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1.
Medicine (Baltimore) ; 100(40): e27372, 2021 Oct 08.
Article in English | MEDLINE | ID: covidwho-1462558

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) in many countries is still very serious. At present, there is no specific and effective drug for this disease. Traditional Chinese medicine (TCM) has played a great role in fighting against COVID-19. However, their effectiveness and safety are still obscure and deserve further investigation. The aim of the study was to evaluate the efficacy and safety of TCM assisted in conventional treatment in the treatment of mild and common COVID-19. METHODS: PubMed, EMbase, MEDLINE, China National Knowledge Infrastructure Database, WANFANG DATA, and VIP Chinese Science and Technology Periodical Database were searched for randomized controlled trials (RCTs) and non-randomized controlled trials of TCM assisted in conventional treatment. The RCT research quality was evaluated by Cochrane 5.1.0 bias risk scale and the non-randomized controlled trial research quality was evaluated by Newcastle Ottawa scale, and the statistical analysis was conducted by Revman 5.3 and R software. The bias and sensitivity of the statistical results were analyzed by STATA 14.0. Registration number: CRD42020210619. RESULTS: Fifteen studies were included with 7 RCT studies and 8 retrospective cohort studies, involving a total of 1623 patients. Compared with the control group, TCM can improve the main index clinical effective rate (odds ratio [OR] = 2.64, 95% Confidence interval (CI) [1.94,3.59], P < .00001). The results of Begg test (Pr > z = 0.266) and sensitivity analysis showed that the results were relatively stable. Toujie Quwen (OR = 4.9, 95%CI [1.9,14.0]), Shufeng Jiedu (OR = 2.9, 95%CI [1.5,5.7]), and Lianhua Qingwen (OR = 2.4, 95%CI [1.6,3.6]) were with the best. It can also improve the main clinical symptoms (fever, cough, fatigue, and the regression time of the 3 symptoms), severe conversion rate, and computed tomography improvement rate. Its safety was not significantly compared with conventional treatment. However, in terms of safety of a single TCM, Shufeng Jiedu (OR = -0.86, 95%CI [-1.89,0.09]) and Lianhua Qingwen (OR = -0.49, 95%CI[-0.94,-0.05]) were lower than those of conventional treatment. CONCLUSION: TCM as an adjuvant therapy combined with conventional treatment has good curative effect on mild and common type of COVID-19 patients. Its advantages lie in clinical efficacy and improvement of symptom group, and can prevent patients from transforming to severe disease. In terms of clinical efficacy and safety, Shufeng Jiedu and Lianhua Qingwen have obvious advantages, which are worthy of clinical promotion.

2.
American Journal of Chinese Medicine ; 49(4):785-803, 2021.
Article in English | CAB Abstracts | ID: covidwho-1408304

ABSTRACT

The coronavirus disease 2019 (COVID-19) spreads and rages around the world and threatens human life. It is disappointing that there are no specific drugs until now. The combination of traditional Chinese medicine (TCM) and western medication seems to be the current more effective treatment strategy for COVID-19 patients in China. In this review, we mainly discussed the relationship between COVID-19 and gut microbiota (GM), as well as the possible impact of TCM combined with western medication on GM in the treatment of COVID-19 patients, aiming to provide references for the possible role of GM in TCM against COVID-19. The available data suggest that GM dysbiosis did occur in COVID-19 patients, and the intervention of GM could ameliorate the clinical condition of COVID-19 patients. In addition, TCMs (e.g., Jinhua Qinggan granule, Lianhua Qingwen capsule, Qingfei Paidu decoction, Shufeng Jiedu capsule, Qingjin Jianghuo decoction, Toujie Quwen granules, and MaxingShigan) have been proven to be safe and effective for the treatment of COVID-19 in Chinese clinic. Among them, Ephedra sinica, Glycyrrhiza uralensis, Bupleurum chinense, Lonicera japonica, Scutellaria baicalensi, and Astragalus membranaceus are common herbs and have a certain regulation on GM, immunity, and angiotensin converting enzyme 2 (ACE2). Notably, Qingfei Paidu decoction and MaxingShigan have been demonstrated to modulate GM. Finally, the hypothesis of GM-mediated TCM treatment of COVID-19 is proposed, and more clinical trials and basic experiments need to be initiated to confirm this hypothesis.

