A scoping review of clinical research evidence for traditional Chinese medicine in the treatment of coronavirus disease 2019_West China Medical Journal

Authors：

SUN Yanjun ¹ , ZHANG Ludan ¹ , LI Nan ¹ , GAO Shengwei ¹ , ZHANG Li ² , XING Yongfa ² , MU Wei ² , GU Xufang ² , WANG Baohe ³ ,  HUANG Yuhong ²

1. Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China;
2. Department of Clinical Pharmacology, the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300150, P. R. China;
3. Department of Integrated Management, the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300073, P. R. China;

Corresponding author：

HUANG Yuhong, Email: hyh101@126.com

Keywords：

Traditional Chinese medicine; severe acute respiratory syndrome coronavirus 2; coronavirus disease 2019; scoping review

DOI：

10.7507/1002-0179.202211154

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To conduct a scoping review on the clinical research evidence for the treatment of coronavirus disease 2019 (COVID-19) with traditional Chinese medicine, identify relevant problems in the literature, and provide ideas for the follow-up research. Methods PubMed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Digital Journal Full-text Database, and China Biomedical Literature Database were searched from inception to July 21st, 2022. The clinical research evidence for the treatment of COVID-19 with traditional Chinese medicine was included, the data information was sorted out, and the results were descriptively analyzed. Results A total of 132 studies were included, including 53 randomized controlled trials, 17 non-randomized controlled trials, and 62 retrospective cohort studies, all of which were published between 2020 and 2022. The clinical studies were carried out in 19 provincial level regions, among which Hubei province had the largest number of studies (49.2%, 65/132). The sample sizes of the studies were mostly between 50 and 100 cases (43.2%, 57/132). Most of the studies had a treatment course of 0-14 days (50.0%, 66/132). The most compared intervention measures were traditional Chinese medicine + conventional western medicine treatment vs. conventional western medicine treatment, accounting for 75.0% (99/132) of the studies. The COVID-19 patients included in the studies were mainly mild and moderate. Outcome indicators included changes in symptoms/signs, laboratory indicators, CT indicators, clinical outcomes, safety indicators, functional scales, etc. The main adverse reactions/events in intervention/exposure groups were gastrointestinal reactions. Conclusions There has been a lot of clinical research evidence on the treatment of COVID-19 by traditional Chinese medicine. To provide strong evidence support for the treatment of COVID-19 by traditional Chinese medicine, more clinical trials with large samples and international collaboration are needed in the future.

Citation： SUN Yanjun, ZHANG Ludan, LI Nan, GAO Shengwei, ZHANG Li, XING Yongfa, MU Wei, GU Xufang, WANG Baohe, HUANG Yuhong. A scoping review of clinical research evidence for traditional Chinese medicine in the treatment of coronavirus disease 2019. West China Medical Journal, 2023, 38(4): 506-512. doi: 10.7507/1002-0179.202211154 Copy

