Effectiveness of traditional Chinese medicine for clinical symptoms during the recovery period of COVID-19 infection: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

QIANG Xiaoyu , MA Yucong ,  CHEN Zhe ,  WANG Hui

Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China;

Corresponding author：

CHEN Zhe, Email: chenzhetcm@163.com; WANG Hui, Email: wangh@tice.com.cn

Keywords：

Traditional Chinese medicine; COVID-19; Recovery period; Systematic review; Meta-analysis

DOI：

10.7507/1672-2531.202211064

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the efficacy and safety of traditional Chinese medicine on clinical symptoms during the recovery period of COVID-19. Methods The CNKI, WanFang Data, SinoMed, VIP, PubMed, Cochrane Library and EMbase databases were electronically searched to collect studies related to objectives from inception to February 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 8 studies involving 740 patients were included in the meta-analysis, including 4 randomized controlled trials (RCTs) and 4 non-RCTs. The results of the meta-analysis showed that traditional Chinese medicine could effectively relieve patients’ fatigue symptoms compared with blank control (MD=−1.07, 95%CI −1.46 to −0.68, P<0.01). Chinese patent medicine combined with conventional Western medicine treatment effectively improved cough symptoms in patients compared with conventional Western medicine treatment (MD=−0.80, 95%CI −1.30 to −0.30, P<0.01), symptoms of dry pharynx (MD=−0.86, 95%CI −1.22 to −0.51, P<0.01), symptoms of chest tightness (MD=−0.58, 95%CI −0.79 to −0.36, P<0.01), and total efficiency (RR=1.42, 95%CI 1.18 to 1.71, P<0.01). Conclusion Current evidence shows that traditional Chinese medicine can effectively improve the clinical symptoms such as fatigue, cough, dry pharynx and chest tightness in patients with novel coronavirus infection in the recovery period. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.

Citation： QIANG Xiaoyu, MA Yucong, CHEN Zhe, WANG Hui. Effectiveness of traditional Chinese medicine for clinical symptoms during the recovery period of COVID-19 infection: a systematic review. Chinese Journal of Evidence-Based Medicine, 2023, 23(6): 647-653. doi: 10.7507/1672-2531.202211064 Copy