3.
Phytochem Rev ; : 1-19, 2021 Aug 27.
Article in English | MEDLINE | ID: covidwho-1378978

ABSTRACT

Whilst Western research for the COVID-19 crisis focuses on vaccination, in East Asia traditional herbal prescriptions are studied for SARS-CoV2 therapy. In Japan, Maoto (Ephedrae herba 4 g, Armeniacae semen 4 g, Cinnamomi cortex 3 g, and Glycyrrhizae radix 2 g, JPXVII) is used based on clinical evidence for its effect on early phase influenza (also caused by RNA viruses) comparable to that of oseltamivir. The Health Ministry of Thailand has approved Andrographis paniculata (Jap. Senshinren) extracts for treatment of COVID-19. Its combination (4 g) with Maoto, Maoto-ka-senshinren, seems most promising for the treatment of viral pandemics. In China, the official guideline for COVID-19 treatment contains TCM medications with antiviral, as well as immunmodulatory and anti-inflammatory effects such as: Qing-Fei-Pai-Du-Tang (Jap. Seihai-haidokuto) contains 21 drugs; Shufeng Jiedu Jiaonang (Bupleuri radix 8 g, Forsythiae fructus 8 g, Glycyrrhizae radix 4 g, Isatidis radix 8 g, Patriniae herba 8 g, Phragmitis rhizoma 6 g, Polygoni cuspidati rhizoma 10 g, Verbenae herba 8 g); Fufang Yuxingcao Heiji (Forsythiae fructus 0.6 g, Houttuyniae herba 6 g, Isatidis radix 1.5 g, Lonicerae flos 0.6 g, Scutellariae radix 1.5 g) first gained prominence during the 2002 SARS epidemic. With no Western medicine available, the following overview discusses efficacy and mechanisms in view of viral entry and replication of different East Asian herbal remedies for COVID-19 treatment.

4.
Research on Biomedical Engineering ; 2021.
Article in English | PMC | ID: covidwho-1343087

ABSTRACT

Purpose: COVID-19 has spread and continues to spread rapidly across the world. There is still no approved and effective treatment for the disease. Several drugs are being administered empirically to patients, based on results from studies with limited methodologies. There is an urgent need for systematic reviews to support decision makers and the development of guidelines. The purpose of this paper was to conduct a systematic review of drug studies carried out worldwide for COVID-19, verifying the effectiveness and methodological quality. Method: The search for relevant articles was performed in the Cochrane Central, MEDLINE, and Embase databases. The terms and combinations used for the search were ((coronavirus OR “2019-nCoV” OR 2019nCoV OR nCoV2019 OR “nCoV-2019” OR “COVID-19” OR COVID19 OR “HCoV-19” OR HCoV19 OR CoV OR “2019 novel*” OR Ncov OR “n-cov” OR “SARS-CoV-2” OR “SARSCoV-2” OR “SARSCoV2” OR “SARSCoV2” OR SARSCov19 OR “SARS-Cov19” OR “SARS-Cov-19”) OR “severe acute respiratory syndrome*” OR ((corona* OR corono*) AND (virus* OR viral* OR virinae*)) AND ((treatment) OR (medication) OR (symptoms)) AND (drugs)). The review process of the articles was carried out independently by four reviewers using the PRISMA-P method. Results: As a result, a total of 30 articles were selected, which addressed the study of one or more medications for severe cases of COVID-19, which were hydroxychloroquine (or chloroquine) and azithromycin, lopinavir/ritonavir, lopinavir/ritonavir, arbidol, and Shufeng Jiedu Capsule, Combinations: remdesivir/lopinavir/homoharringtonine/emetine, remdesivir, interferon, lopinavir and ritonavir, thalidomide/methylprednisolone, tocilizumab, antimicrobial therapy. Conclusion: Despite efforts and studies, research does not provide evidence for the use of any drug to treat COVID-19, as the effects, safety, and efficacy are still uncertain. Thus, there is a need for systematic reviews to monitor, synthesize, and update the literature data on the subject, generating reliable evidence for decision makers. COVID-19 should be monitored and the need to develop effective drugs and vaccines to prevent disease progression must be reinforced.

