Herbal medicines for viral myocarditis

Liu ZL, Liu ZJ, Liu JP, Yang M, Kwong J

Published Online:

July 7, 2010

Viral myocarditis is a disease where the muscles in the walls of heart become infected with a virus. This systematic review evaluates the effect of various herbal formulations (including single herbs, ingredients, and mixtures of different herbs) for treating acute and chronic viral myocarditis patients. Fourteen identified clinical trials were performed and published in China. The review of trials found that some of the herbal medicines may have a positive effect on improving cardiac function, lowering blood enzymes and relieving symptoms in viral myocarditis patients. Data on adverse events were only available from one trial. However, the methodological quality of the clinical trials evaluating these herbal medicines was generally poor.

Abstract (click to read)

Background:

Herbal medicines are being used for treating viral diseases including viral myocarditis, and many controlled trials have been done to investigate their efficacy.

Objectives:

To assess the effects of herbal medicines on clinical and indirect outcomes in patients with viral myocarditis.

Search strategy:

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library Issue 3, 2009, MEDLINE (January 1966 - July 2009), EMBASE (January 1998 - July 2009), Chinese Biomedical Database (1979 - 2009), China National Knowledge Infrastructure (1979 - 2009), Chinese VIP Information (1989 - 2009), Chinese Academic Conference Papers Database and Chinese Dissertation Database (1980 - 2009), AMED (1985 - 2009), LILACS accessed in July 2009 and the trials register of the Cochrane Complementary Medicine Field. We handsearched Chinese journals and conference proceedings. No language restrictions were applied.

Selection criteria:

Randomised controlled trials of herbal medicines (with a minimum of seven days treatment duration) compared with placebo, no intervention, or conventional interventions were included. Trials of herbal medicine plus conventional drug versus drug alone were also included. Only trials that reported adequate description of allocation sequence generation were included.

Data collection and analysis:

Two review authors independently extracted data and evaluated trial quality. Adverse effects information was collected from the trials.

Main results:

Fourteen randomised trials involving 1463 people were included. All trials were conducted and published in China. Quality of the trials was assessed to be low. No trial had diagnosis of viral myocarditis confirmed histologically, and only a few trials attempted to establish viral aetiology. Nine different herbal medicines were tested in the included trials. The trials reported electrocardiogram results, level of myocardial enzymes, cardiac function, symptoms, and adverse effects.

Astragalus membranaceus (either as an injection or granules) showed significant positive effects in symptom improvement, normalisation of electrocardiogram results, CPK levels, and cardiac function. Shengmai injection also showed significant effects in symptom improvement. Shengmai decoction triggered significant improvement in quality of life measured by SF-36. No serious adverse effects were reported.

Authors' conclusions:

Some herbal medicines may lead to improvement of symptoms, ventricular premature beat, electrocardiogram, level of myocardial enzymes, and cardiac function in viral myocarditis. However, interpretation of these findings should be taken with care due to the low methodological quality, small sample size, and limited number of trials on individual herbs. Further robust trials are needed to explore the use of herbal medicines in viral myocarditis.

This record should be cited as:

Liu ZL, Liu ZJ, Liu JP, Yang M, Kwong J. Herbal medicines for viral myocarditis. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD003711. DOI: 10.1002/14651858.CD003711.pub3

Assessed as up to date:

January 29, 2010

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Primary Review Group:

Heart Group

Health topics:

Infectious disease > Heart diseases > Myocarditis

Complementary & alternative medicine > Infectious disease > Heart diseases

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Herbal medicines for viral myocarditis

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