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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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.	趙玉斌, 肖穎, 崔淑華, 等. “新冠后狀態”人群的中醫綜合康復研究策略. 中醫雜志, 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.
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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.	時克, 冉崇平, 張群, 等. 中西醫結合治療新型冠狀病毒肺炎Meta分析. 山東中醫雜志, 2022, 41(3): 290-297.
15.	王躍, 宋麗, 付丹, 等. 中西醫結合治療新型冠狀病毒肺炎療效和安全性的Meta分析. 湖北民族大學學報(醫學版), 2022, 39(2): 15-20.
16.	吳雨沁, 鄒璐, 喻曉, 等. 中西醫結合治療新型冠狀病毒肺炎的系統評價. 上海中醫藥雜志, 2020, 54(6): 29-36.
17.	歐陽嘉慧, 江紫妍, 張淼, 等. 中醫藥治療輕型、普通型新型冠狀病毒肺炎療效和安全性的Meta分析. 中國中醫急癥, 2021, 30(1): 17-20,26.
18.	任毅, 劉華寶, 王瑜婧, 等. 中醫藥綜合康復方案干預重型、危重型新冠肺炎康復期患者的臨床隨訪研究. 中國中醫急癥, 2022, 31(3): 387-390.
19.	朱津麗, 張碩, 秦云普, 等. 新型冠狀病毒肺炎后遺癥及中西醫康復研究概況. 中醫雜志, 2021, 62(24): 2198-2203.
20.	國家衛生健康委員會辦公廳, 國家中醫藥管理辦公室. 關于印發新型冠狀病毒肺炎恢復期中醫康復指導建議（試行）的通知. 2020.
21.	鄭筱萸. 中藥新藥臨床研究指導原則（試行）. 北京: 中國醫藥科技出版社, 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.	陳江建, 周亞林, 陳富剛, 等. 連花清瘟膠囊聯合干擾素α-2b治療新冠肺炎康復期病人的臨床療效研究. 臨床醫學進展, 2020, 10(6): 1144-1149.
25.	史鎖芳, 方祝元, 熊侃, 等. 中醫綜合療法治療新型冠狀病毒肺炎恢復期氣陰兩虛證30例臨床研究. 江蘇中醫藥, 2021, 53(1): 25-28.
26.	楊宏志, 林瑞超, 董汛, 等. 香藿噴霧劑聯合基礎康復療法治療新型冠狀病毒肺炎恢復期余毒未清證60例臨床研究. 中醫雜志, 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.	劉娜. 連花清瘟膠囊聯合干擾素α-2b治療新冠肺炎康復期. 飲食保健, 2020, (46): 33.
29.	趙鋒, 楊震, 劉素香, 等. 宣肺達郁湯治療新型冠狀病毒肺炎恢復階段臨床研究. 陜西中醫, 2020, 41(7): 846-848.
30.	史鎖芳, 方祝元, 熊侃, 等. 扶土生金康復方治療COVID-19恢復期肺脾不足證患者臨床觀察. 南京中醫藥大學學報, 2020, 36(3): 281-285.
31.	王巧琳, 孫龍飛, 趙明芬, 等. 清肺排毒湯在新冠肺炎氣陰兩虛證患者恢復期治療中的應用. 中醫學報, 2021, 36(5): 910-914.
32.	魯楊, 陳琳, 顧吉娜, 等. "長新冠"綜合征的研究進展. 中華醫院感染學雜志, 2022, 32(16): 2556-2560.
33.	史鎖芳, 張曉娜, 王博寒. 中醫藥干預新型冠狀病毒肺炎恢復期后遺癥的研究進展. 南京中醫藥大學學報, 2021, 37(3): 473-476.
34.	李曉東, 劉保延, 王宜, 等. 關于《新型冠狀病毒肺炎恢復期中醫康復指導建議(試行)》的解讀. 中醫雜志, 2020, 61(11): 928-934.
35.	李貝金, 李瀟, 薛嘉睿, 等. 新冠肺炎炎癥風暴的機制探討及中醫藥的干預作用. 中國實驗方劑學雜志, 2020, 26(13): 32-38.
36.	吳舒靈, 朱宇, 鄭丹丹, 等. 中醫藥在新型冠狀病毒肺炎治療中的研究進展. 藥學研究, 2022, 41(9): 588-594.
37.	羅輝, 廖星, 王茜. 中醫證候積分在療效評價中的應用: 基于240項隨機對照試驗的比較研究. 中國中西醫結合雜志, 2015, 35(10): 1261-1266.
38.	耿洪嬌, 謝雁鳴. 中醫藥對新冠病毒肺炎恢復期及出院患者免疫功能調節理論探討. 世界科學技術-中醫藥現代化, 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.	陳木興, 范欣欣, 陳曉紅, 等. T淋巴細胞亞群檢測在新型冠狀病毒肺炎臨床應用價值中的研究進展. 結核與肺部疾病雜志, 2022, 3(4): 343-346.

