Persian medicine recommendations for the prevention of pandemics related to the respiratory system: a narrative literature review

The effect of Phytopaj ) Ferula assa-foetida L. oleo gum resin and tragacanth( in patients with COVID-19: A randomized clinical trial

Objective

Exogenous hydrogen sulfide (H2S) has a positive effect on respiratory diseases. Oleo-gum of Ferula assa-foetida contains this compound. This study assessed the effects of Ferula assa-foetida L. oleo gum resin and tragacanth (Phytopaj) on patients with COVID-19.

Materials and Methods

A randomized, single-blinded, controlled trial (RCT) phase 2 was conducted in Mashhad on hospitalized COVID-19 patients. In this RCT, 122 patients were randomly assigned to either receive a 14-day oral phytopaj plus ordinary treatment or ordinary treatment only. Changes in peripheral blood lymphocyte count (LC) and blood oxygen saturation (PO2) were the endpoints.

Results

Mean±SD of PO2 in Phytopaj comparison ordinary treatment before intervention was 91.86±4.62 and 91.41±9.18, after the intervention it was 93.22±4.26 and 91.91±5.92 mmHg; before intervention, mean±SD of peripheral blood lymphocyte count was 1015.90±500.55, and 1104.28±543.61, and after intervention, it was 1652.27±921.38 and 1326.12±719.28/μL respectively.

Conclusion

Phyopaj is most useful in moderate stages of Covid19, and it is not recommended for elderly patients and patients with comorbidity until more insight is gained.

Medicinal Plants for Viral Respiratory Diseases: A Systematic Review on Persian Medicine

Introduction

Many medicinal plants have been introduced in Persian medicine references for various respiratory disorders. Considering the growing interest in herbal medicines, this review aimed to introduce medicinal herbs recommended by Persian Medicine (PM) references for respiratory diseases and to discuss their activity against respiratory viruses.

Methods

The medicinal plants recommended for respiratory disorders were extracted from the main PM textbooks. Subsequently, their activity against respiratory viruses was systematically investigated via queries of scientific databases.

Results

Searching PM references for medicinal plants used in the management of respiratory disorders yielded 45 results. Of them, 18 possess antiviral activity against respiratory viruses. There were 29 in vitro studies (including studies on human cell lines) and 5 in vivo studies.

Conclusion

This research demonstrated that many of the medicinal plants mentioned for the respiratory diseases in PM have considerable activity against respiratory viruses. However, human studies regarding the reported medicinal plants are scarce.

Prevalence and associated factors of complementary and integrative medicine use in patients afflicted with COVID-19

Background

Complementary and Integrative Medicine (CIM) is often taken up by individuals seeking relief from different diseases. This study investigates the prevalence and associated factors of CIM use in patients with COVID-19.

Methods

In this telephone-based, cross-sectional study, data on CIM usage were collected from COVID-19 patients from February till June 2020 in Fars province, Iran using a researcher-made checklist. Additionally, we asked about the patients’ attitudes toward these treatments.

Results

Out of 453 patients diagnosed with COVID-19, 400 (88.30%) responded to our calls and agreed to participate in the study. Among them, 276 patients reported using CIM to treat COVID-19 [prevalence: 69% (95% CI: 64.2 to 73.5)]. The most frequently used herbal medicine among COVID-19 patients was ginger (n = 273, 98.9%), thyme (n = 263, 95.3%), and black cumin (n = 205, 74.3%). Most of these patients were recommended to use herbal medicine by their families and friends (n = 96, 34.8%). Univariable logistic regression revealed that age under 50 years old, residency in urban areas (including the capital of the province and small cities), employment, academic education, and being an outpatient were statistically significant factors resulting in CIM usage. Multivariable logistic regression revealed that CIM use among outpatients was 3.65 times more than among inpatients. In addition, patients under 50 years old used CIM 85% more than older patients. Ultimately, only 9 (3.3%) patients consulted with their doctors regarding these medications. No side effects due to CIM use were reported.

Conclusion

Many patients with COVID-19 used CIM, but few consulted with their physicians in this regard. Therefore, physicians should ask their patients about CIM usage, and patients should also report their use of CIM therapies during their medical visits. Furthermore, age and hospitalization status affected CIM use among patients with COVID-19.

Efficacy of a Persian herbal medicine compound on coronavirus disease 2019 (COVID-19): a randomized clinical trial

Background

The global attention to the capacities of traditional medicine for alleviating the clinical manifestations of COVID-19 has been growing. The present trial aimed to evaluate the efficacy and safety of a Persian herbal medicine formula among patients with COVID-19.

Methods

The present trial was conducted in Afzalipour hospital, Kerman, Iran, from June to September 2020. Hospitalized COVID-19 patients were randomly divided into intervention (Persian herbal medicine formula + routine treatment) or control (only routine treatment) groups. The intervention group received both capsule number 1 and 2 every 8 hours for 7 days. Capsule number 1 contained extract of the Glycyrrhiza glabra, Punica granatum, and Rheum palmatum, and the second capsule was filled by Nigella sativa powder. Participants were followed up to 7 days. The primary outcome was the number of hospitalization days, while cough, fever, and respiratory rate, days on oxygen (O₂) therapy, and mortality rate were considered as the secondary outcomes.

Results

Eighty-two patients were enrolled to the study, while 79 cases completed the trial and their data were analyzed (mean age: 59.1 ± 17.1 years). Based on the results, the Persian medicine formula decreased the mean hospitalization days, so that the mean difference of length of hospitalization as primary outcome was 2.95 ± 0.43 days. A significant clinical improvement was observed regarding dyspnea, need for O₂) therapy, and respiratory rate in the intervention group. No adverse effects were reported.

Conclusion

The present study supported the use of the Persian medicine formula as an adjuvant therapy for hospitalized COVID-19 patients. Study registration: Iranian Registry of Clinical Trials (www.irct.ir): IRCT20200330046899N1.

Study registration

Iranian Registry of Clinical Trials (www.irct.ir): IRCT20200330046899N1.

Cinnamon and its possible impact on COVID-19: The viewpoint of traditional and conventional medicine

The COVID-19 global epidemic caused by coronavirus has affected the health and other aspects of life for more than one year. Despite the current pharmacotherapies, there is still no specific treatment, and studies are in progress to find a proper therapy with high efficacy and low side effects. In this way, Traditional Persian Medicine (TPM), due to its holistic view, can provide recommendations for the prevention and treatment of new diseases such as COVID-19. The muco-obstruction of the airway, which occurs in SARS-CoV-2, has similar features in TPM textbooks that can lead us to new treatment approaches. Based on TPM and pharmacological studies, Cinnamomum verum (Darchini)'s potential effective functions can contribute to SARS-CoV-2 infection treatment and has been known to be effective in corona disease in Public beliefs. From the viewpoint of TPM theories, Cinnamon can be effective in SARS-CoV-2 improvement and treatment through its anti-obstructive, diuretic, tonic and antidote effects. In addition, there is pharmacological evidence on anti-viral, anti-inflammatory, antioxidant, organ-o-protective and anti-depression effects of Cinnamon that are in line with the therapeutic functions mentioned in TPM.Overall, Cinnamon and its ingredients can be recommended for SARS-CoV2 management due to multi-targeting therapies. This review provides basic information for future studies on this drug's effectiveness in preventing and treating COVID-19 and similar diseases.