Mixed Chinese herbs and Western medicine for novel coronavirus disease 2019 (COVID-19): a mixed method review

BackgroundCoronavirus disease 2019 (COVID-19) is a pandemic affecting millions around the world. There is no existing pharmaceutical treatment that is known to be effective. Preliminary data shows that San Yao San Fang (SYSF) has clinical benefits in patients with COVID-19. The aim of this paper is to review existing data regarding the use of formulas within San Yao San Fang in the treatment of COVID-19 Search StrategyWe searched through EMBASE, Pubmed, Cochrane, Wanfang and China National Knowledge Infrastructure (CNKI) for studies on SYSF and patients with COVID-19 through April 2020. Eligibility CriteriaWe included studies that included a formula within San Yao San Fang with or without Western interventions against Western interventions. Main resultsWe included 7 studies involving 532 patients. 3 retrospective observational studies and 1 randomised control trial reported on Lian Hua Qing Wen Jiao Nang, 1 randomised control trial on Jin Hua Qing Gan Ke Li, 1 retrospective observational study on Xue Bi Jing Zhu Se Ye and 1 randomised control trial on Qing Fei Pai Du Tang. SYSF combined with Western interventions improved the recovery rate of symptoms such as fever (Risk Ratio (RR) 0.40 (95% CI 0.24 to 0.66, P < 0.01)), cough (RR 0.56 (95% CI 0.38 to 0.82, P < 0.01)) and fatigue (RR 0.61 (95% CI 0.47 to 0.78, P < 0.01)) and other symptoms such as headache, gastrointestinal symptoms, myalgia, dyspnoea and chest tightness (RR 0.63 (95% CI 0.47 to 0.83, P < 0.01)) as compared to the control group. SYSF combined with Western interventions reduced the duration of fever as compared to the control group. (Mean difference (MD) -1.18 (95% CI -1.45 to -0.91, P < 0.01)) In regards to adverse events, there is no statistical difference between the treatment group treated with SYSF and Western interventions and the control group. (RR 1.62 (95% CI 0.83 to 3.17, P = 0.16)). SYSF combined with Western interventions did not show to significantly reduce duration of hospitalisation as compared to the control group. (MD -0.73 (95% CI -5.19 to 3.73, P = 0.75)) ConclusionSYSF appears to be clinically effective and safe. Further research is required to ensure the efficacy of SYSF.