHM improves the clinical parameters through the immunity profile during COVID-19, we performed the present study. METHODS For this systematic review and meta-analysis, 11 databases were searched for relevant studies assessing oral CHM for COVID-19 on November 20, 2020 (updated March 9, 2021). Primary outcomes mainly included immunity profiles. Secondary outcomes included all-cause mortality; the remission time of fever, cough, chest tightness, and fatigue. The random effect was used to estimate the heterogeneity of the studies. Summary relative risks, weight mean difference and standardized mean difference were measured with 95% confidence intervals. Modified Jadad scale and Newcastle-Ottawa Scale were used to assess the risk of bias of randomized controlled trials (RCTs) and observational studies, respectively. The certainty of evidence was evaluated using the GRADE approach. RESULTS We analyzed findings from 3,145 patients in 30 eligible studies. Compared with routine treatment, oral CHM, as an adjuvant medicine, improved lymphocyte counts, CD4+, and CD4+/CD8+ ratio with low quality of evidence; improved CD3+ with moderate quality of evidence; and reduced TNF-α with low certainty of evidence. Besides, oral CHM, as an adjuvant medicine reduced the time to clinical symptoms remission with a lower risk of all-cause mortality, compared with routine treatment alone. CONCLUSION CHM may be recommended as an adjuvant immunotherapy for disease modification and symptom relief in COVID-19 treatment. However, large RCTs objectively assessing the efficacy of CHM on immune responses in COVID-19 are needed to confirm our findings.
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Affiliation(s)
- Shihua Shi
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fei Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Huan Yao
- Department of Rheumatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Shuo Kou
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Weihao Li
- Division of Cardiology, West China Hospital, Sichuan University, Chengdu, China
| | - Bonan Chen
- Department of Anatomical and Cellular Pathology, State Key Laboratory of Translational Oncology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yongcan Wu
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaomin Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Caixia Pei
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Demei Huang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yilan Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Pan Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yacong He
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhenxing Wang
- Department of Geriatric, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Rofiyati W, Hadi H, Rosyada RW, Putri TIYL, Putra MGA, Ayuningtyas I, Mulyanti M. Herbal Medicine on Response Immune Patient with COVID-19 Infection a Scoping Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: COVID-19 has spread through the world and has caused a global pandemic. There is a lot of evidence that taking herbal medicines could increase the immune response but otherwise, the relation of herbal medicine and inflammation factors that lead to cytokine storm is still discussing.
AIM: The purpose of this article is to review the evidence of herbal medicine that use in COVID-19 patients and the effect on the immune response of patients with COVID-19 infection.
METHOD: We conducted a scoping review on the PubMed and Science Direct databases from January 1 to July 2020 using searching terms “COVID-19”, “SARS-CoV2 Infection”, “Herbal Medicine” AND “Immune Response” Or “Humoral Immune, Response”. We use only scientific articles that discuss herbal medicine and its effect on the immune response. There were eight articles included in the analysis, many types of herbal medicines are used to maintain symptom management and to enhance the patient’s immune response, including, Echinacea, QPD (qingfei paidu) and Western medicine, Jiedu Capsule (SFJDC), Yidu-toxicity blocking lung decoction and Ayush Kwath, nagella sative, and LHQW.
RESULTS: This article concludes that several alternative herbal medicines affect the immune response in COVID-19 patients, especially in reducing inflammatory agents, cytokine levels, and immunomodulators. Echinacea, Jiedu Capsule (SFJD), QPD (qingfei paidu) and Western medicine, and Ayush Kwath, nagella sative, and Lianhuaqingwen (LHQW) are the alternative herbal medicines that could provide benefits for COVID-19 patients, although research on the target mechanism must need more exploration.
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Lyu M, Fan G, Xiao G, Wang T, Xu D, Gao J, Ge S, Li Q, Ma Y, Zhang H, Wang J, Cui Y, Zhang J, Zhu Y, Zhang B. Traditional Chinese medicine in COVID-19. Acta Pharm Sin B 2021; 11:3337-3363. [PMID: 34567957 PMCID: PMC8450055 DOI: 10.1016/j.apsb.2021.09.008] [Citation(s) in RCA: 109] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 09/02/2021] [Accepted: 09/06/2021] [Indexed: 02/07/2023] Open
Abstract
COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.
