The use of maoto (Ma-Huang-Tang), a traditional Japanese Kampo medicine, to alleviate flu symptoms: a systematic review and meta-analysis

Abstract

BackgroundInfluenza is a common viral infection worldwide. Maoto (ma-huang-tang) was developed in ancient China and is used to alleviate flu symptoms. Currently, no meta-analyses have evaluated the efficacy and safety of maoto for alleviating flu symptoms.MethodsIn the present study, we searched MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, a Japanese database (Ichushi), two Chinese databases (China National Knowledge Infrastructure and VIP), and two Korean databases (Korean Medical database and Korean Association of Medical Journal Editors) for studies published in or before October 2017. Clinical studies that compared maoto plus neuraminidase inhibitors (NAIs) vs. NAIs alone, or maoto alone vs. NAIs alone, were included in the present analysis. The primary outcome measure (efficacy) was the length of time from the start of medication to resolution of influenza symptoms (fever, headache, malaise, myalgia, and chills) and virus isolation. The secondary outcome measures (safety) were as follows: (1) side effects and adverse reactions, such as nausea, abnormal behaviour, or discontinuation of symptomatic treatment; (2) morbidity (complications caused by influenza infection) or mortality; and (3) hospitalisation for any reason.ResultsTwelve relevant studies were identified, including two randomised controlled trials (RCTs, N = 60) and ten non-randomised studies (NRSs, N = 1110). We found that maoto plus NAIs was superior to NAIs alone in terms of the duration of fever in one RCT (P < 0.05, median difference = − 6 h) and four NRSs (P = 0.003, weighted mean difference = − 5.34 h). The duration of symptoms or virus isolation did not differ between maoto and NAIs. No severe side effects or adverse reactions were reported related to maoto or NAIs.ConclusionsAlthough we could not reach a definitive conclusion because of the small sample sizes and high risk of bias in the analysed studies, maoto may lower the duration of fever when it is used alone or in combination with NAIs and may be a well-tolerated treatment. More RCTs are needed to determine the efficacy and safety of maoto.Electronic supplementary materialThe online version of this article (10.1186/s12906-019-2474-z) contains supplementary material, which is available to authorized users.

Kakkonto, shosaikoto, Platycodon grandiflorum root, and gypsum (a Japanese original combination drug known as saikatsugekito): Pharmacological review of its activity against viral infections and respiratory inflammatory conditions and a discussion of its applications to COVID‐19

“…Kampo medicine could be useful in terms of medical cost reduction. For example, maoto is effective for the treatment of influenza symptoms [85], and its medical cost for one patient (150 yen) is considerably lower than that using neuraminidase inhibitors (3260 yen) [86]. The current average prices of KKT, SST, and kikyosekko extract in Japan are 50, 156, and 50 yen per day, respectively (June 2020), and the price of these Kampo formulas has been kept low under the national health care insurance system.…”

Effects of maoto (ma-huang-tang) on host lipid mediator and transcriptome signature in influenza virus infection

“…Maoto (MT; or ma-huang-tang in Chinese), a traditional herbal medicine in Japan (Kampo), is prescribed widely to care for symptoms of upper respiratory infections and influenza 11 , 12 . Maoto is a mixture of four component herbs: Armeniacae semen (32.3%), Glycyrrhizae radix (9.6%), Cinnamomi cortex (25.8%), and Ephedrae herba (32.3%).…”

Screening of Antiviral Components of Ma Huang Tang and Investigation on the Ephedra Alkaloids Efficacy on Influenza Virus Type A

“…MHT, a famous classical prescription, has been widely used to treat lung diseases such as influenza, fever, headache, bronchitis, asthma and many other respiratory infections (Ma et al, 2014; Zheng et al, 2015a). Modern clinical research has also proved that MHT has been extensively applied for the treatment of seasonal influenza (Yoshino et al, 2019). In addition to China, MHT has been used in the treatment of influenza and asthma for many years in Korea and Japan (Lim et al, 2016; Kitagawa et al, 2019).…”