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Table 2 Summary of study characteristics for included studies

From: The efficacy and safety of combined chinese herbal medicine and western medicine therapy for COVID-19: a systematic review and meta-analysis

Author Randomization COVID-19
type
Age (M ± SD) Sex   Disease course Sample size (T/C) Intervention (dose, dosing & duration) Outcomes
  Male Female   Treatment (T) Control (C) Efficacy P value Safety P value
Chen. 2021
[39]
Random number table method Mild/ Moderate T: 19–61(50.16 ± 5.11)
C: 20–62(49.52 ± 5.06)
T: 17
C:18
T:13
C:12
NR 30/30 Lianhua Qingwen Capsules
4 capsules/time, oral, tid, medication until discharge
plus control
Recombinant human interferon α2b (5 million U, arm, bid, < 10d);
Lopinavir and tonavir tablets (2 slices/time, oral, bid, < 10d)
↓: Turn severe rate P < 0.05 Nausea and vomiting P > 0.05
↓: Time for group fatigue, cough, shortness of breath and other symptoms to disappear P < 0.05 Mild diarrhea P > 0.05
Clinical recovery time, nucleic acid turning negative time P > 0.05 Liver damage P > 0.05
Time for fever to subside P > 0.05 Dizziness P > 0.05
↓: IL-10, PCT, hs-CRP P > 0.05   
Chen. 2020
[40]
Random number
table method
Confirmed T: 26–58(42.6 ± 3.5)
C: 24–59(43.1 ± 3.2)
T:8
C:9
T:7
C:6
T: 4-18d(6.9 ± 1.5)d
C: 3-19d(6.2 ± 1.4)d
15/15 Xuebijing Injection
10 ml, oral, bid, 14d
plus control
Ifn-α, lopinavir, ritonavir ↑: Total effectiveness rate P < 0.05 NR NR
Complications of patients P > 0.05   
Serum CRP levels before treatment P > 0.05   
↓: Serum CRP levels after treatment P < 0.05   
Duan. 2020
[41]
SPSS random number table grouping
(2: 1)
Mild T: 51.99 ± 13.88
C: 50.29 ± 13.17
T: 39
C: 23
T: 43
C: 18
NR 82/41 Jinhua Qinggan Granules
10 g, oral, tid, 5d
plus control
Antivirals or antibiotics ↓: Disappearance rate of clinical symptoms P > 0.05 ↑: Diarrhea P < 0.01
↓: TCM symptoms score P < 0.05   
Hospitalization rate P > 0.05   
Hamilton anxiety scale score P < 0.01   
Fu 2020a
[42]
Random number
table method
Mild/ Moderate T: 29–65(43.26 ± 7.15)
C: 30–70(43.68 ± 6.45)
T: 17
C: 19
T: 15
C: 14
T:7.56 ± 1.25
C: 8.47 ± 1.35
32/33 Toujie Quwen Granules
no, oral, bid, 10d
plus control
Abidol (0.2 g, oral, tid, 10d), Moxifloxacin (0.4 g, oral, qid, 10d); Ambroxol (0.03 g, oral, tid, 10d) ↓: Curative effect of patients after treatment P = 0.022 NR NR
↓: Scores of TCM syndrome in two groups after treatment P < 0.05   
Curative effect of chest CT in two groups after treatment P > 0.05   
WBC, LYM% after treatment P < 0.05   
↓: CRP, PCT in two groups after treatment P < 0.05   
D-Dimer in two groups after treatment P > 0.05   
↑: LYM cell counts, ↓: NEU% in two groups after treatment P < 0.05   
Fu 2020b
[43]
NR Moderate T: 29–65(45.26 ± 7.25)
C: 30–70(44.68 ± 7.45)
T: 19
C: 19
C: 18
C: 17
T: 7.56 ± 1.25
C: 8.47 ± 1.35
37/36 Toujie Quwen Granules
no, oral, bid, 15d
plus control
Abidol (0.2 g, oral, tid, 10d);
Ambroxol (0.03 g, oral, tid, 15d)
↓: The effect of treatments and discharge rate P < 0.05 NR NR
↓:The scores of TCM syndrome P < 0.05   