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Affiliation(s)
- Ming Lyu
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Artemisinin Research Center, Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Guanwei Fan
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China
| | - Guangxu Xiao
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Taiyi Wang
- Oxford Chinese Medicine Research Centre, University of Oxford, Oxford OX1 3PT, UK
| | - Dong Xu
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jie Gao
- College of Traditional Chinese Medicine, Hebei University, Baoding 071002, China
| | - Shaoqin Ge
- College of Traditional Chinese Medicine, Hebei University, Baoding 071002, China
| | - Qingling Li
- Institute of Basic Medicine and Cancer, the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Chinese Academy of Sciences, Hangzhou 310022, China
| | - Yuling Ma
- Oxford Chinese Medicine Research Centre, University of Oxford, Oxford OX1 3PT, UK
| | - Han Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Jigang Wang
- Artemisinin Research Center, Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yuanlu Cui
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Junhua Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Yan Zhu
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
| | - Boli Zhang
- State Key Laboratory of Component-based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
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18
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Badakhsh M, Dastras M, Sarchahi Z, Doostkami M, Mir A, Bouya S. Complementary and alternative medicine therapies and COVID-19: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2021; 36:443-450. [PMID: 33838089 DOI: 10.1515/reveh-2021-0012] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 03/23/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Despite the high prevalence of coronavirus and various treatment approaches, including complementary and alternative medicine (CAM), there is still no definitive treatment for coronavirus. The present study aimed to evaluate the effect of CAM interventions on COVID-19 patients. CONTENT Four databases (Web of Science, PubMed, Scopus, and EMBASE) were searched from the inception of databases until July 16, 2020. Keywords included complementary and alternative medicine therapies and Coronavirus. SUMMARY AND OUTLOOK Of the 1,137 studies searched, 14 studies performed on 972 COVID-19 patients entered the systematic review final stage. The results showed that different CAM interventions (acupuncture, Traditional Chinese medicine [TCM], relaxation, Qigong) significantly improved various psychological symptoms (depression, anxiety, stress, sleep quality, negative emotions, quality of life) and physical symptoms (inflammatory factors, physical activity, chest pain, and respiratory function) in COVID-19 patients. The results showed that various CAM interventions have a positive effect on improving the various dimensions of coronavirus disease but since there are few studies in this regard, further studies using different CAM approaches are recommended.
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Affiliation(s)
- Mahin Badakhsh
- Department of Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Majid Dastras
- Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zohreh Sarchahi
- Department of Nursing, Faculty of Nursing, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mahboobe Doostkami
- Department of Operating Room, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Adel Mir
- Faculty of Nursing and Midwifery, Zabol University of Medical Sciences, Zabol, Iran
| | - Salehoddin Bouya
- Internal Medicine and Nephrology, Clinical Immunology Research Center, Ali-Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran
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19
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Wang H, Xu B, Zhang Y, Duan Y, Gao R, He H, Li X, Li J. Efficacy and Safety of Traditional Chinese Medicine in Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis. Front Pharmacol 2021; 12:609213. [PMID: 34421581 PMCID: PMC8379002 DOI: 10.3389/fphar.2021.609213] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 07/06/2021] [Indexed: 01/08/2023] Open
Abstract
