Abstract
BackgroundCoronavirus Disease 2019 (COVID-19) is an emerging and rapidly evolving disease, with no recommended effective anti-coronavirus drug treatment. Traditional Chinese Patent Medicines (CPMs) have, however, been widely used to treat COVID-19 in China, and a number of clinical practice results have shown them to have a significant role in its treatment. Consequently, numerous guidelines and expert consensus have recommended the use of CPMs to treat COVID-19.Aim of the StudyThe objectives of this review are to provide up-to-date information on the pharmacology and clinical research on CPMs in the treatment of COVID-19, discuss the research findings, and to better guide clinical application and scientific research on CPMs in the treatment of COVID-19.MethodsThe frequencies of CPM recommendations by guidelines and expert consensus for treatment of COVID-19 in China were ranked. This report identifies the top 10 CPMs, which include Huoxiang Zhengqi capsule (HXZQC), Lianhua Qingwen capsule (LHQWC), Jinhua Qinggan granule (JHQGG), Shufeng Jiedu capsule (SFJDC), Tanreqing injection (TRQI), Xiyanping injection (XYPI), Xuebijing injection (XBJI), Shenfu injection (SFI), Shengmai injection (SMI), and Angong Niuhuang pill (AGNHP). Relevant studies from 2000 to 2020 on these top 10 CPMs, covering usage, dosage, mechanism, curative effect, and precautions, were collected from pharmacopoeia, reports, and theses via library and digital databases (including PubMed, CNKI, Google Scholar, Web of Science, and Elsevier).ResultsThe properties of the top 10 CPMs included antiviral, antibacterial, anti-inflammatory, antipyretic and analgesic, anti-acute lung injury, anti-shock, immune regulation, and enhancement of pulmonary function. In addition, clinical research results and Chinese treatment data showed that the CPMs had good therapeutic efficacy in the treatment of COVID-19, and adverse reactions were minimal.ConclusionsKnowledge of the characteristics of the top 10 CPMs and precautions that should be taken may help clinicians to rationally improve therapeutic efficacy, and promote the role of Chinese Medicine in the control of the COVID-19 global epidemic.
Highlights
COVID-19 is an emerging and rapidly evolving epidemic
The results showed that Lianhua Qingwen capsule (LHQWC) significantly reduced lactate dehydrogenase (LDH) and malondialdehyde (MDA) serum levels in rats with lung injury, increased levels of glutathione peroxidase (GSH-Px), reduced pathological damage of lung tissues, and inhibited exudation of inflammatory cells into the alveolar cavity
The results showed that Shufeng Jiedu capsule (SFJDC) influenced the immune function of the mice, improved pneumonia symptoms caused by influenza virus, reduced the lung index of mice infected with H1N1, significantly reduced mortality, and had good therapeutic efficacy (Liu et al, 2010)
Summary
COVID-19 is an emerging and rapidly evolving epidemic. The cumulative number of confirmed cases globally reached 1,040,772 on April 4, 2020, comprising 149,790 (14.39%) cured cases, and 55,698 (5.35%) deaths. There is no evidence supporting the efficacy of broad-spectrum antibiotics, Abbreviations: COVID-19, Coronavirus Disease 2019; CPMs, Chinese Patent Medicines; TCM, Traditional Chinese Medicine; HXZQC, Huoxiang Zhengqi capsule; LHQWC, Lianhua Qingwen capsule; JHQGG, Jinhua Qinggan granule; SFJDC, Shufeng Jiedu capsule; TRQI, Tanreqing injection; XYPI, Xiyanping injection; XBJI, Xuebijing injection; SFI, Shenfu injection; SMI, Shengmai injection; AGNHP, Angong Niuhuang pill; WHO, World Health Organization; ICU, intensive care unit; MODS, multiple organ dysfunction syndromes; AIV, avian influenza virus; LPS, lipopolysaccharide; IFN-g, interferon-g; IgG, immunoglobulin G; IBS, irritable bowel syndrome; IL-1, interleukin-1; IL-2, interleukin-2; IL-6, interleukin-6; IL-8, interleukin-8; IL-10, interleukin-10; IL17, interleukin-17; IL-1a, interleukin-1a; IL-1b, interleukin-1b; TNF-a, tumor necrosis factor alpha; MCP-1, macrophage chemotactic factor-1; 5-HT, 5hydroxytryptamine; LDH, lactate dehydrogenase; CRP, C-reactive protein; PCT, procalcitonin; AST, aspartate aminotransferase; ALT, glutamate transaminase; MDA, malondialdehyde; ATP, adenosine triphosphate; SOD, superoxide dismutase; ROS, reactive oxygen species; CPE, cytopathic effect; WBC, white blood cell; Th, T helper cell; NK, natural killer; MAPK, mitogen-activated protein kinase; PI3K, phosphatidylinositol 3 kinase; NF-kB, nuclear factor kappa B; HLADR, human leukocyte antigen-DR; ICAM-1, intracellular adhesion molecule 1; VCAM-1, vascular cell adhesion molecule 1; TXA2, thromboxane A2; ANP, atrial natriuretic peptide; BALF, bronchoalveolar lavage fluid; URI, upper respiratory infection; SARS, severe acute respiratory syndrome; MERS, Middle East respiratory syndrome; RCTs, randomized controlled trials; CAP, community acquired pneumonia; COPD, chronic obstructive pulmonary disease; AECOPD, acute exacerbation of chronic obstructive pulmonary disease; MRSA, methicillinresistant Staphylococcus aureus; SIRS, systemic inflammatory response syndrome; APACHE-II, acute physiology and chronic health evaluation II. Numerous guidelines and expert consensus have recommended the use of CPMs to treat COVID-19
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