1. 國家衛生健康委員會辦公廳, 國家中醫藥管理局辦公室. 新型冠狀病毒感染診療方案(試行第十版). 心肺血管病雜志, 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. 趙玉斌, 肖穎, 崔淑華, 等. “新冠后狀態”人群的中醫綜合康復研究策略. 中醫雜志, 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. 時克, 冉崇平, 張群, 等. 中西醫結合治療新型冠狀病毒肺炎Meta分析. 山東中醫雜志, 2022, 41(3): 290-297.
15. 王躍, 宋麗, 付丹, 等. 中西醫結合治療新型冠狀病毒肺炎療效和安全性的Meta分析. 湖北民族大學學報(醫學版), 2022, 39(2): 15-20.
16. 吳雨沁, 鄒璐, 喻曉, 等. 中西醫結合治療新型冠狀病毒肺炎的系統評價. 上海中醫藥雜志, 2020, 54(6): 29-36.
17. 歐陽嘉慧, 江紫妍, 張淼, 等. 中醫藥治療輕型、普通型新型冠狀病毒肺炎療效和安全性的Meta分析. 中國中醫急癥, 2021, 30(1): 17-20,26.
18. 任毅, 劉華寶, 王瑜婧, 等. 中醫藥綜合康復方案干預重型、危重型新冠肺炎康復期患者的臨床隨訪研究. 中國中醫急癥, 2022, 31(3): 387-390.
19. 朱津麗, 張碩, 秦云普, 等. 新型冠狀病毒肺炎后遺癥及中西醫康復研究概況. 中醫雜志, 2021, 62(24): 2198-2203.
20. 國家衛生健康委員會辦公廳, 國家中醫藥管理辦公室. 關于印發新型冠狀病毒肺炎恢復期中醫康復指導建議（試行）的通知. 2020.
21. 鄭筱萸. 中藥新藥臨床研究指導原則（試行）. 北京: 中國醫藥科技出版社, 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. 陳江建, 周亞林, 陳富剛, 等. 連花清瘟膠囊聯合干擾素α-2b治療新冠肺炎康復期病人的臨床療效研究. 臨床醫學進展, 2020, 10(6): 1144-1149.
25. 史鎖芳, 方祝元, 熊侃, 等. 中醫綜合療法治療新型冠狀病毒肺炎恢復期氣陰兩虛證30例臨床研究. 江蘇中醫藥, 2021, 53(1): 25-28.
26. 楊宏志, 林瑞超, 董汛, 等. 香藿噴霧劑聯合基礎康復療法治療新型冠狀病毒肺炎恢復期余毒未清證60例臨床研究. 中醫雜志, 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. 劉娜. 連花清瘟膠囊聯合干擾素α-2b治療新冠肺炎康復期. 飲食保健, 2020, (46): 33.
29. 趙鋒, 楊震, 劉素香, 等. 宣肺達郁湯治療新型冠狀病毒肺炎恢復階段臨床研究. 陜西中醫, 2020, 41(7): 846-848.
30. 史鎖芳, 方祝元, 熊侃, 等. 扶土生金康復方治療COVID-19恢復期肺脾不足證患者臨床觀察. 南京中醫藥大學學報, 2020, 36(3): 281-285.
31. 王巧琳, 孫龍飛, 趙明芬, 等. 清肺排毒湯在新冠肺炎氣陰兩虛證患者恢復期治療中的應用. 中醫學報, 2021, 36(5): 910-914.
32. 魯楊, 陳琳, 顧吉娜, 等. "長新冠"綜合征的研究進展. 中華醫院感染學雜志, 2022, 32(16): 2556-2560.
33. 史鎖芳, 張曉娜, 王博寒. 中醫藥干預新型冠狀病毒肺炎恢復期后遺癥的研究進展. 南京中醫藥大學學報, 2021, 37(3): 473-476.
34. 李曉東, 劉保延, 王宜, 等. 關于《新型冠狀病毒肺炎恢復期中醫康復指導建議(試行)》的解讀. 中醫雜志, 2020, 61(11): 928-934.
35. 李貝金, 李瀟, 薛嘉睿, 等. 新冠肺炎炎癥風暴的機制探討及中醫藥的干預作用. 中國實驗方劑學雜志, 2020, 26(13): 32-38.
36. 吳舒靈, 朱宇, 鄭丹丹, 等. 中醫藥在新型冠狀病毒肺炎治療中的研究進展. 藥學研究, 2022, 41(9): 588-594.
37. 羅輝, 廖星, 王茜. 中醫證候積分在療效評價中的應用: 基于240項隨機對照試驗的比較研究. 中國中西醫結合雜志, 2015, 35(10): 1261-1266.
38. 耿洪嬌, 謝雁鳴. 中醫藥對新冠病毒肺炎恢復期及出院患者免疫功能調節理論探討. 世界科學技術-中醫藥現代化, 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. 陳木興, 范欣欣, 陳曉紅, 等. T淋巴細胞亞群檢測在新型冠狀病毒肺炎臨床應用價值中的研究進展. 結核與肺部疾病雜志, 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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