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Therapeutic effects and safety of oral Chinese patent medicine for COVID-19: a rapid systematic review and meta-analysis of randomized controlled trials

Therapeutic effects and safety of oral Chinese patent medicine for COVID-19: a rapid systematic review and meta-analysis of randomized controlled trials
Therapeutic effects and safety of oral Chinese patent medicine for COVID-19: a rapid systematic review and meta-analysis of randomized controlled trials

Introduction: Chinese patent medicine (CPM) is an indispensable part of traditional Chinese medicine. Coronavirus Disease 2019 (COVID-19) manifests is an acute respiratory infectious disease. This systematic review aimed to evaluate the therapeutic effects and safety of oral CPM for COVID-19. Methods: We included randomized controlled trials (RCTs) that tested oral CPM for the treatment of COVID-19 identified from publications in CNKI, Wanfang, VIP, Web of Science, SinoMed, PubMed, Embase, BioRxiv, MedRxiv and arXiv before November 2nd, 2020. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. Results: Seven RCTs including 1079 participants were identified. The overall bias was assessed as “-high risk of bias” for all included trials. Oral CPM investigated were: Lianhua Qingwen capsule/granules (LHQW), Jinhua Qinggan granules (JHQG), Huoxiang Zhengqi dripping pills (HXZQ), Toujie Quwen granules (TJQW) and Lianhua Qingke granules (LHQK). Compared with conventional western therapy alone for people with COVID-19: regarding the main outcomes, the results showed that oral CPM combined with conventional western therapy improved cure rate (RR = 1.20, 95 % CI 1.04–1.38, involving LHQW and TJQW), reduced aggravation rate (RR = 0.50, 95 % CI 0.29 – 0.85, involving LHQW, JHQG, LHQK and TJQW); with regard to additional outcomes, the results showed that add-on oral CPM shortened the duration of fever, cough and fatigue, improved the recovery rate of cough and fatigue, and increased the improvement and recovery rate of chest CT manifestations. There were some differences in therapeutic effects among various CPMs for the same COVID-19 outcome. The use of TJQW and LHQG appeared not to increase the risk of adverse events, but JHQG may cause mild diarrhea. Conclusion: Low-certainty or very low-certainty evidence demonstrated that oral CPM may have add-on potential therapeutic effects for patients with non-serious COVID-19. These findings need to be further confirmed by well-designed clinical trials with adequate sample sizes.

Chinese herbal medicine, Chinese patent medicine, Coronavirus Disease 2019, COVID-19, Meta-analysis, Systematic review
0965-2299
Liang, Shi Bing
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Fang, Min
f2e0535d-d833-4380-8fe9-9fe3044ecd95
Liang, Chang Hao
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Lan, Hui Di
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Shen, Chen
6c0a14c3-0e05-4e94-8a50-c6a7866a55b2
Yan, Li Jiao
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Hu, Xiao Yang
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Han, Mei
94e2baee-f8b0-4bd9-9e5b-83d33f464683
Robinson, Nicola
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Liu, Jian Ping
4c1de9c3-e9c2-4d4e-a0a4-dad123a39c76
Liang, Shi Bing
2a2dd82a-23b1-437c-9c02-625dfea79fd4
Fang, Min
f2e0535d-d833-4380-8fe9-9fe3044ecd95
Liang, Chang Hao
26ca5d35-510a-4d9e-b634-22c8723dc6a2
Lan, Hui Di
0a50b9d9-4b37-4140-b327-aa1cc7b8f6bc
Shen, Chen
6c0a14c3-0e05-4e94-8a50-c6a7866a55b2
Yan, Li Jiao
2ddd55cf-cc2f-49b0-9683-b8ca38e36687
Hu, Xiao Yang
65904b24-3775-4b14-9532-eb703a056655
Han, Mei
94e2baee-f8b0-4bd9-9e5b-83d33f464683
Robinson, Nicola
8d9e1831-747b-4d1e-aa37-51e0909484c1
Liu, Jian Ping
4c1de9c3-e9c2-4d4e-a0a4-dad123a39c76

Liang, Shi Bing, Fang, Min, Liang, Chang Hao, Lan, Hui Di, Shen, Chen, Yan, Li Jiao, Hu, Xiao Yang, Han, Mei, Robinson, Nicola and Liu, Jian Ping (2021) Therapeutic effects and safety of oral Chinese patent medicine for COVID-19: a rapid systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 60, [102744]. (doi:10.1016/j.ctim.2021.102744).