↑: LYM cell counts P < 0.05   
↓: Changes of CRP P < 0.05   
WBC, LYM% P > 0.05   
He 2021
[44]
Random number table method Mild NR NR NR NR 36/36 Buzhong Yiqi Decoction
1 dose, oral, bid, 10d
plus control
Abidor(0.2 g, oral, tid, 5d) ↓:The scores of TCM syndrome P < 0.05 NR NR
↑: Curative effect P < 0.05   
↓: hs-CRP、ESR P < 0.05   
↓: IL-6 P > 0.05   
Blood analysis, PCT P > 0.05   
Hu 2021
[45]
Block random method (1:1) Confirmed T: 50.4 ± 15.2
C: 51.8 ± 14.8
T: 79
C: 63
T: 71
C: 71
T: 9.5 ± 5.1
C: 9.9 ± 5.9
142/142 Lianhua Qingwen Capsules
4 capsules, oral, tid, 14d
plus control
Oxygen therapy, antiviral medications, systemic corticosteroids ↑: Rate of symptoms recovery at day 14 P = 0.022 Abnormal liver function P = 1.000
↓: Median Time to symptom recovery P < 0.001 Renal dysfunction P = 0.476
↑: Rate of recovery of chest CT manifestations P < 0.001 Headache P = 1.000
↑: Overall rate of clinical cure P < 0.05 Nausea P = 0.758
Conversion rate of SARS-CoV-2 viral assay findings P = 0.279 Vomiting P = 0.652
Median viral assay conversion time P = 0.151 Diarrhea P = 0.026
Loss of appetite P = 0.584
Lin 2020
[46]
Random number Moderate T: 20–80(46.02 ± 12.09)
C: 26–67(43.08 ± 12.34)
T: 15
C: 23
T: 26
C: 18
T: 1–14(5.07 ± 3.467)
C: 1–17(6.02 ± 3.698)
41/41 Xuanfei Qingre Decoction
0.4 g, oral, qd, 5d
plus control
Ifn-α (5 million U, aerosol inhalation, bid, 10d); Lopinavir/Litonavir (0.4 g/0.1 g oral, bid,14d), bed rest, support treatment ↓: Cough score and total score of TCM syndromes P < 0.05 Turn to severe group (T:0; C:2); critical group (T:0, C:0) P > 0.05
↓: Days for sputum nucleic acid turns cloudy, hospitalization days; hospitalization expenses P < 0.05
↓: Days for symptoms to disappear P < 0.05
↑: Absorption effect of lung lesions P = 0.003
↑: TCM symptom curative effect P = 0.002
Fever, fatigue, sore throat, chest tightness, anorexia, diarrhea P > 0.05
Remaining indicators P > 0.05
↑: CRP, ALT, AST, ESR P < 0.05
Liu 2021
[47]
Random number table method Mild T: 15–80(48.51 ± 4.56)
C: 18–79(48.43 ± 4.52)
T: 16
C: 15
T: 28
C: 29
NR 44/44 Lianhua Qingwen Capsule
1.4 g, oral, tid, 21d
Pneumonia Agreement 2
1 dose, oral, bid, 21d
plus control
Abidor(0.2 g, oral, tid, 21d); Oseltamivir(0.015 g, oral, bid, 21d) ↑: Total effectiveness rate for clinical efficacy P = 0.011 ↓: Diarrhea NR
↓: Headache NR
↓: Dizziness NR
↓: Nausea and vomiting NR
↓: Total adverse rate P = 0.02
Liu 2021
[48]
NR Severe T: 26–70(48.0 ± 1.6)
C: 27–70(48.5 ± 1.3)
T: 14
C: 13
T: 11
C: 12
NR 25/25 Huashi Baidu Recipe
1 ~ 2 dose/day, oral,100 ~ 200 m/time, oral or nasal feeding, bid ~ qid, 21d
plus control
Tocilizumab (0.004 ~ 0.008 g/kg for the first dose, 0.4 g for the recommended dose, iv drop, bid, 30d) ↑: Clinical efficacy P < 0.05 ↓: Gastrointesti-nal hemorrhage P < 0.05
↑: WBC, LYM P < 0.05 ↓: Clotting time P < 0.05
↓: CRP, ESR P < 0.05 ↓: Total adverse event rate P < 0.05
Wang 2020
[49]
Random allocation, (1:1) Moderate T: 21–65(43.75 ± 4.10)
C: 23–63(42.56 ± 4.58)
T: 23
C: 25
T: 22
C: 20
T: 2–14(7.50 ± 2.42)
C: 2–15(7.18 ± 2.16)
45/45 Bifidobacterium Tablets
3 tablets, oral, tid, 15d