1.	Liu Z, Du S, Shao F, et al. Efficacy of Qingfei Paidu decoction on patients with COVID-19 pneumonia in Wuhan, China: a propensity score matching study. Evid Based Complement Alternat Med, 2021, 2021: 4303380.
2.	Shi N, Guo L, Liu B, et al. Efficacy and safety of Chinese herbal medicine versus lopinavir-ritonavir in adult patients with coronavirus disease 2019: a non-randomized controlled trial. Phytomedicine, 2021, 81: 153367.
3.	Xiong WZ, Wang G, Du J, et al. Efficacy of herbal medicine (Xuanfei Baidu decoction) combined with conventional drug in treating COVID-19: a pilot randomized clinical trial. Integr Med Res, 2020, 9(3): 100489.
4.	An X, Xu X, Xiao M, et al. Efficacy of Jinhua Qinggan granules combined with western medicine in the treatment of confirmed and suspected COVID-19: a randomized controlled trial. Front Med (Lausanne), 2021, 8: 728055.
5.	Zhang L, Zheng X, Bai X, et al. Association between use of Qingfei Paidu Tang and mortality in hospitalized patients with COVID-19: a national retrospective registry study. Phytomedicine, 2021, 85: 153531.
6.	Xiong Y, Tian Y, Ma Y, et al. The effect of Huashibaidu formula on the blood oxygen saturation status of severe COVID-19: a retrospective cohort study. Phytomedicine, 2022, 95: 153868.
7.	Chen G, Su W, Yang J, et al. Chinese herbal medicine reduces mortality in patients with severe and critical coronavirus disease 2019: a retrospective cohort study. Front Med, 2020, 14(6): 752-759.
8.	Fang J, Li H, Du W, et al. Efficacy of early combination therapy with Lianhuaqingwen and arbidol in moderate and severe COVID-19 patients: a retrospective cohort study. Front Pharmacol, 2020, 11: 560209.
9.	Wu HT, Ji CH, Dai RC, et al. Traditional Chinese medicine treatment for COVID-19: an overview of systematic reviews and meta-analyses. J Integr Med, 2022, 20(5): 416-426.
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12.	Xiao M, Tian J, Zhou Y, et al. Efficacy of Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules in treatment of COVID-19: a randomized controlled trial. Pharmacol Res, 2020, 161: 105126.
13.	Zhang XY, Lv L, Zhou YL, et al. Efficacy and safety of Xiyanping injection in the treatment of COVID-19: a multicenter, prospective, open-label and randomized controlled trial. Phytother Res, 2021, 35(8): 4401-4410.
14.	Liu J, Yang W, Liu Y, et al. Combination of Hua Shi Bai Du granule (Q-14) and standard care in the treatment of patients with coronavirus disease 2019 (COVID-19): a single-center, open-label, randomized controlled trial. Phytomedicine, 2021, 91: 153671.
15.	Zhou S, Feng J, Xie Q, et al. Traditional Chinese medicine shenhuang granule in patients with severe/critical COVID-19: a randomized controlled multicenter trial. Phytomedicine, 2021, 89: 153612.
16.	Zhang J, Liu L, Zhang G, et al. Treating patients infected with the SARS-CoV-2 Omicron variant with a traditional Chinese medicine, Shufeng Jiedu capsule. Biosci Trends, 2022, 16(3): 238-241.
17.	Hu K, Guan WJ, Bi Y, et al. Efficacy and safety of Lianhuaqingwen capsules, a repurposed Chinese herb, in patients with coronavirus disease 2019: a multicenter, prospective, randomized controlled trial. Phytomedicine, 2021, 85: 153242.
18.	Ni L, Wen Z, Hu X, et al. Effects of Shuanghuanglian oral liquids on patients with COVID-19: a randomized, open-label, parallel-controlled, multicenter clinical trial. Front Med, 2021, 15(5): 704-717.
19.	Zhao Z, Li Y, Zhou L, et al. Prevention and treatment of COVID-19 using traditional Chinese medicine: a review. Phytomedicine, 2021, 85: 153308.
20.	Pham MT, Rajić A, Greig JD, et al. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Res Synth Methods, 2014, 5(4): 371-385.
21.	Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
22.	Zhang L, Wu L, Xu X, et al. Efficacy and safety of Lianhua Qingke tablets in the treatment of mild and common-type COVID-19: a randomized, controlled, multicenter clinical study. Evid Based Complement Alternat Med, 2022, 2022: 8733598.
23.	Williamson P, Altman D, Blazeby J, et al. Driving up the quality and relevance of research through the use of agreed core outcomes. J Health Serv Res Policy, 2012, 17(1): 1-2.
24.	Jin X, Pang B, Zhang J, et al. Core outcome set for clinical trials on coronavirus disease 2019 (COS-COVID). Engineering (Beijing), 2020, 6(10): 1147-1152.

