Mahaboob Ali Anees Ahmed, Bugarcic Andrea, Naumovski Nenad, Ghildyal Reena
Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Canberra, Australia.
National Centre for Naturopathic Medicine, Southern Cross University, Lismore, New South Wales, Australia.
Phytomed Plus. 2022 Aug;2(3):100286. doi: 10.1016/j.phyplu.2022.100286. Epub 2022 Apr 20.
While Molnupiravir and Paxlovid have recently been approved for use in some countries, there are no widely available treatments for COVID-19, the disease caused by SARS-CoV-2 infection. Herbal extracts have been used to treat respiratory clinical indications by Ayurvedic medicine practitioners with minimal adverse reactions and intense research efforts are currently under way to develop some of these formulations for COVID-19 treatment.
Literature search for and clinical studies on the topic of Ayurvedic formulations for potential COVID-19 treatment, in order to present the current state of current knowledge by integrating information across all systems.
The search yielded 20 peer reviewed articles on studies examining the interaction of phytoconstituents of popular Ayurvedic formulations with SARS-CoV-2 components and its receptors; five articles on preclinical investigations of the ability of selected Ayurvedic formulations to inhibit functions of SARS-CoV-2 proteins; and 51 completed clinical trials on the efficacy of using Ayurvedic formulations for treatment of mild to moderate COVID-19. Clinical data was available from 17 of the 51 trials. There was a considerable overlap between formulations used in the studies and the clinical trials. This finding was unexpected as there is no clearly stated alignment between studies and the traditional pathway to drug discovery- basic discovery leading to and proof of concept, followed by validation in clinical trials. This was further demonstrated in the majority of the studies where focus was on potential antiviral mechanisms, while the clinical trials were focused on patient recovery using oral treatments. In all 17 clinical trials where data was available, Ayurvedic treatments lead to a shorter period to recovery in participants with COVID-19.
The most commonly used Ayurvedic treatments for management of respiratory symptoms associated with SARS-CoV-2 infection appear to have prophylactic and/or therapeutic properties. It would be of particular interest to assess synergistic and concomitant systemic effects and antiviral activities of individual phytoconstituents and their combinations in the Ayurvedic treatments.
虽然莫努匹拉韦和帕罗韦德最近已在一些国家获批使用，但对于由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染引起的新冠肺炎，尚无广泛可用的治疗方法。阿育吠陀医学从业者已使用草药提取物来治疗呼吸道临床病症，且不良反应极小，目前正在进行大量研究以开发其中一些制剂用于新冠肺炎治疗。
检索关于用于潜在新冠肺炎治疗的阿育吠陀制剂主题的文献及临床研究，以便通过整合所有系统的信息来呈现当前的知识状态。
检索得到20篇同行评审文章，涉及研究常用阿育吠陀制剂的植物成分与SARS-CoV-2成分及其受体相互作用的研究；5篇关于所选阿育吠陀制剂抑制SARS-CoV-2蛋白功能能力的临床前研究文章；以及51项关于使用阿育吠陀制剂治疗轻至中度新冠肺炎疗效的已完成临床试验。51项试验中有17项可获得临床数据。研究中使用的制剂与临床试验中使用的制剂之间存在相当大的重叠。这一发现出乎意料，因为研究与传统药物发现途径（从基础发现到先导化合物和概念验证，再到临床试验验证）之间没有明确的一致性。在大多数研究中进一步证明了这一点，其中重点是潜在的抗病毒机制，而临床试验则侧重于使用口服治疗使患者康复。在所有可获得数据的17项临床试验中，阿育吠陀治疗使新冠肺炎参与者的康复时间缩短。
用于管理与SARS-CoV-2感染相关呼吸道症状的最常用阿育吠陀治疗方法似乎具有预防和/或治疗特性。评估阿育吠陀治疗中单个植物成分及其组合的协同和伴随全身效应以及抗病毒活性将特别有意义。
