Background. Asthma is a chronic condition that results in the inflammation and narrowing of airways, often clinically presenting as wheeze and shortness of breath. Little is known of the mechanisms of action (MOA) of herbs used to treat asthma. The aim of this study is to review existing data regarding known MOA of traditional Chinese medicine which will aid in the understanding of possible interactions between Western drugs and Chinese herbs as well as the standardization of management via a proposed guideline to improve patient safety and possible synergism in the long term. Methods. We searched through 5 databases for commonly prescribed herbs and formulas for asthma and narrowed down the search to identify the underlying MOA of individual herbs that could specifically target asthma symptoms. We included studies that stated the MOA of individual herbs when used for treating symptoms of asthma, excluding them if they are described as part of a formula. Results. A total of 26 herbs commonly prescribed for asthma with known mechanism of action were identified. Herbs used for asthma were found to have similar MOA as that for drugs. Based on existing GINA guidelines, a guideline is proposed which includes a total of 5 steps depending on the severity of asthma and the herbs’ MOA. 16 formulas were subsequently identified for the management of asthma, which consist of 12 “stand-alone” and 4 “add-on” formulas. “Stand-alone” formulas used independently for asthma generally follow the GINA guidelines but do not proceed beyond step 3. These formulas consist mainly of beta-agonist and steroid-like effects. “Add-on” formulas added as adjunct to “stand-alone” formulas, however, mainly act on T helper cells or have steroid-like effects. Conclusion. Through the understanding of MOA of herbs and their respective formulas, it will ensue greater patient safety and outcomes.
Background: Coronavirus 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 Strategy: We searched through 5 databases for studies on SYSF and patients with
COVID-19 through April 2020.
Eligibility Criteria: We included studies that included formulas within San Yao San Fang
with or without Western interventions against Western interventions.
Main results: We included 7 studies involving 532 patients.
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 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))
Conclusion: SYSF appears to be clinically effective and safe. Further research is required to
ensure the efficacy of SYSF.
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