Introduction: Until now, there is no clinically approved specific medicine to treat COVID-19. Prior systematic reviews (SRs) have shown that traditional Chinese medicine (TCM) reduces the number of patients with severe disease and time to fever clearance, promotes clinical effectiveness, and improves chest images and the negativity rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid test. Few SRs arrived at a definitive conclusion, and more randomized controlled trials (RCTs) were published. We conducted this study to summarize the latest evidence of TCM in COVID-19. Methods: Eight online databases were searched from December 2019 to July 2020, updated to March 2021. Only RCTs evaluating the clinical efficacy and safety of TCM in the treatment of COVID-19 were included. Primary outcomes were clinical cure and the negativity of the SARS-CoV-2 nucleic acid test. Secondary outcomes included clinical deterioration, ARDS, mechanical ventilation, death, time to fever clearance, duration of hospitalization, and chest imaging improvement. Safety outcomes included adverse events and serious adverse events during treatment. Two reviewers selected the included articles, assessed the risk of bias, and extracted data independently and in duplicate. Results: A total of 25 RCTs involving 2222 participants were selected in the systematic review, and seven RCTs were included in the meta-analysis. The results showed that TCM plus routine treatment was significantly better than routine treatment alone in clinical cure (risk ratio [RR] = 1.20, 95% confidence interval (CI) [1.04, 1.38], P = 0.01) and chest image improvement (RR = 1.22, 95% CI [1.07, 1.39], P = 0.01) and could reduce clinical deterioration (RR = 0.39, 95% CI [0.18, 0.86], P = 0.02), ARDS (RR = 0.28, 95% CI [0.11, 0.69], P = 0.01), mechanical ventilation (RR = 0.30, 95% CI [0.12, 0.77], P = 0.01), or death rate (RR = 0.28, 95% CI [0.09, 0.84], P = 0.02). No significant difference between TCM and routine treatment in the negativity of SARS-CoV-2 nucleic acid test (RR = 1.08, 95% CI [0.94, 1.23], P = 0.29) was observed. Finally, there was no overall significant difference in the incidence of adverse events between the two groups. The summary of evidence showed moderate confidence of a benefit of 11.8% in clinical cure and 14.0% in chest image improvement and a reduction of 5.9% in clinical deterioration, 25.4% in ARDS, 18.3% in mechanical ventilation, and 4.5% in death with TCM plus routine treatment compared to routine treatment alone in patients with COVID-19. A low confidence of a benefit of 5.4% in the negativity of SARS-CoV-2 nucleic acid test was also observed. Conclusions: Synethized evidence of 21 outcomes in 8 RCTs showed moderate certainty that TCM treatment plus routine treatment may promote a clinical cure and chest image improvement compared to routine treatment alone while reducing clinical deterioration, development of ARDS, use of mechanical ventilation, and death in patients with COVID-19. TCM treatment plus routine treatment may not promote the negativity of the SARS-CoV-2 nucleic acid test compared to routine treatment alone. TCM treatment was found to be safe for patients with COVID-19.
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Affiliation(s)
- Heping Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Bowen Xu
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Zhang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuanyuan Duan
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
- Department of Respiratory, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ruike Gao
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Haoqiang He
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiuyang Li
- Department of Medical Affairs, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jie Li
- Department of Medical Affairs, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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20
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Wang D, Chen L, Wang L, Hua F, Li J, Li Y, Zhang Y, Fan H, Li W, Clarke M. Abstracts for reports of randomised trials of COVID-19 interventions had low quality and high spin. J Clin Epidemiol 2021; 139:107-120. [PMID: 34224834 PMCID: PMC8253697 DOI: 10.1016/j.jclinepi.2021.06.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/22/2021] [Accepted: 06/29/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To assess the reporting quality of abstracts for published randomized controlled trials (RCTs) of interventions for coronavirus disease 2019 (COVID-19), including the use of spin strategies and the level of spin for RCTs with statistically non-significant primary outcomes, and to explore potential predictors for reporting quality and the severity of spin. STUDY DESIGN AND SETTING PubMed was searched to find RCTs that tested interventions for COVID-19, and the reporting quality and spin in the abstracts were assessed. Linear regression analyses were used to identify potential predictors. RESULTS Forty RCT abstracts were included in our assessment of reporting quality, and a higher word count in the abstract was significantly correlated with higher reporting scores (95% CI 0.044 to 0.658, P=0.026). Multiple spin strategies were identified. Our multivariate analyses showed that geographical origin was associated with severity of spin, with research from non-Asian regions containing fewer spin strategies (95% CI -0.760 to -0.099, P=0.013). CONCLUSIONS The reporting quality of abstracts of RCTs of interventions for COVID-19 is far from satisfactory. A relatively high proportion of the abstracts contained spin, and the findings reported in the results and conclusion sections of these abstracts need to be interpreted with caution.
