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Kitajska zeliščna medicina za COVID-19: trenutni dokazi s sistematičnim pregledom in meta-analizo

Updated: Oct 10



Bolezen koronavirusa 2019 (COVID-19) je postala globalna pandemija, ki se je ne more ustaviti z nobenim standardnim protivirusnim zdravilom ali cepivom. Kitajski zdravniki in znanstveniki so predlagali rabo tradicionalne kitajske medicine kot vir zdravil, ki se lahko uporabljajo neposredno proti koronavirusu. Razlog za to je, da je TKM dokazala svojo učinkovitost tudi pri pacientih s hudim akutnim respiratornim sindromom (SARS) med epidemijo SARS-a. Vse od začetka izbruha COVID-19 so kitajsko zeliščno medicino (CHM) obširno uporabljali na celinski Kitajski, kar je prineslo novo upanje glede preventive in nadzora nad COVID-19.



TKM in COVID-19: Pregled in perspektiva


Skupina raziskovalcev iz Ameriškega TKM Združenja (ATCMA), Federacije kitajske medicine in Akupunkturnih društev Avstralije (FCMA) in Raziskovalna skupina za na dokazih utemeljeno kitajsko medicino so skupaj izvedli sistematični pregled in meta-analizo rabe kitajske zeliščne medicine (CHM) proti COVID-19 [1].


Raziskovalci so v raziskavo vključili tudi randomizirane nadzorovane poskuse (RCT) iz strokovno pregledanih revij in nepregledanih publikacij. Vsi RCT so vključevali kontrolno skupino, ki je bila deležna standardne oskrbe (SC; kot so konvencionalna zdravljenja iz zahodne medicine ali rutinska zdravniška oskrba) in skupino s terapijo, ki je prejela SC in CHM.


Primarni rezultati so vključevali rezultate, ki so predstavljali spremembe v simptomih in znakih preko obdobja zdravljenja. Sekundarni rezultati so vključevali raven vnetnih markerjev, izboljšanje v pljučnici, kar so potrdili z računalniško tomografijo (CT), in neugodne dogodke.


V to meta-analizo so vključili sedem originalnih študij, ki so skupno vključevale 732 odraslih ljudi. V primerjavi s samo SC je imela kombinacija CHM in SC nadpovprečni vpliv na spreminjanje simptomov in znakov, na vnetni marker C-reaktivni protein in na število pacientov z izboljšanimi CT-slikami. V RCT ni bilo zabeleženih znatnejših negativnih primerov. Raziskovalci so povzeli, da trenutni dokazi kažejo, da CHM kot dodatna oblika zdravljenja k standardni oskrbi pomaga pri izboljšanju rezultatov zdravljenja pri primerih COVID-19.


Druga skupina raziskovalcev iz Pekinga, Nanjinga in Hong Konga na Kitajskem je izvedla pregled izčrpne literature o kitajski zeliščni medicini (CHM) za COVID-19 [2]. Literaturo so iskali po 7 kitajskih oz. angleških elektronskih podatkovnih bazah z datumom vse do 21. junija 2020 z namenom ocene učinkovitosti in varnosti CHM za zdravljenje COVID-19. Vključili so osemnajst randomiziranih kontroliranih poskusov (RCT) s sodelujočimi 2275 pacienti.


Meta-analiza je odkrila, da je v primerjavi CHM skupine s skupino s konvencionalnimi zdravili zahodne medicine imela CHM skupina izboljšave številnih kliničnih parametrov, vključno s CT pljuč, stopnjo kliničnega zdravljenja z razponom od lažjih do kritičnih primerov, dolžino bolnišnične oskrbe, skupnim rezultatom kliničnih simptomov, časom zbijanja vročine, simptomatskim rezultatom vročine, številom primerov z redukcijo kašlja, simptomatskim rezultatom kašlja, številom primerov z redukcijo utrujenosti, simptomatskim rezultatom utrujenosti, časom minevanja utrujenosti, TKM sindromom, testiranjem na virusne nukleinske kisline in vnetnimi biomarkerji (C-reaktivni protein). Poleg tega niso s CHM identificirali nobenih negativnih stranskih učinkov.


Raziskovalci so povzeli, da bi kitajska medicina lahko bila uporabljena kot potencialni kandidat za boj proti COVID-19.


VIRI:

1. https://doi.org/10.1016/j.joim.2020.07.008

2. https://doi.org/10.1016/j.phrs.2020.105056


prevod: Tanja Topić

vir fotografij: internet


Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis


Coronavirus disease 2019 (COVID-19) is a global pandemic with no standard antiviral drugs or vaccines. Chinese doctors and scientists have suggested using Traditional Chinese Medicine (TCM) as a source of medicines that can be used directly against the Coronavirus. Reason of this is that TCM also proved to be effective by patients with the severe acute respiratory syndrome (SARS) during the SARS epidemic. Since the outbreak of COVID-19, Chinese herbal medicine (CHM), has been widely applied in mainland China, bringing new hope for the prevention and control of COVID-19.


TCM and COVID-19: Review and Perspective


A group of researcher from the American TCM Association (ATCMA), Federation of Chinese Medicine & Acupuncture Societies of Australia (FCMA) and Research Group for Evidence-based Chinese Medicine conducted a systematic review and meta-analysis for the use of Chinese herbal medicines (CHM) for COVID-19. [1]


The researchers included randomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed publications. All the 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.


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.


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, on inflammatory marker C-reactive protein, on the number of patients with improved lung CT scans. No significant adverse events were recorded in the included RCTs.


The researchers concluded that current evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.

Another group of researchers from Beijing, Nanjing and Hong Kong in China conducted a comprehensive literature review for Chinese herbal medicine (CHM) for COVID-19 [2]. They were searching for literature in 7 Chinese or English electronic databases up to June 21, 2020 to evaluate the efficacy and safety of CHM for COVID-19. Eighteen randomized controlled trials (RCTs) involving 2275 patients were enrolled.


The meta-analyses found that comparing CHM group and conventional western medicine group, CHM group has improvements in several clinical parameters including lung CT, clinical cure rate, ranging from mild to critical cases, length of hospital stay, total score of clinical symptoms, fever reduction time, symptom score of fever, number of cough reduction cases, symptom score of cough, number of fatigue reduction cases, symptom score of fatigue, disappearing time of fatigue, TCM syndrome, viral nucleic acid testing, and inflammatory biomarkers (C-reactive protein). Besides, no severe adverse effects were identified by CHM. CHM, especially classical Chinese herbal formulas.


The researchers concluded that Chinese herbal medicine could be used as potential candidates for COVID-19 in this battle.


1. https://doi.org/10.1016/j.joim.2020.07.008

2. https://doi.org/10.1016/j.phrs.2020.105056


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