A review on the treatment of Herbal Medicine for asymptomatically infected COVID-19 patients

Seonhyung Jeong; Kyoungeun Lee; Minjeong Jeong; Mideok Song; Insoo Jang; Jeong, Seonhyung; Lee, Kyoungeun; Jeong, Minjeong; Song, Mideok; Jang, Insoo

doi:10.13048/jkm.21007

JKM > Volume 42(1); 2021 > Article

Jeong, Lee, Jeong, Song, and Jang: A review on the treatment of Herbal Medicine for asymptomatically infected COVID-19 patients

Review article

The Journal of Korean Medicine 2021; 42(1): 99-109.

Published online: March 01, 2021

DOI: https://doi.org/10.13048/jkm.21007

A review on the treatment of Herbal Medicine for asymptomatically infected COVID-19 patients

Seonhyung Jeong¹

, Kyoungeun Lee¹

, Minjeong Jeong²

, Mideok Song³

, Insoo Jang⁴^{, *}

¹Department of Korean Medicine, College of Korean Medicine, Woosuk University

²Department of Pediatrics, College of Korean Medicine, Woosuk University

³Kyunghee Oriental Medical Clinic, Seoul

⁴Department of Internal Medicine, College of Korean Medicine, Woosuk University

Correspondence to: 장인수 54987 전라북도 전주시 완산구 어은로 46 우석대학교부속한방병원 Tel：+82-63-220-8617 Fax：+82-63-220-8616, E-mail: mackayj@naver.com

Received February 3, 2021 Revised February 16, 2021 Accepted February 18, 2021

Abstract

Objectives

Objective: The purpose of this study is to investigate the treatment of herbal medicine for patients with COVID-19 asymptomatic infections.

Method

In English, search engines such as ‘PubMed’, ‘Science Direct’, and ‘Cumulative Index to Nursing and Allied Health Literature (CINAHL)’ were used. In Chinese, search engines such as ‘China National Knowledge Infrastructure (CNKI)’ and Wanfang were used. The keywords for the search engines were ‘COVID-19’, ‘asymptomatic infection’, ‘Korean Medicine’, ‘traditional Chinese medicine’, ‘herbal medicine’, and etc. Only clinical studies using herbal medicine for patients without fever or respiratory symptoms were selected. We excluded the cases that do not fit the research topic.

Results

A total of 5 studies were finally selected. Among them, four of them used integrated herbal medicine and Western medicine, and one of the studies treated exclusively for herbal medicine. There were a total of seven prescriptions for herbal medicine used in the study. Outcome variables were used as following: lab test, nucleic acid conversion time, hospitalization period, chest CT, and etc. In the RCT study, herbal medicine and Western medicine decreased nucleic acid conversion time, average hospitalization time compared to the control group, but it was not statistically significant. No other adverse reactions were reported in all studies.

Conclusion

According to the results, integrated herbal medicine and Western medicine might be an effective treatment for patients with COVID-19 asymptomatic infection reducing hospitalization period, time of nucleic acid turning negative. No severe adverse effects were reported. However, it is thought that better-designed research will be needed in the future.

Keywords: COVID-19, asymptomatic infection, herbal medicine, Korean medicine

Fig. 1

PRISMA flow chart.

Table 1

Summary of Included Studies

First author	Study design	Participants N gender (number): age	Interventions		Control	Outcome variables	Results	Treatment duration	Adverse event
First author	Study design	Participants N gender (number): age	Herbal medicine	Western medicine	Control	Outcome variables	Results	Treatment duration	Adverse event
Wang8	RCT	N=16 Control group (n=8) M (4), F (4): 36.3±12.4/Treatment group (n=8) M (5), F (3): 30.1±17.9	Lanxiang Jiedu oral liquid (蘭香解毒口服液)	Interferon α2b+Umifenovir	Interferon α2b+Umi fenovir	Nucleic acid conversion time Average hospitalization duration Ct values	15.3±8.2 days/11.9±5.4 days (p>0.05) 18.5±8.4 days/13.0±6.0 days (p>0.05) p>0.05	7 days	Not mentioned
Xie9	Case series	N=46 M (18): 38.3±14.0, F (28): 36.6±13.8	Chaihu Ganlu Decoction (柴胡甘露飮)	Not mentioned	(−)	Nucleic acid conversion time Conversion rate of severe cases Lung imaging indexes 3–1. Time of beginning inflammation absorption 3–2. Time of inflammation absorption Lab test (lymphocytes)	10.7±4.2 days 0% 3–1. 5.2±2.6 days (n=18) 3–2. 10.2±4.2 days (n=12) 1.7± 0.57×10/L	Not mentioned	(−)
Luo10	Case series	N=50 M (21), F (29): 37.3±13.8	Huopu Touxie Decoction (藿朴透邪湯) (n=24), Chaihu Ganlu Decoction (柴胡甘露飮) (n=26)	Interferon (n=50), Thymopentin (n=45), Umifenovir (n=31), Ribavirin (n=29), Thymalfasin (n=12), Antibiotics (n=9), Antidiabetic drug (n=12)	(−)	Lab test Chest CT Average hospitalization duration Nucleic acid conversion time	WBC, LYM, BUN: p>0.05, CRP, ALT, AST, Cr: p<0.05 Inflammation completely or apparently absorbed 14.0±4.9 days 6.8±3.1 days	14.0±4.9 days	(−)
Chen11	Case report	N=1 M: 7-year-old	Zhengyang Decoction (正陽湯), Qingfei Paidu Decoction (清肺排毒湯), Toujie Quwen Granules (透解祛瘟顆粒)	Interferon, Lopinavir/Ritonavir, Ribavirin	(−)	Lab test (leukocyte, granulocyte, lymphocyte)	WNL	22 days	Not mentioned
Liu12	Case report	N=1 M: 23-month-old	Not mentioned the prescription’s name	(−)	(−)	Chest CT Lab test	WNL WNL	21 days	Not mentioned