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Affiliation(s)
- Dongguang Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Lingmin Chen
- Department of Anesthesiology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University & The Research Units of West China (2018RU012, Chinese Academy of Medical Sciences), Chengdu, China
| | - Lian Wang
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China
| | - Fang Hua
- Center for Evidenced-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Center, Manchester, UK
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuxi Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yonggang Zhang
- Department of Periodical Press, West China Hospital, Sichuan University, Chengdu, China
| | - Hong Fan
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China.
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, West China Hospital/West China School of Medicine, Sichuan University, Chengdu, China.
| | - Mike Clarke
- Northern Ireland Clinical Trials Unit and Methodology Hub, Centre for Public Health, Queen's University Belfast, Belfast, UK.
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21
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Sun QG, An XD, Xie P, Jiang B, Tian JX, Yang Q, Li XY, Luo M, Liu P, Zhao SH, Duan LY, Lang SP, Fan A, Luo PC, Lian FM, Huang XD, Tong XL. Traditional Chinese Medicine Decoctions Significantly Reduce the Mortality in Severe and Critically Ill Patients with COVID-19: A Retrospective Cohort Study. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2021; 49:1063-1092. [PMID: 34107858 DOI: 10.1142/s0192415x21500518] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Coronavirus disease (COVID-19) is a new infectious disease associated with high mortality, and traditional Chinese medicine decoctions (TCMDs) have been widely used for the treatment of patients with COVID-19 in China; however, the impact of these decoctions on severe and critical COVID-19-related mortality has not been evaluated. Therefore, we aimed to address this gap. In this retrospective cohort study, we included inpatients diagnosed with severe/critical COVID-19 at the Tongren Hospital of Wuhan University and grouped them depending on the recipience of TCMDs (TCMD and non-TCMD groups). We conducted a propensity score-matched analysis to adjust the imbalanced variables and treatments and used logistic regression methods to explore the risk factors associated with in-hospital death. Among 282 patients with COVID-19 who were discharged or died, 186 patients (66.0%) received TCMD treatment (TCMD cohort) and 96 (34.0%) did not (non-TCMD cohort). After propensity score matching at a 1:1 ratio, 94 TCMD users were matched to 94 non-users, and there were no significant differences in baseline clinical variables between the two groups of patients. The all-cause mortality was significantly lower in the TCMD group than in the non-TCMD group, and this trend remained valid even after matching (21.3% [20/94] vs. 39.4% [37/94]). Multivariable logistic regression model showed that disease severity (odds ratio: 0.010; 95% CI: 0.003, 0.037; [Formula: see text]¡ 0.001) was associated with increased odds of death and that TCMD treatment significantly decreased the odds of in-hospital death (odds ratio: 0.115; 95% CI: 0.035, 0.383; [Formula: see text]¡ 0.001), which was related to the duration of TCMD treatment. Our findings show that TCMD treatment may reduce the mortality in patients with severe/critical COVID-19.
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Affiliation(s)
- Qin-Guo Sun
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Xue-Dong An
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Ping Xie
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Bo Jiang
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Jia-Xing Tian
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Qian Yang
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Xiu-Yang Li
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Meng Luo
- Department of Traditional Chinese Medicine, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Ping Liu
- Drug clinical trial institution, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Sheng-Hui Zhao
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Li-Yun Duan
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Su-Ping Lang
- Data center, GCP ClinPlus Co., Ltd., Beijing 100160, P R. China
| | - An Fan
- Data center, GCP ClinPlus Co., Ltd., Beijing 100160, P R. China
| | - Peng-Cheng Luo
- Department of Urology, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Feng-Mei Lian
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
| | - Xiao-Dong Huang
- Department of Gastrology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, Wuhan 430060, P. R. China
| | - Xiao-Lin Tong
- Department of Endocrine, Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine, Beijing 100053, P. R. China
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22