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5.	Huang L, Li X, Gu X, et al. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. Lancet Respir Med, 2022, 10(9): 863-876.
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13.	Barker-Davies RM, O'Sullivan O, Senaratne KPP, et al. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Br J Sports Med, 2020, 54(16): 949-959.
14.	时克, 冉崇平, 张群, 等. 中西医结合治疗新型冠状病毒肺炎Meta分析. 山东中医杂志, 2022, 41(3): 290-297.
15.	王跃, 宋丽, 付丹, 等. 中西医结合治疗新型冠状病毒肺炎疗效和安全性的Meta分析. 湖北民族大学学报(医学版), 2022, 39(2): 15-20.
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17.	欧阳嘉慧, 江紫妍, 张淼, 等. 中医药治疗轻型、普通型新型冠状病毒肺炎疗效和安全性的Meta分析. 中国中医急症, 2021, 30(1): 17-20,26.
18.	任毅, 刘华宝, 王瑜婧, 等. 中医药综合康复方案干预重型、危重型新冠肺炎康复期患者的临床随访研究. 中国中医急症, 2022, 31(3): 387-390.
19.	朱津丽, 张硕, 秦云普, 等. 新型冠状病毒肺炎后遗症及中西医康复研究概况. 中医杂志, 2021, 62(24): 2198-2203.
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24.	陈江建, 周亚林, 陈富刚, 等. 连花清瘟胶囊联合干扰素α-2b治疗新冠肺炎康复期病人的临床疗效研究. 临床医学进展, 2020, 10(6): 1144-1149.
25.	史锁芳, 方祝元, 熊侃, 等. 中医综合疗法治疗新型冠状病毒肺炎恢复期气阴两虚证30例临床研究. 江苏中医药, 2021, 53(1): 25-28.
26.	杨宏志, 林瑞超, 董汛, 等. 香藿喷雾剂联合基础康复疗法治疗新型冠状病毒肺炎恢复期余毒未清证60例临床研究. 中医杂志, 2021, 62(17): 1509-1513.
27.	An X, Peng B, Huang X, et al. Ludangshen oral liquid for treatment of convalescent COVID-19 patients: a randomized, double-blind, placebo-controlled multicenter trial. Chin Med, 2022, 17(1): 42.
28.	刘娜. 连花清瘟胶囊联合干扰素α-2b治疗新冠肺炎康复期. 饮食保健, 2020, (46): 33.
29.	赵锋, 杨震, 刘素香, 等. 宣肺达郁汤治疗新型冠状病毒肺炎恢复阶段临床研究. 陕西中医, 2020, 41(7): 846-848.
30.	史锁芳, 方祝元, 熊侃, 等. 扶土生金康复方治疗COVID-19恢复期肺脾不足证患者临床观察. 南京中医药大学学报, 2020, 36(3): 281-285.
31.	王巧琳, 孙龙飞, 赵明芬, 等. 清肺排毒汤在新冠肺炎气阴两虚证患者恢复期治疗中的应用. 中医学报, 2021, 36(5): 910-914.
32.	鲁杨, 陈琳, 顾吉娜, 等. "长新冠"综合征的研究进展. 中华医院感染学杂志, 2022, 32(16): 2556-2560.
33.	史锁芳, 张晓娜, 王博寒. 中医药干预新型冠状病毒肺炎恢复期后遗症的研究进展. 南京中医药大学学报, 2021, 37(3): 473-476.
34.	李晓东, 刘保延, 王宜, 等. 关于《新型冠状病毒肺炎恢复期中医康复指导建议(试行)》的解读. 中医杂志, 2020, 61(11): 928-934.
35.	李贝金, 李潇, 薛嘉睿, 等. 新冠肺炎炎症风暴的机制探讨及中医药的干预作用. 中国实验方剂学杂志, 2020, 26(13): 32-38.
36.	吴舒灵, 朱宇, 郑丹丹, 等. 中医药在新型冠状病毒肺炎治疗中的研究进展. 药学研究, 2022, 41(9): 588-594.
37.	罗辉, 廖星, 王茜. 中医证候积分在疗效评价中的应用: 基于240项随机对照试验的比较研究. 中国中西医结合杂志, 2015, 35(10): 1261-1266.
38.	耿洪娇, 谢雁鸣. 中医药对新冠病毒肺炎恢复期及出院患者免疫功能调节理论探讨. 世界科学技术-中医药现代化, 2021, 23(2): 482-487.
39.	Li M, Guo W, Dong Y, et al. Elevated exhaustion levels of NK and CD8+ T cells as indicators for progression and prognosis of COVID-19 disease. Front Immunol, 2020, 11: 580237.
40.	Alahyari S, Rajaeinejad M, Jalaeikhoo H, et al. Immunological evaluation of patients with 2019 novel coronavirus pneumonia: CD4+ and CD16+ cells may predict severity and prognosis. PLoS One, 2022, 17(8): e0268712.
41.	Wen XS, Jiang D, Gao L, et al. Clinical characteristics and predictive value of lower CD4+T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study. BMC Infect Dis, 2021, 21(1): 57.
42.	陈木兴, 范欣欣, 陈晓红, 等. T淋巴细胞亚群检测在新型冠状病毒肺炎临床应用价值中的研究进展. 结核与肺部疾病杂志, 2022, 3(4): 343-346.