5.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 33(6): 714-720, 2021 Jun.
Article in Chinese | MEDLINE | ID: covidwho-1323328

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy and safety of combination of traditional Chinese and Western medicine in the treatment of coronavirus disease 2019 (COVID-19) by Meta analysis. METHODS: The clinical randomized controlled trials (RCT) and cohort studies on the treatment of COVID-19 with combination of Chinese traditional and Western medicine published on CNKI, Wanfang database, VIP database and PubMed were searched by computer from January 2020 to June 2020. Patients in the simple Western medicine treatment group were treated with routine treatment of Western medicine, and the patients in integrated traditional Chinese and Western medicine treatment group were treated with traditional Chinese medicine on the basis of routine treatment of Western medicine. The main outcome was the total effective rate of treatment. The secondary outcome were the antipyretic rate, chest CT recovery rate, lymphocyte count (LYM), C-reactive protein (CRP) level and safety. The Cochrane manual and the Newcastle Ottawa Scale (NOS) were used to evaluate the quality of the literature; the RevMan5.3 software was used to analyze the articles that meets the quality standards, and a funnel chart was drawn to evaluate the total effective publication bias. RESULTS: Thirteen articles were analyzed, including 1 039 COVID-19 patients, 559 in integrated traditional Chinese and Western medicine treatment group and 480 in simple Western medicine treatment group. The results of Meta- analysis showed that compared with the simple Western medicine treatment group, the combination of routine treatment of Western medicine and traditional Chinese medicine Qingfei Paidu decoction, Lianhua Qingwen granule, Shufeng jiedu capsule, Xuebijing injection or Reyanning mixture could significantly improve the total effective rate, antipyretic rate and chest CT recovery rate [total effective rate: odds ratio (OR) = 2.95, 95% confidence interval (95%CI) was 2.10-4.14, P < 0.000 01; antipyretic rate: OR =3.01, 95%CI was 1.64-5.53, P = 0.000 4; chest CT recovery rate: OR = 2.53, 95%CI was 1.83-3.51, P = 0.000 1], increase LYM levels [mean difference (MD) = 0.26, 95%CI was 0.02-0.50, P = 0.03], and reduce of CRP content (MD = -17.68, 95%CI was -33.14 to -2.22, P = 0.02). Based on the funnel chart analysis of 12 articles with total efficiency, the result showed that the funnel chart distribution was not completely symmetrical, indicating that there might be publication bias. CONCLUSIONS: On the basis of routine treatment with Western medicine, combined with traditional Chinese medicine can significantly improve the total effective rate of COVID-19 and improve the laboratory results and clinical symptoms of patients. Compared with the routine treatment of Western medicine alone, the combination of traditional Chinese and Western medicine has better clinical efficacy and safety.


Subject(s)
COVID-19 , Drugs, Chinese Herbal , China , Drugs, Chinese Herbal/therapeutic use , Humans , Medicine, Chinese Traditional , SARS-CoV-2 , Treatment Outcome
6.
Pharmacol Res ; 158: 104896, 2020 08.
Article in English | MEDLINE | ID: covidwho-1318933

ABSTRACT

Corona virus disease (COVID-19) has now spread to all parts of the world and almost all countries are battling against it. This study aimed to assess the efficacy and safety of Integrated Traditional Chinese and Western Medicine (Hereinafter referred to as "Integrated Medicine") to COVID-19. We searched six major Chinese and English databases to identify randomized controlled trials (RCTs) and case-control studies (CCSs) of Integrated Medicine on COVID-19. Two reviewers independently screened, identified studies, and extracted data. Cochrane Risk of Bias tool and the Newcastle-Ottawa Scale were used to assess the quality of included RCTs and CCSs, respectively. Stata (version 13.0; StataCorp) was used to perform meta-analyses with the random-effects model. Risk ratio (RR) was used for dichotomous data while the weighted mean difference (WMD) was adopted for continuous variables as effect size, both of which were demonstrated in effect size and 95% confidence intervals (CI). A total of 11 studies were included. Four were RCTs and seven were CCSs. The sample size of including studies ranged from 42 to 200 (total 982). The traditional Chinese medicine included Chinese medicine compound drugs (QingFei TouXie FuZhengFang) and Chinese patent medicine (e.g. Shufeng Jiedu Capsule, Lianhua Qingwen granules). Compared with the control group, the overall response rate [RR = 1.230, 95%CI (1.113, 1.359), P = 0.000], cure rate [RR = 1.604, 95%CI (1.181, 2.177), P = 0.002], severity illness rate [RR = 0.350, 95%CI (0.154, 0.792), P = 0.012], and hospital stay [WMD = -1.991, 95%CI (-3.278, -0.703), P = 0.002] of the intervention group were better. In addition, Integrated Medicine can improve the disappearance rate of fever, cough, expectoration, fatigue, chest tightness and anorexia and reduce patients' fever, and fatigue time (P < 0.05). This review found that Integrated Medicine had better effects and did not increase adverse drug reactions for COVID-19. More high-quality RCTs are needed in the future.