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Feng Z, Yang J, Xu M, Lin R, Yang H, Lai L, Wang Y, Wahner-Roedler DL, Zhou X, Shin KM, Salinas M, Mallory MJ, Tang C, Patchett DC, Bauer BA, Cui S. Dietary supplements and herbal medicine for COVID-19: A systematic review of randomized control trials. Clin Nutr ESPEN 2021; 44:50-60. [PMID: 34330513 PMCID: PMC8166807 DOI: 10.1016/j.clnesp.2021.05.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The world is currently struggling with the Coronavirus disease 2019 (COVID-19) pandemic. Dietary supplements (DSs) and herbal medicine provide a potentially convenient and accessible method for its recovery, but direct evidence is limited. OBJECTIVE This study aims to investigate the effectiveness of DSs and herbs in patients with COVID-19. METHODS A systematic literature search was conducted in multiple electronic English and Chinese databases. Randomized controlled trials (RCTs) involving DSs or herbal medicine interventions on patients with COVID-19 from November 2019 to February 2021 were included. Data was extracted, summarized and critically examined. RESULTS Out of 9402 records identified in the initial search, twelve RCTs were included in this review. Risk of bias of these RCTs was deemed high. Most of the trials were of low methodologic quality. Nine studies showed herbal supplements were beneficial to the recovery of COVID-19 patients; zinc sulfate could shorten the duration of loss of smell but not total recovery from COVID-19. No severe adverse events were reported. CONCLUSION Herbal supplements may help patients with COVID-19, zinc sulfate is likely to shorten the duration of olfactory dysfunction. DS therapy and herbal medicine appear to be safe and effective adjuvant therapies for patients with COVID-19. These results must be interpreted with caution due to the overall low quality of the included trials. More well-designed RCTs are needed in the future.
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Affiliation(s)
- Zitong Feng
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Juan Yang
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Mingzhu Xu
- Department of Rehabilitation, Shenzhen Hospital, Southern Medical University, 1333 Xinhu Road, Shenzhen, 518100, Guangdong, China
| | - Run Lin
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, Guangdong, China
| | - Huijun Yang
- Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, Guangdong, China
| | - Liting Lai
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yixiao Wang
- Department of Rehabilitation, Shenzhen Hospital, Southern Medical University, 1333 Xinhu Road, Shenzhen, 518100, Guangdong, China
| | | | - Xuan Zhou
- Formula- Pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong, China
| | - Kyung-Min Shin
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Manisha Salinas
- Division of Family Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - Molly J Mallory
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chunzhi Tang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - David C Patchett
- Department of Family Medicine, Mayo Clinic, Scottsdale, AZ, USA; Department of Integrative Medicine, Mayo Clinic, Scottsdale, AZ, USA.
| | - Brent A Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
| | - Shaoyang Cui
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China; Department of Rehabilitation, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, Guangdong, China.
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23
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The direct evidence and mechanism of traditional Chinese medicine treatment of COVID-19. Biomed Pharmacother 2021; 137:111267. [PMID: 33508618 PMCID: PMC7836975 DOI: 10.1016/j.biopha.2021.111267] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 02/07/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third coronavirus causing serious human disease to spread across the world in the past 20 years, after SARS and Middle East respiratory syndrome. As of mid-September 2020, more than 200 countries and territories have reported 30 million cases of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, including 950,000 deaths. Supportive treatment remains the mainstay of therapy for COVID-19. The World Health Organization reported that four candidate drugs, including remdesivir, are ineffective or have little effect on COVID-19. According to China News, 90 % of Chinese patients with COVID-19 use traditional Chinese medicine (TCM), with an effectiveness rate of 80 %, and no deterioration in patient condition. We have compiled the direct evidence of TCM treatment for COVID-19 as of December 31, 2020. We describe the advantages of TCM in the treatment of COVID-19 based on clinical evidence and the required methods for its clinical use. TCM can inhibit virus replication and transcription, prevent the combination of SARS-CoV-2 and the host, and attenuate the cytokine storm and immune deficiency caused by the virus infection. The cooperation of many countries is required to establish international guidelines regarding the use of TCM in patients with severe COVID-19 from other regions and of different ethnicities. Studies on the psychological abnormalities in patients with COVID-19, and medical staff, is lacking; it is necessary to provide a complete chain of evidence to determine the efficacy of TCM in the related prevention, treatment, and recovery. This study aims to provide a reference for the rational use of TCM in the treatment of COVID-19.
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