1. 国家卫生健康委员会办公厅, 国家中医药管理局办公室. 新型冠状病毒感染诊疗方案(试行第十版). 心肺血管病杂志, 2023, 42(1): 1-8.
2. World Health Organization. WHO coronavirus (COVID-19) dashboard. 2023.
3. Pillay J, Rahman S, Guitard S, et al. Risk factors and preventive interventions for post COVID-19 condition: systematic review. Emerg Microbes Infect, 2022, 11(1): 2762-2780.
4. Osikomaiya B, Erinoso O, Wright KO, et al. 'Long COVID': persistent COVID-19 symptoms in survivors managed in Lagos State, Nigeria. BMC Infect Dis, 2021, 21(1): 304.
5. Huang L, Li X, Gu X, et al. Health outcomes in people 2 years after surviving hospitalisation with COVID-19: a longitudinal cohort study. Lancet Respir Med, 2022, 10(9): 863-876.
6. 赵玉斌, 肖颖, 崔淑华, 等. “新冠后状态”人群的中医综合康复研究策略. 中医杂志, 2022, 63(14): 1313-1318.
7. Soriano JB, Murthy S, Marshall JC, et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis, 2022, 22(4): e102-e107.
8. Lechner-Scott J, Levy M, Hawkes C, et al. Long COVID or post COVID-19 syndrome. Mult Scler Relat Disord, 2021, 55: 103268.
9. Ngo B, Lapp SA, Siegel B, et al. Cerebrospinal fluid cytokine, chemokine, and SARS-CoV-2 antibody profiles in children with neuropsychiatric symptoms associated with COVID-19. Mult Scler Relat Disord, 2021, 55: 103169.
10. Davis HE, McCorkell L, Vogel JM, et al. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol, 2023, 21(3): 133-146.
11. Jimeno-Almazán A, Martínez-Cava A, Buendía-Romero Á, et al. Relationship between the severity of persistent symptoms, physical fitness, and cardiopulmonary function in post-COVID-19 condition: a population-based analysis. Intern Emerg Med, 2022, 17(8): 2199-2208.
12. Yang F, Pang B, Jin X, et al. Post-COVID burden: focus on the short-term condition. Acupuncture and Herbal Medicine, 2022, 2(3): 139-142.
13. Barker-Davies RM, O'Sullivan O, Senaratne KPP, et al. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Br J Sports Med, 2020, 54(16): 949-959.
14. 时克, 冉崇平, 张群, 等. 中西医结合治疗新型冠状病毒肺炎Meta分析. 山东中医杂志, 2022, 41(3): 290-297.
15. 王跃, 宋丽, 付丹, 等. 中西医结合治疗新型冠状病毒肺炎疗效和安全性的Meta分析. 湖北民族大学学报(医学版), 2022, 39(2): 15-20.
16. 吴雨沁, 邹璐, 喻晓, 等. 中西医结合治疗新型冠状病毒肺炎的系统评价. 上海中医药杂志, 2020, 54(6): 29-36.
17. 欧阳嘉慧, 江紫妍, 张淼, 等. 中医药治疗轻型、普通型新型冠状病毒肺炎疗效和安全性的Meta分析. 中国中医急症, 2021, 30(1): 17-20,26.
18. 任毅, 刘华宝, 王瑜婧, 等. 中医药综合康复方案干预重型、危重型新冠肺炎康复期患者的临床随访研究. 中国中医急症, 2022, 31(3): 387-390.
19. 朱津丽, 张硕, 秦云普, 等. 新型冠状病毒肺炎后遗症及中西医康复研究概况. 中医杂志, 2021, 62(24): 2198-2203.
20. 国家卫生健康委员会办公厅, 国家中医药管理办公室. 关于印发新型冠状病毒肺炎恢复期中医康复指导建议（试行）的通知. 2020.