Sanren decoction
1 pay, oral, tid,15d
plus control
Oseltamivir capsule (0.1 g, oral, tid, 15d) ↓:Clinical symptom score P < 0.05 NR NR
↓: Severe transfer rate P > 0.05   
↑: Total effectiveness rate P > 0.05   
↓: blood CRP, PCT, D-dimer level P < 0.05   
Wang 2021
[50]
NR Moderate T: 18–80(48 ± 13.2)
C: 19–79(49.4 ± 13.3)
T: 35
C: 36
T: 35
C: 34
NR 70/70 Qingfei Paidu Decoction
100 mL, oral, bid, 10d
plus control
Moxifloxacin hydrochloride tablets (0.4 g, oral, qd, 10d); Arbidol hydrochloride dispersible tablets (0.2 g, oral, tid, 10d) ↑: Clinical efficacy P < 0.05 Palpitations (T:C = 0:2) NR
↓: TCM syndrome score P < 0.05 Nausea (T:C = 1:4) NR
↓: Hospitalization days P < 0.05 Fatigue (T:C = 1:3) NR
↑: Inflammation absorption P < 0.05 ↓: total adverse event rate P < 0.05
↓: WBC, LYM%, CRP P < 0.05   
Wang 2020a
[51]
Random allocation, (1:1:1) Confirmed T1: 35–70(39.24 ± 10.01)
T2:43–71(54.90 ± 3.61)
C: 29–66(55.90 ± 
3.71)
T1: 5
T2:4
C: 5
T1: 5
T2: 6
C: 5
NR 10/10/10 Traditional Chinese Medicine
no, oral + fume absorption, bid, 7d
plus control
TCM + Vitamin C
no, oral + fume absorption, bid, 7d
plus control
Ribavirin, anti-infection, auxiliary support drugs Time of improvement of fatigue, cough, dry throat, and shortness of breath P < 0.05 (A-C) NR NR
Therapeutic effects on symptoms P = 0.014 (A-B)
P = 0 (A-C)
P = 0.11 (B-C)
  
Nucleic acid turns negative P > 0.05   
Time of improvement of fatigue, cough, dry throat, and shortness of breath P > 0.05   
Wang 2020b
[52]
Random number
table method
Moderate T: 4–70(43.43 ± 17.51)
C: 6–67(41.73 ± 15.16)
T: 6
C: 5
T: 5
C: 6
T: 1–21(6.5 ± 4.3)
C: 1-18d(41。73 ± 15.16)
11/11 Qingre Kang oral liquid
20 ml, oral, tid, 10d
plus control
Recombinant human interferon α2b injection (5 million U, injection, bid, 10d);
Arbidol hydrochloride (0.2 g, oral, tid,10d)
↑: Fever, cough and fatigue disappearance rate, CT findings P > 0.05 NR NR
↓: Duration of fever P > 0.05   
↑: Lung CT lesion absorption P > 0.05   
Wen 2020
[53]
Random number
table method
Severe T: 49.1 ± 4.8(50 ml);47.1 ± 5.2(10 ml)
C: 47.7 ± 5.7
T:11(50 ml)
T:12(50 ml)
C: 9
T:8(50 ml)
T:9(50 ml)
C:11
NR 20/20/20 Xuebijing Injection
50 ml, oral, bid, 7d
plus control
Xuebijing Injection
100 ml, oral, bid, 7d
plus control
Did not state details ↑: Condition improvement P < 0.05 NR NR
Nucleic acid turns negative P > 0.05   
↓: CRP, ESR P < 0.05   
↓: APACHEIIscore P < 0.05   
↑: WBC P < 0.05   
Ye 2020
[54]
Random allocation
(1:2)
Severe T: 53–69
C:47–67
T: 2
C: 4
T: 25
C: 10
T: 9(6.5–11.5)
C: 9.5(6–14)
28/14 Maxinshigantang–Dayuanyin Decoction or Shengfutang Decoction
200 ml, oral, bid, 7d
plus control
Antivirals, antibiotics, immune modulators, systemic corticosteroids Clinical improvement P = 0.350 Mortality rate P = 0.454
Yu 2020
[55]
Random number
table method
Mild/ Moderate T: 48.27 ± 9.56
C: 47.25 ± 8.67
T: 82
C: 89
T: 65
C: 59
NR 147/148 Lianhua Qingwen Granules
6 g, oral, tid, 7d
plus control
Abidol hydrochloride dispersible tablets (0.2 g, oral, tid, 14d), Moxifloxacin hydrochloride tablets (0.4 g, oral, qd,14d), Ambroxol hydrochloride (0.03 g, oral, tid,14d) ↑: Clinical efficacy P < 0.05 NR NR