Ct: Cycle threshold, WBC: white blood cell, LYM: lymphocyte, BUN: blood urea nitrogen, CRP: C-reactive protein, ALT: alanine transaminase, AST: aspartate transaminase, Cr: creatinine, WNL: within normal limits

Table 2

Composition of herbal medicine formula

Herbal medicine	Composition (g)
Chaihu Ganlu Decoction (柴胡甘露飮)9,10)	Bupleurum falcatum (柴胡) 10, Scutellaria baicalensis (黃芩) 10, Acorus gramineus (石菖蒲) 15, Agastache rugosa (藿香) 10, Amomum kravanh (白豆蔲) 6, Forsythia suspensa (蓮翹) 15, Adenophora triphylla (南沙蔘) 30, Coix lacryma-jobi var. mayuen (薏苡仁) 30, Magnolia officinalis (厚朴) 10 g, Poria cocos (茯苓) 15, Pinellia ternata (薑半夏) 12, Citrus unshiu (陳皮) 6, Cryptotympana dubia (蟬蛻) 10, Bombyx mori (白殭蠶) 15, Prunus ansu (杏仁) 10, Platycodon grandiflorum (桔梗) 10, Hordeum vulgare (麥芽) 15 g/day
Lanxiang Jiedu oral liquid (蘭香解毒口服液)8)	Pogostemon cablin (廣藿香), Eupatorium fortunei (佩蘭), Atractylodes chinensis (蒼朮), Magnolia officinalis (厚朴), Citrus unshiu (陳皮), Zingiber officinale (生薑), Poria cocos (茯苓), Pinellia ternata (清半夏), Lonicera japonica (金銀花), Forsythia suspensa (蓮翹), Dryopteris crassirhizoma (貫衆), Prunus persica (桃仁), Angelica sinensis (當歸), Glycyrrhiza uralensis (甘草)*
Zhengyang Decoction (正陽湯)11)	Astragalus membranaceus (黄芪) 10, Morus alba (桑白皮) 10, Atractylodes macrocephala (白术) 6, Zingiber officinale (炮薑) 4, Pseudosrellaria heterophylla (太子蔘) 10, Paeoniae lactiflora (白芍藥) 6, Belamcanda chinensis (射干) 3, Glycyrrhiza uralensis (甘草) 3, Scrophularia buergeriana (玄蔘) 6, Lonicera japonica (金銀花) 6 g/day
Qingfei Paidu Decoction (清肺排毒湯)11)	Ephedra sinica (麻黃) 9, Glycyrrhiza uralensis (灸甘草) 6, Prunus ansu (杏仁) 9, CaSO₄ (石膏) 15, Cinnamomum cassia (桂枝) 9, Alisma plantago-aquatica (澤瀉) 9, Polyporus umbellatus (豬苓) 9, Atractylodes macrocephala (白朮) 9, Poria cocos (茯苓) 15, Bupleurum falcatum (柴胡) 16, Scutellaria baicalensis (黃芩) 6, Pinellia ternata (半夏) 9, Zingiber officinale (生薑) 9, Aster tataricus (紫莞) 9, Belamcanda chinensis (射干) 9, Asarum sieboldii (細辛) 6, Discorea japonica (山藥) 12, Poncirus trifoliata (枳實) 6, Citrus unshiu (陳皮) 6, Agastache rugosa (藿香) 9 g/day
Toujie Quwen Granules (透解祛瘟顆粒)11)	Forsythia suspensa (蓮翹) 30, Lonicera japonica (金銀花) 15, Cremastra appendiculata (山慈菇) 20, Scutellaria baicalensis (黄芩片) 10, Persicaria tintoria (大青葉) 10, Bupleurum falcatum (柴胡) 5, Artemisia annua (青蒿) 10, Cryptotympana dubia (蟬蛻) 10, Peucedanum decursivum (前胡) 5, Fritillaria cirrhosa (川貝母) 10, Fritillaria thunbergii (浙貝母) 10, Poria cocos (茯苓) 30, Prunnus mume (烏梅) 30, Scrophularia buergeriana (玄蔘) 10, Astragalus membranaceus (黄芪) 45, Pseudosrellaria heterophylla (太子蔘) 15 g/day
Huopu Touxie Decoction (藿朴透邪湯)10)	Agastache rugosa (藿香) 10, Magnolia officinalis (厚朴) 10, Poria cocos (茯苓) 15, Citrus unshiu (陳皮) 6, Massa Medicata Fermentata (神麴) 10, Areca catechu (大腹皮) 10, Coix lacryma-jobi var. mayuen (薏苡仁) 15, Cryptotympana dubia (蟬蛻) 10, Bombyx mori (白殭蠶) 15, Prunus ansu (杏仁) 10, Cimicifuga heracleifolia (升麻) 10, Paeoniae lactiflora (赤芍藥) 10, Pinellia ternata (法半夏) 12 g/day
Herbal medicine prescription12	Prunus ansu (杏仁) 4, Lophatherum gracile (淡竹葉) 6, Poria cocos (茯苓) 6, Forsythia suspensa (蓮翹) 6, Amomum villosum (砂仁) 4, Crataegus pinnatifida (山査) 6, Massa Medicata Fermentata (神麴) 6, Hordeum vulgare (麥芽) 6, Pueraria lobata (葛根) 9 g/day

* not mentioned the weight

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