21. 郑筱萸. 中药新药临床研究指导原则（试行）. 北京: 中国医药科技出版社, 2002.
22. Higgins JP, Green S. Cochrane handbook for systematic review of intervention (Version 5.1. 0).
23. Dent O. Methodological index for non-randomized studies. ANZ J Surg, 2003, 73(9): 675-676.
24. 陈江建, 周亚林, 陈富刚, 等. 连花清瘟胶囊联合干扰素α-2b治疗新冠肺炎康复期病人的临床疗效研究. 临床医学进展, 2020, 10(6): 1144-1149.
25. 史锁芳, 方祝元, 熊侃, 等. 中医综合疗法治疗新型冠状病毒肺炎恢复期气阴两虚证30例临床研究. 江苏中医药, 2021, 53(1): 25-28.
26. 杨宏志, 林瑞超, 董汛, 等. 香藿喷雾剂联合基础康复疗法治疗新型冠状病毒肺炎恢复期余毒未清证60例临床研究. 中医杂志, 2021, 62(17): 1509-1513.
27. An X, Peng B, Huang X, et al. Ludangshen oral liquid for treatment of convalescent COVID-19 patients: a randomized, double-blind, placebo-controlled multicenter trial. Chin Med, 2022, 17(1): 42.
28. 刘娜. 连花清瘟胶囊联合干扰素α-2b治疗新冠肺炎康复期. 饮食保健, 2020, (46): 33.
29. 赵锋, 杨震, 刘素香, 等. 宣肺达郁汤治疗新型冠状病毒肺炎恢复阶段临床研究. 陕西中医, 2020, 41(7): 846-848.
30. 史锁芳, 方祝元, 熊侃, 等. 扶土生金康复方治疗COVID-19恢复期肺脾不足证患者临床观察. 南京中医药大学学报, 2020, 36(3): 281-285.
31. 王巧琳, 孙龙飞, 赵明芬, 等. 清肺排毒汤在新冠肺炎气阴两虚证患者恢复期治疗中的应用. 中医学报, 2021, 36(5): 910-914.
32. 鲁杨, 陈琳, 顾吉娜, 等. "长新冠"综合征的研究进展. 中华医院感染学杂志, 2022, 32(16): 2556-2560.
33. 史锁芳, 张晓娜, 王博寒. 中医药干预新型冠状病毒肺炎恢复期后遗症的研究进展. 南京中医药大学学报, 2021, 37(3): 473-476.
34. 李晓东, 刘保延, 王宜, 等. 关于《新型冠状病毒肺炎恢复期中医康复指导建议(试行)》的解读. 中医杂志, 2020, 61(11): 928-934.
35. 李贝金, 李潇, 薛嘉睿, 等. 新冠肺炎炎症风暴的机制探讨及中医药的干预作用. 中国实验方剂学杂志, 2020, 26(13): 32-38.
36. 吴舒灵, 朱宇, 郑丹丹, 等. 中医药在新型冠状病毒肺炎治疗中的研究进展. 药学研究, 2022, 41(9): 588-594.
37. 罗辉, 廖星, 王茜. 中医证候积分在疗效评价中的应用: 基于240项随机对照试验的比较研究. 中国中西医结合杂志, 2015, 35(10): 1261-1266.
38. 耿洪娇, 谢雁鸣. 中医药对新冠病毒肺炎恢复期及出院患者免疫功能调节理论探讨. 世界科学技术-中医药现代化, 2021, 23(2): 482-487.
39. Li M, Guo W, Dong Y, et al. Elevated exhaustion levels of NK and CD8+ T cells as indicators for progression and prognosis of COVID-19 disease. Front Immunol, 2020, 11: 580237.
40. Alahyari S, Rajaeinejad M, Jalaeikhoo H, et al. Immunological evaluation of patients with 2019 novel coronavirus pneumonia: CD4+ and CD16+ cells may predict severity and prognosis. PLoS One, 2022, 17(8): e0268712.
41. Wen XS, Jiang D, Gao L, et al. Clinical characteristics and predictive value of lower CD4+T cell level in patients with moderate and severe COVID-19: a multicenter retrospective study. BMC Infect Dis, 2021, 21(1): 57.
42. 陈木兴, 范欣欣, 陈晓红, 等. T淋巴细胞亚群检测在新型冠状病毒肺炎临床应用价值中的研究进展. 结核与肺部疾病杂志, 2022, 3(4): 343-346.

Chinese Journal of Evidence-Based Medicine

Effectiveness of traditional Chinese medicine for clinical symptoms during the recovery period of COVID-19 infection: a systematic review

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