Clinical Evidence on the Use of Chinese Herbal Medicine for Acute Infectious Diseases: An Overview of Systematic Reviews

Xufei Luo; Yikai Zhang; Huishan Li; Mengjuan Ren; Yunlan Liu; Yunwei Liu; Yilin Zhang; Zhuoran Kuang; Yefeng Cai; Yaolong Chen; Xiaojia Ni

doi:10.3389/fphar.2022.752978

Clinical Evidence on the Use of Chinese Herbal Medicine for Acute Infectious Diseases: An Overview of Systematic Reviews

Front Pharmacol. 2022 Feb 25:13:752978. doi: 10.3389/fphar.2022.752978. eCollection 2022.

Authors

Xufei Luo¹, Yikai Zhang², Huishan Li², Mengjuan Ren¹, Yunlan Liu¹, Yunwei Liu², Yilin Zhang³, Zhuoran Kuang², Yefeng Cai^{2

4}, Yaolong Chen^{1

5

6

7

8

9

10

11

12}, Xiaojia Ni^{2

4}

Affiliations

¹ School of Public Health, Lanzhou University, Lanzhou, China.
² Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial, Academy of Chinese Medical Sciences, The Second Clinical School of Guangzhou University of Chinese Medicine, Guangzhou, China.
³ The School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China.
⁴ Guangdong Provincial Key Laboratory of Research on Emergency in Traditional Chinese Medicine, Guangzhou, China.
⁵ Research Unit of Evidence-Based Evaluation and Guidelines, Chinese Academy of Medical Sciences (2021RU017), School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
⁶ Institute of Health Data Science, Lanzhou University, Lanzhou, China.
⁷ Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China.
⁸ WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.
⁹ Guideline International Network Asia, Lanzhou, China.
¹⁰ Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou University, Lanzhou, China.
¹¹ Lanzhou University GRADE Center, Lanzhou, China.
¹² Lanzhou University, An Affiliate of the Cochrane China Network, Lanzhou, China.

Abstract

Background: Acute infectious diseases constitute the most prevalent public health emergency (PHE) in China. Chinese herbal medicine (CHM) has long been used in the treatment of acute infections, but the overall evidence of its benefit and harm has not been comprehensively and systematically evaluated. Methods: We searched CBM, CNKI, Wanfang, PubMed, Cochrane Library, embase and preprint platforms to retrieve systematic reviews (SRs) on CHM for acute infectious. Participants with COVID-19, SARS, H1N1, tuberculosis, bacillary dysentery, mumps, herpangina, hand-foot-and-mouth disease (HFMD), and other acute infectious diseases were included. Interventional group consisting of patients treated with CHM combined with Western medicine or CHM alone. The AMSTAR 2 tool was used to assess the methodological quality of the retrieved studies. Information on interventions, control measures and outcomes of the included studies was extracted, and meta-analyses were qualitatively synthesized. Results: A total of 51 SRs and meta-analyses were eligible for this overview, including 19 for COVID-19, 11 for hand-foot-and-mouth disease, 8 for severe acute respiratory syndrome (SARS), 4 for tuberculosis, 3 for mumps, 2 for bacillary dysentery, 2 for H1N1 influenza and 2 for herpangina. Six systematic reviews were of high quality, all of which were on the use of CHM for COVID-19; 24 were of moderate quality; 10 were of low quality; and 11 were of very low quality. CHM appeared to have potential benefits in improving clinical symptoms and signs for most infections with an acceptable safety profile, and the clinical evidence of the benefits of CHM for acute respiratory infections such as COVID-19, SARS and H1N1 seems more sufficient than that for other acute infections. Conclusion: Overall, CHM, both decoction and Chinese patent medicine, used alone or in combination with conventional medicine may offer potential benefits to relieving symptoms of people with acute respiratory infections. Full reporting of disease typing, staging, and severity, and intervention details is further required for a better evidence translation to the responses for PHE. Future CHM research should focus mainly on the specific aspects of respiratory infections such as its single use for mild infections, and the adjunct administration for sever infections, and individual CHM prescriptions for well-selected outcomes should be prioritized.

Keywords: COVID-19; Chinese herbal medicine; acute infectious diseases; overview of systematic reviews; public health emergency.

Publication types

Review