中医药治疗新冠肺炎Covid19 (Fan AY, Gu S, Alemi SF. Chinese herbal medicine for COVID19-Metaanalysis 2020)

“中医药治疗新冠肺炎 COVID-19 的最新证据:系统评价和荟萃分析” (Chinese herbal medicine for
COVID-19: Current evidence with systematic review and meta-analysis) 日前由《结合医学杂志》网上先
期发表, 这项研究是由来自全美中医药学会(ATCMA)的樊蓥(Arthur Yin Fan)、莎拉阿拉米(Sarah F.
Alemi) 和澳洲全国中医药针灸学会联合会(FCMA)的古旭明(Sherman Gu)博士组成的中医循证研究组完
成,樊蓥、古旭明为共同通讯作者。
截止 2020 年 8 月 12 日, 新冠肺炎 COVID-19 全球确诊病例已高达 20,786,855 人、病死 751,560 人、而
康复者仅为 13,690,389 人、 尚有许多病人未有最后结局。美国新冠肺炎 COVID-19 患者人数达到
5,360,302 人、 病死 169,131 人; 一些发达国家新冠肺炎 COVID-19 患者的病死率达到 14.13%–16.21% 。
尴尬的是、 迄今为止仍然缺乏治愈 COVID-19 这种高传染性和高病死率的疾病的有效西药或疗法。 而
中国采用中西医结合的方案,治疗新冠肺炎 COVID-19 取得了瞩目的疗效、控制了疫情的蔓延,在 3
月 15 日之前的第一阶段中,中国有 91.5% (或 74,187)的病人接受了这种中西医结合疗法、疗效在 90%
以上。但是,国际上有一些人始终质疑中医药的科学性。本系统综述和荟萃分析为中医药治疗新冠肺
炎 COVID-19 提供了最新高等级证据。
 

Background: There is currently no drug or therapy that cures COVID-19, a highly contagious and
life-threatening disease.
Objective: This systematic review and meta-analysis summarized contemporary studies that report the
use of Chinese herbal medicine (CHM) to treat COVID-19.
Search strategy: Six electronic databases (PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google
Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15,

2020 with the following search terms: traditional Chinese medicine, Chinese medicine,
Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized
controlled trial.
Inclusion criteria: Randomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed
publications were included. Further, included RCTs had a control group that was given standard care
(SC; such as conventional Western medicine treatments or routine medical care), and a treatment group
that was given SC plus CHM.
Data extraction and analysis: Two evaluators screened and collected literature independently; information
on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias
was assessed. The primary outcomes included scores that represented changes in symptoms and signs
over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement

of pneumonia confirmed by computed tomography (CT), and adverse events. Dichotomous data
were expressed as risk ratio or hazard ratio with 95% confidence interval (CI); where time-to-event analysis

was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as
difference in means (MD) with 95% CI, and standardized mean difference (SMD) was used when different
outcome scales were pooled.
Results: Seven original studies, comprising a total of 732 adults, were included in this meta-analysis.
Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score
(1.30 by SMD, 95% CI [2.43, 0.16]; 3 studies; n = 261, P = 0.03), on inflammatory marker
C-reactive protein (CRP, mg/L; 11.82 by MD, 95% CI [17.95, 5.69]; 5 studies; n = 325, P = 0.0002),
on number of patients with improved lung CT scans (1.34 by risk ratio, 95% CI [1.19, 1.51]; 4 studies;
n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs.
Conclusion: Current evidence shows that CHM, as an adjunct treatment with standard care, helps to
improve treatment outcomes in COVID-19 cases.
Please cite this article as: Fan AY, Gu S, Alemi SF. Chinese herbal medicine for COVID-19: Current evidence
with systematic review and meta-analysis. J Integr Med. 2020; xx(x): xxx–xxx
2020 Shanghai Changhai Hospital. Published by ELSEVIER B.V.