Chinese herbs combined with Western medicine for treating severe acute respiratory syndrome (SARS)

Liu X, Zhang M, He L, Li Y

Published Online:

October 6, 2010

Severe acute respiratory syndrome (SARS) is an acute respiratory disease which first appeared in 2002. Integrated Chinese and Western medicines played an important role in the treatment of SARS and this review assessed the effectiveness and safety of this integrated treatment approach. Among 5327 confirmed cases, 3104 patients received traditional Chinese medicine.

We identified 12 randomized controlled trials and one quasi-randomized controlled trial involving 654 SARS patients. Clinical evidence shows that integrated Western and Chinese medicine does not decrease the mortality rate. It is possible that different Chinese herbs combined with Western medicines may improve symptoms, quality of life, lung infiltrate absorption and decrease corticosteroid dosage. No severe adverse events were found. The evidence is weak because of the poor quality of the included trials.

Abstract (click to read)

Background:

Severe acute respiratory syndrome (SARS) is an acute respiratory disease caused by a novel coronavirus, which first appeared in Foshan City, China on 22 December 2002. Chinese herbs were used in its treatment.

Objectives:

To evaluate the possible effectiveness and safety of Chinese herbs combined with Western medicines versus Western medicines alone for SARS patients.

Search strategy:

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2010, issue 1) which contains the Acute Respiratory Infection Group's Specialized Register, MEDLINE (1966 to February Week 4, 2010), EMBASE (1990 to March 2010) and the Chinese Biomedical Literature (issue 1, 2010).

Selection criteria:

Randomized controlled trials (RCTs) and quasi-RCTs of Chinese herbs combined with Western medicines versus Western medicines alone for patients diagnosed with SARS.

Data collection and analysis:

Two review authors (XL, MZ) independently extracted trial data. We extracted dichotomous and continuous data with 95% confidence intervals (CI). For dichotomous data, risk ratio (RR) was used. For continuous data, we calculated mean differences (MD). Overall results were calculated based on the random-effects model if heterogeneity existed between studies. If no heterogeneity was detected between the studies, we used the fixed-effect model. We used the Z score and the Chi2 statistic with significance being set at P < 0.05 tested heterogeneity.

Main results:

We included twelve RCTs and one quasi-RCT. A total of 654 SARS patients and 12 Chinese herbs were identified. We did not find Chinese herbs combined with Western medicines decreased morbidity versus Western medicines alone. Two herbs may improve symptoms. Five herbs may improve lung infiltrate absorption. Four herbs may decrease the dosage of corticosteroids. Three herbs may improve the quality of life of SARS patients. One herb may shorten the length of stay in hospital. Only two trials reported adverse events.

Authors' conclusions:

Chinese herbs combined with Western medicines made no difference in decreasing morbidity versus Western medicines alone. It is possible that Chinese herbs combined with Western medicines may improve symptoms, quality of life, lung infiltrate absorption and decrease the corticosteroid dosage for SARS patients. The evidence is weak because of the poor quality of the included trials. Long-term follow up of these included trials is needed.

This record should be cited as:

Liu X, Zhang M, He L, Li Y. Chinese herbs combined with Western medicine for severe acute respiratory syndrome (SARS). Cochrane Database of Systematic Reviews 2006, Issue 1. Art. No.: CD004882. DOI: 10.1002/14651858.CD004882.pub2

Assessed as up to date:

March 5, 2010

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Primary Review Group:

Acute Respiratory Infections Group

Health topics:

Infectious disease > Respiratory infections > SARS

Lungs & airways > Respiratory infections > SARS

Complementary & alternative medicine > Infectious disease > Respiratory infections

Complementary & alternative medicine > Lungs & airways > Respiratory infections

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Chinese herbs combined with Western medicine for treating severe acute respiratory syndrome (SARS)

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