↓: Severe disease rate P < 0.05   
↓: TCM syndrome
score
P < 0.05   
Chest CT effectiveness P > 0.05   
↑: WBC, LYM P > 0.05   
↓: CRP, PCT P < 0.05   
Zhang 2020
[56]
NR Moderate T: 53.7 ± 3.5
C: 55.6 ± 4.2
T: 9
C: 13
T: 10
C: 13
NR 22/23 Modified Dayuan formula
no, oral, tid, 7d
plus control
Oxygen therapy, symptomatic treatment, antivirus treatment ↑: Clinical efficacy P < 0.05 NR NR
↑: Chest CT improvement rate P < 0.05   
↑: LYM% P < 0.05   
↓: CRP P < 0.05   
WBC P > 0.05   
Zhang 2020
[57]
Random allocation, (1:2) Moderate T: 53.4 ± 13.70
C: 52.0 ± 14.10
T: 50
C: 23
T: 30
C: 17
T: 2.65 ± 1.45
C: 2.41 ± 1.59
80/40 Jinyinhua oral liquid
60 ml, oral, tid, 10d
plus control
Lopinavir (0.4 g, oral, bid, 10d);
Ritonavir (0.1 g, oral, bid, 10d);
Ifn-α (5 million U, injection, bid, 10d)
↑: Disappearance rate of clinical symptoms P < 0.05 Mild diarrhea (1:0) P > 0.05
↓: Chest CT examination score after treatment for 10d P < 0.01 Total adverse event rate P > 0.05
Negative conversion rate of SARS-CoV-2-qRT-PCR P > 0.05   
Zhao 2020
[58]
Random
selection
Severe NR T: 8
C: 14
T: 7
C: 10
T:6.5(4.0–7.5)
C:5.5(3.0–7.0)
15/24 Yidu-toxicity blocking lung Decoction
no, oral, no,14d
plus control
Did not state details Cure rate P = 0.878 NR NR
Hospital stay P = 0.662   
↑: TNF-α P = 0.035   
↑: IL-6 P = 0.013   
Spearman analysis for CD4 and IL-6 P = 0.772   
Zheng 2020
[59]
Random number table method Confirmed T: 52.47 ± 9.87
C: 52.47 ± 10.99
T: 32
C: 20
T: 28
C: 24
NR 40/40 Sodium tanshinone IIA sulfonate
0.06 g, oral, qd, 10d
plus control
Oxygen inhalation, fluid rehydration, anti-inflammatory, antivirals, ventilator assisted breathing, psychological guidance, vital signs monitoring ↑: Total effectiveness rate P < 0.05 NR NR
↑: Level of lung function P < 0.05   
↓: Levels of inflammatory factors P < 0.05   
Zhou 2020
[60]
Random number table method Moderate T: 25–63(42.17)
C: 12–77(40.88)
T: 8
C: 9
T: 9
C: 8
NR 52/52 Diammonium Glycyrrhizinate enteric coated capsules
0.15 g, oral, qid, 14d
plus control
Lopinavir tablets / ritonavir tablets (0.5 g, oral, bid,14d) ↑: Cure rate, excellent, total effectiveness rate P < 0.05 Nausea and vomiting (T:C = 4:3) NR
↓: CRP, IL-4, TNF-α P < 0.05 Diarrhea (T:C = 3:3) NR
↑: CD3+ CD4+, CD8+,
CD4+/CD8+
P < 0.05 Abnormal liver function (T:C = 1:9) NR
↓: Total adverse event rate P = 0.013
  1. ↓ decreased; ↑: increased, Qd Once a day, Bid Twice a day, Tid three times a day, Qid four times a day, NR not reported, TCM Traditional Chinese medicine, WBC White blood cell count, LYM Lymphocyte absolute value, LYM% Lymphocyte ratio, CRP c-reactive protein, PCT Procalcitonin, RT-PCR Reverse transcription-polymerase chain reaction, IL-10 Interleukin-10, IL-6 Interleukin-6, IL-4 Interleukin-4, hs-CRP Hypersensitive-c-reactive-protein, NEU Neutrophils, ALT Alaninetransaminase, AST Glutamic oxaloacetic transaminase, ESR Erythrocyte sedimentation rate, APACHE-II Acute physiology and chronic health evaluation, CD Cluster of differentiation, TNF-α Tumor necrosis factor