1. Liu Z, Du S, Shao F, et al. Efficacy of Qingfei Paidu decoction on patients with COVID-19 pneumonia in Wuhan, China: a propensity score matching study. Evid Based Complement Alternat Med, 2021, 2021: 4303380.
2. Shi N, Guo L, Liu B, et al. Efficacy and safety of Chinese herbal medicine versus lopinavir-ritonavir in adult patients with coronavirus disease 2019: a non-randomized controlled trial. Phytomedicine, 2021, 81: 153367.
3. Xiong WZ, Wang G, Du J, et al. Efficacy of herbal medicine (Xuanfei Baidu decoction) combined with conventional drug in treating COVID-19: a pilot randomized clinical trial. Integr Med Res, 2020, 9(3): 100489.
4. An X, Xu X, Xiao M, et al. Efficacy of Jinhua Qinggan granules combined with western medicine in the treatment of confirmed and suspected COVID-19: a randomized controlled trial. Front Med (Lausanne), 2021, 8: 728055.
5. Zhang L, Zheng X, Bai X, et al. Association between use of Qingfei Paidu Tang and mortality in hospitalized patients with COVID-19: a national retrospective registry study. Phytomedicine, 2021, 85: 153531.
6. Xiong Y, Tian Y, Ma Y, et al. The effect of Huashibaidu formula on the blood oxygen saturation status of severe COVID-19: a retrospective cohort study. Phytomedicine, 2022, 95: 153868.
7. Chen G, Su W, Yang J, et al. Chinese herbal medicine reduces mortality in patients with severe and critical coronavirus disease 2019: a retrospective cohort study. Front Med, 2020, 14(6): 752-759.
8. Fang J, Li H, Du W, et al. Efficacy of early combination therapy with Lianhuaqingwen and arbidol in moderate and severe COVID-19 patients: a retrospective cohort study. Front Pharmacol, 2020, 11: 560209.
9. Wu HT, Ji CH, Dai RC, et al. Traditional Chinese medicine treatment for COVID-19: an overview of systematic reviews and meta-analyses. J Integr Med, 2022, 20(5): 416-426.
10. Qing GC, Zhang H, Bai Y, et al. Traditional Chinese and Western medicines jointly beat COVID-19 pandemic. Chin J Integr Med, 2020, 26(6): 403-404.
11. Ni L, Chen L, Huang X, et al. Combating COVID-19 with integrated traditional Chinese and Western medicine in China. Acta Pharm Sin B, 2020, 10(7): 1149-1162.
12. Xiao M, Tian J, Zhou Y, et al. Efficacy of Huoxiang Zhengqi dropping pills and Lianhua Qingwen granules in treatment of COVID-19: a randomized controlled trial. Pharmacol Res, 2020, 161: 105126.
13. Zhang XY, Lv L, Zhou YL, et al. Efficacy and safety of Xiyanping injection in the treatment of COVID-19: a multicenter, prospective, open-label and randomized controlled trial. Phytother Res, 2021, 35(8): 4401-4410.
14. Liu J, Yang W, Liu Y, et al. Combination of Hua Shi Bai Du granule (Q-14) and standard care in the treatment of patients with coronavirus disease 2019 (COVID-19): a single-center, open-label, randomized controlled trial. Phytomedicine, 2021, 91: 153671.
15. Zhou S, Feng J, Xie Q, et al. Traditional Chinese medicine shenhuang granule in patients with severe/critical COVID-19: a randomized controlled multicenter trial. Phytomedicine, 2021, 89: 153612.
16. Zhang J, Liu L, Zhang G, et al. Treating patients infected with the SARS-CoV-2 Omicron variant with a traditional Chinese medicine, Shufeng Jiedu capsule. Biosci Trends, 2022, 16(3): 238-241.
17. Hu K, Guan WJ, Bi Y, et al. Efficacy and safety of Lianhuaqingwen capsules, a repurposed Chinese herb, in patients with coronavirus disease 2019: a multicenter, prospective, randomized controlled trial. Phytomedicine, 2021, 85: 153242.
18. Ni L, Wen Z, Hu X, et al. Effects of Shuanghuanglian oral liquids on patients with COVID-19: a randomized, open-label, parallel-controlled, multicenter clinical trial. Front Med, 2021, 15(5): 704-717.
19. Zhao Z, Li Y, Zhou L, et al. Prevention and treatment of COVID-19 using traditional Chinese medicine: a review. Phytomedicine, 2021, 85: 153308.
20. Pham MT, Rajić A, Greig JD, et al. A scoping review of scoping reviews: advancing the approach and enhancing the consistency. Res Synth Methods, 2014, 5(4): 371-385.
21. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
22. Zhang L, Wu L, Xu X, et al. Efficacy and safety of Lianhua Qingke tablets in the treatment of mild and common-type COVID-19: a randomized, controlled, multicenter clinical study. Evid Based Complement Alternat Med, 2022, 2022: 8733598.
23. Williamson P, Altman D, Blazeby J, et al. Driving up the quality and relevance of research through the use of agreed core outcomes. J Health Serv Res Policy, 2012, 17(1): 1-2.
24. Jin X, Pang B, Zhang J, et al. Core outcome set for clinical trials on coronavirus disease 2019 (COS-COVID). Engineering (Beijing), 2020, 6(10): 1147-1152.

West China Medical Journal

A scoping review of clinical research evidence for traditional Chinese medicine in the treatment of coronavirus disease 2019

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