Subject(s)
Betacoronavirus , Clinical Medicine/methods , Combined Modality Therapy/adverse effects , Combined Modality Therapy/methods , Coronavirus Infections/therapy , Medicine, Chinese Traditional/methods , Pneumonia, Viral/therapy , COVID-19 , Humans , Pandemics , SARS-CoV-2
7.
Journal of Pharmaceutical Analysis ; 2021.
Article in English | ScienceDirect | ID: covidwho-1284248

ABSTRACT

A fast, reliable, and cost-effective liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was established to determine the effects of the traditional Chinese medicine employed to treat coronavirus disease 2019, namely, Lianhua Qingwen granules, Huoxiang Zhengqi capsules, Jinhua Qinggan granules, Shufeng Jiedu capsules, and Angong Niuhuang pills, on the pharmacokinetic of lopinavir/ritonavir in rats. Blood samples were prepared using the protein precipitation method and atazanavir was selected as the internal standard (IS). Separation was performed on an Agilent ZORBAX eclipse plus C18 (2.1 mm × 50 mm, 1.8 μm) column using acetonitrile and water containing 0.1% formic acid as the mobile phase for gradient elution. The flow rate was 0.4 mL/min and the injection volume was 2 μL. Agilent Jet Stream electrospray ionization was used for mass spectrometry detection under positive ion multiple reaction monitoring mode at a transition of m/z 629.3 → 447.3 for lopinavir, m/z 721.3 → 296.1 for ritonavir, and m/z 705.4 → 168.1 for the IS. The method showed good linearity in the concentration range of 25–2500 ng/mL (r = 0.9981) for lopinavir and 5–500 ng/mL (r = 0.9984) for ritonavir. The intra-day and inter-day precision and accuracy were all within ±15%. Items, such as dilution reliability and residues, were also within the acceptable limits. The method was used to determine the effects of five types of traditional Chinese medicine on the pharmacokinetics of lopinavir/ritonavir in rats. The pharmacokinetic results showed that the half-life (t1/2) of ritonavir in the groups administered Lianhua Qingwen granules and Huoxiang Zhengqi capsules combined with lopinavir/ritonavir was prolonged by approximately 1.5–2-fold relative to that in the control group. Similarly, the pharmacokinetic parameters of lopinavir were altered. Overall, the results of this study offer important theoretical parameters for the effective clinical use of five types of traditional Chinese medicine combined with lopinavir/ritonavir to reduce the occurrence of clinical adverse reactions.

8.
Chinese Medicine ; 11(1):9-18, 2020.
Article in English | CAB Abstracts | ID: covidwho-1236888

ABSTRACT

The paper is proposed to explore the potential effects of Shufeng Jiedu Capsule against COVID-19. The ingredients and targets of Shufeng Jiedu Capsule were collected by the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and the gene names of potential targets were extracted by UniProtKB. Then we did protein-protein interaction networks functional enrichment analysis by the STRING platform, reconstructed drug-target pathways and networks to predict the likely protein targets of the capsule against COVID-19 with software Cytoscape 3.6.1, and carried out GO enrichment analysis and KEGG analysis with R 5.3.2 software. At last we validated our predictions on molecular docking. The results suggested that Shufeng Jiedu Capsule contained 155 ingredients and 237 targets, including 26 main active ingredients and 45 key targets. There were 2334 biological processes (BP), 103 cell composition (CC) and 198 molecular functions (MF) in GO Enrichment Analysis, and 177 pathways in the KEGG analysis. The molecular docking analysis showed that binding energy for 26 main active ingredients ranged from -32.21 to -25.94 kJ.mol-1, and the main targets bind to SARS-CoV-2 3CL hydrolase by acting on CASP9, PRKCA, RELA and others. Our study suggested that Shufeng Jiedu Capsule has potential therapeutic effects on COVID-19.

