Ali je lahko kitajska medicina uporabljena kot preventiva proti bolezni koronavirus 2019 (COVID-19)?

IZVLEČEK (povzeto po https://www.ncbi.nlm.nih.gov/pubmed/32065348)

CILJ

Od decembra 2019, ko se je virusna bolezen korona 2019 (COVID-19) pojavila v Wuhanu, se je bolezen hitro razširila na skoraj vse dele Kitajske. Temu so sledili preventivni programi, ki so kot preventivo priporočali kitajsko medicino (KM). Z namenom pridobitve dokazov o utemeljenosti priporočil CM, smo pregledali starodavno klasiko o študijah človeka.

METODE

Iz različnih podatkovnih baz in spletnih strani, objavljenih do 12. februarja 2020, so pridobili različne zgodovinske zapise iz klasik KM glede preventive in zdravljenja vnetij, klinične dokaze iz KM glede preventive resnejšega akutnega respiratornega sindroma (SARS) in gripe H1N1 ter preventivnih programov KM, ki so jih izdali zdravstveni uradi na Kitajskem vse od izbruha COVID-19. Raziskovalni dokazi so vključevali podatke iz kliničnih raziska, kohortnih ali drugih populacijskih raziskav, ki so za preventivo proti nalezljivim virusnim boleznim dihal uporabljale KM.

REZULTATI

Raba KM kot oblika preventive proti epidemiji nalezljivih bolezni se je pojavila že v starodavni kitajski praksi, kar so citirali v Huangdijevi interni klasiki (Huang Di Nei Jing); tu so zapisani tudi učinki preventive. Izvedene so bile 3 študije glede KM kot preventive za SARS in 4 študije za gripo H1N1. Nihče izmed sodelujočih, ki je bil deležen KM, v 3 študijah ni zbolel za SARS. Pojavnost gripe H1N1 v skupini s KM je bila znatno manjša kot pri skupini brez KM (relativno tveganje 0,36; interval zaupanja pri 95% 0,24-0,52; n=4). Za preventivo proti COVID-19 so bili v 23 kitajskih provincah izdani KM programi. Glavni princip rabe KM je krepitev Qija za zaščito pred zunanjim patogenom, razbliniti veter in ohladiti vročino (izraza za obrambo pred patogenom, op.prev.) ter odstranitev vlažnosti. Najpogosteje rabljena zelišča vključujejo Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), in Fructus forsythia (Lianqiao).

SKLEP

Glede na zgodovinske zapise in dokaze glede preventive pred SARS in gripo H1N1 pri človeku bi lahko bila kitajska zeliščna formula alternativni pristop za preventivo pred COVID-19 pri populaciji z visokim tveganjem. Bodoče in dosledne raziskave bodo potrebne za potrditev potencialnega preventivnega učinka KM.

prevod: Tanja Topić

vir fotografij: internet

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Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)?

ABSTRACT

OBJECTIVE

Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies.

METHODS

Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases.

RESULTS

The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24-0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao).

CONCLUSIONS

Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.