Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Zurich, Switzerland.
Faculty of Health Sciences, Universidad Francisco de Vitoria (UFV), Madrid, Spain.
J Altern Complement Med. 2020 Jul;26(7):557-570. doi: 10.1089/acm.2020.0189. Epub 2020 Jun 24.
There is currently no effective treatment against coronavirus disease 2019 (COVID-19). The optimal selection of interventions targeting the virus is unknown. Therefore, evidence from randomized controlled trials (RCTs) to support specific treatment against COVID-19 is urgently needed. The use of Chinese herbal medicines (CHMs) might have a role in the treatment and symptomatic management of patients with COVID-19. It was aimed at providing an overview of the available evidence and ongoing trials concerning the effects of CHMs for the treatment of COVID-19. This is a narrative review of relevant studies. Searches were conducted to identify documents published till April 22, 2020. Electronic databases, evidence-based collections, websites of relevant organizations, and trial registries were consulted. A total of 25 guidelines on the treatment of patients with COVID-19 were identified. Four guidelines provided recommendations on the use of CHMs; these guidelines were developed in China and South Korea and were based on the consensus of experts exclusively. The remaining 21 guidelines provided no guidance on CHMs. No finished RCTs of CHMs for the treatment of patients with COVID-19 was found. According to the evidence evaluated in this review, a Cochrane review of CHMs for severe acute respiratory syndrome and five uncontrolled observational studies of the effects of CHMs in patients with COVID-19, the effects of CHMs for COVID-19 are unknown. A total of 52 ongoing clinical trials of CHM interventions for the treatment of COVID-19 were found. These trials will be carried out mostly in China ( = 51). Forty (77%) of the ongoing trials will be randomized, whereas 12 (23%) have an unclear sequence generation procedure. Forty-seven trials (90%) will have a sample size <400 participants. To the authors' knowledge, only the Chinese and the South Korean guidelines recommend CHMs as a treatment option for patients with COVID-19. These guidelines base their recommendations on the consensus of experts. Clinical guidelines or health authorities from other countries do not provide advice on CHMs. Due to the absence of RCT, there is currently no reliable evidence on the effects of any specific CHM intervention for the treatment of patients with COVID-19. A high number of clinical trials of different herbal products are being currently conducted in China.
目前尚无针对 2019 年冠状病毒病（COVID-19）的有效治疗方法。针对该病毒的干预措施的最佳选择尚不清楚。因此，急需提供来自随机对照试验（RCT）的证据以支持针对 COVID-19 的具体治疗方法。中草药（CHM）的使用可能在治疗和缓解 COVID-19 患者的症状方面发挥作用。本研究旨在概述针对 COVID-19 治疗的 CHM 效果的现有证据和正在进行的试验。这是对相关研究的叙述性综述。搜索了截至 2020 年 4 月 22 日发表的文献。查阅了电子数据库、循证收藏、相关组织的网站和试验注册处。确定了 25 项有关治疗 COVID-19 患者的指南。有 4 项指南就 CHM 的使用提供了建议；这些指南是在中国和韩国制定的，完全基于专家的共识。其余 21 条指南未就 CHM 提供指导。未发现针对 COVID-19 患者使用 CHM 的已完成 RCT。根据本综述评估的证据，一项针对严重急性呼吸综合征的 CHM 的 Cochrane 综述和五项针对 COVID-19 患者 CHM 效果的非对照观察性研究，CHM 对 COVID-19 的效果尚不清楚。共发现 52 项针对 COVID-19 的 CHM 干预措施治疗的正在进行的临床试验。这些试验将主要在中国进行（ = 51）。其中 40 项（77％）为随机试验，而 12 项（23％）的随机序列生成程序不明确。47 项试验（90％）的样本量<400 例。据作者所知，只有中国和韩国的指南将 CHM 推荐为 COVID-19 患者的治疗选择。这些指南的建议是基于专家共识。来自其他国家的临床指南或卫生当局并未就 CHM 提供建议。由于缺乏 RCT，目前尚无任何特定 CHM 干预措施治疗 COVID-19 患者效果的可靠证据。目前，中国正在进行大量不同草药产品的临床试验。