Record type: Review

Abstract

Introduction: Chinese patent medicine (CPM) is an indispensable part of traditional Chinese medicine. Coronavirus Disease 2019 (COVID-19) manifests is an acute respiratory infectious disease. This systematic review aimed to evaluate the therapeutic effects and safety of oral CPM for COVID-19. Methods: We included randomized controlled trials (RCTs) that tested oral CPM for the treatment of COVID-19 identified from publications in CNKI, Wanfang, VIP, Web of Science, SinoMed, PubMed, Embase, BioRxiv, MedRxiv and arXiv before November 2nd, 2020. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. RevMan 5.4 software was used for data analyses. The certainty of the evidence was assessed using the online GRADEpro tool. Results: Seven RCTs including 1079 participants were identified. The overall bias was assessed as “-high risk of bias” for all included trials. Oral CPM investigated were: Lianhua Qingwen capsule/granules (LHQW), Jinhua Qinggan granules (JHQG), Huoxiang Zhengqi dripping pills (HXZQ), Toujie Quwen granules (TJQW) and Lianhua Qingke granules (LHQK). Compared with conventional western therapy alone for people with COVID-19: regarding the main outcomes, the results showed that oral CPM combined with conventional western therapy improved cure rate (RR = 1.20, 95 % CI 1.04–1.38, involving LHQW and TJQW), reduced aggravation rate (RR = 0.50, 95 % CI 0.29 – 0.85, involving LHQW, JHQG, LHQK and TJQW); with regard to additional outcomes, the results showed that add-on oral CPM shortened the duration of fever, cough and fatigue, improved the recovery rate of cough and fatigue, and increased the improvement and recovery rate of chest CT manifestations. There were some differences in therapeutic effects among various CPMs for the same COVID-19 outcome. The use of TJQW and LHQG appeared not to increase the risk of adverse events, but JHQG may cause mild diarrhea. Conclusion: Low-certainty or very low-certainty evidence demonstrated that oral CPM may have add-on potential therapeutic effects for patients with non-serious COVID-19. These findings need to be further confirmed by well-designed clinical trials with adequate sample sizes.

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Accepted/In Press date: 1 June 2021
e-pub ahead of print date: 6 June 2021
Published date: August 2021
Additional Information: Funding Prof. Jian-Ping Liu is supported by the National Natural Science Foundation project (No. 81830115) in China. Prof. Nicola Robinson (visiting Professor of Beijing University of Chinese Medicine) is funded by the Project of International Development and Capability Improvement of Evidence-based Chinese Medicine (G20200001187). Dr Xiao-Yang Hu is supported by the National Institute for Health Research (SPCR-143).
Keywords: Chinese herbal medicine, Chinese patent medicine, Coronavirus Disease 2019, COVID-19, Meta-analysis, Systematic review

Identifiers

Local EPrints ID: 450419
URI: http://eprints.soton.ac.uk/id/eprint/450419
ISSN: 0965-2299
PURE UUID: 6c3b39d3-7867-427b-8061-d0f1a1d82c1d
ORCID for Xiao Yang Hu: ORCID iD orcid.org/0000-0002-3143-7999

Catalogue record

Date deposited: 27 Jul 2021 17:26
Last modified: 27 Apr 2022 02:03

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Contributors

Author: Shi Bing Liang
Author: Min Fang
Author: Chang Hao Liang
Author: Hui Di Lan
Author: Chen Shen
Author: Li Jiao Yan
Author: Xiao Yang Hu ORCID iD
Author: Mei Han
Author: Nicola Robinson
Author: Jian Ping Liu

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