9.
Eur J Integr Med ; 40: 101241, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1065081

ABSTRACT

Introduction: The novel coronavirus pneumonia that broke out in 2019 has become a global epidemic. According to the diagnosis and treatment plan issued in China and the existing clinical data, Shufeng Jiedu (SFJD) Capsule can be effectively used in the treatment of COVID-19 patients. This study aimed to explore its mechanism of action by network pharmacology and molecular docking technology. Methods: The Chinese Medicine System Pharmacology Analysis Platform (TCMSP), a Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine (BATMAN-TCM), the Encyclopedia of Traditional Chinese Medicine (ETCM) and related literature records were used to search the composition and main active compounds of SFJD, and to screen out the targets of drug components. Disease-associated genes were obtained by the Human Gene Database (GeneCards), the Human Online Mendelian Inheritance Platform (OMIM) and the DisGeNET database, and the co-targeted genes/proteins as targets of both SFJD and COVID-19 were selected by the Comparative Toxicogenomics Database (CTD). Co-targeted genes/proteins were analyzed by STRING, the Database for Annotation, Visualization and Integrated Discovery (DAVID) and Reactome for proteins to protein interaction (PPI), pathway and GO (gene ontology) enrichment, and predicted by AutoDock for their high-precision docking simulation. In addition, the therapeutic effect for SFJD treatment on COVID-19 was validated by the Chinese medicine anti-novel coronavirus pneumonia drug effect prediction and analysis platform (TCMCOVID). Results: Screening resulted in 163 compounds and 463 targeted genes. The PPI core network contains 76 co-targeted proteins. The Reactome pathways were enriched in signaling by interleukins, immune system, etc. Finally, 6 key proteins of TNF, IL-10, IL-2, IL-6, STAT1 and CCL2 were selected and successfully docked with 4 active ingredients of quercetin, luteolin, wogonin and kaempferol. Conclusion: SFJD may play a role in the prevention and treatment of COVID-19 through multiple active compounds acting on multiple targets and then multiple pathways.

10.
Medicine (Baltimore) ; 100(1): e24198, 2021 Jan 08.
Article in English | MEDLINE | ID: covidwho-1024163

ABSTRACT

BACKGROUND: With the outbreak of novel coronavirus, the treatment of respiratory diseases has been promoted. In particular, many traditional Chinese medicines, including Chinese patent medicines, have been found to be effective in the treatment of respiratory illness in China. chronic obstructive pulmonary disease (COPD) is one of most common respiratory condition. It is predicted that COPD will be become the third frequent cause of death by 2030. The aim of this study is to assess the efficacy and safety of Shufeng Jiedu Capsule in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). METHODS: According to the search strategy, randomized controlled trials (RCTs) of Shufeng Jiedu Capsule in the treatment of AECOPD were obtained from Cochrane Library, MEDLINE, Embase, CNKI, VIP, CBM, and WANGFANG. Studies were screened according to inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to assess the quality of the study. Meta-analysis was performed using Revman 5.4 software. Finally, the evidence level of the results will be evaluated. RESULTS: The purpose of this study was to evaluate the efficacy and safety of Shufeng Jiedu Capsule in the treatment of AECOPD, and to provide basis for clinical rational drug use. CONCLUSION: Our research results of this study could provide reference for clinical decision-making and guiding development in the future COPD patient. INPLASY REGISTRATION NUMBER: INPLASY2020120062.


Subject(s)
Drugs, Chinese Herbal/therapeutic use , Pulmonary Disease, Chronic Obstructive/drug therapy , Research Design , Capsules , Humans , Meta-Analysis as Topic , Systematic Reviews as Topic
11.
Medicine (Baltimore) ; 99(50): e23293, 2020 Dec 11.
Article in English | MEDLINE | ID: covidwho-983597

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) epidemic is spreading worldwide. Shufeng Jiedu capsule (SFJDC) is a commonly used drug in the treatment of COVID-19. However, there is insufficient evidence for clinical efficacy and safety. METHODS: Two authors will independently search the Chinese National Knowledge Infrastructure (CNKI), VIP database, Wanfang database, the Cochrane Library, EMBASE, PubMed and Web of Science, in English and Chinese. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. Review Manager 5.3 and Stata 16.0 software will be used to analyze the eligible data. RESULTS: This protocol will conduct a systematic review and meta-analysis of literature listed above, and reliable outcomes about the clinical efficacy and safety of SFJDC in the treatment of COVID-19 will be obtained. CONCLUSIONS: These findings will provide guidance for clinicians and patients using SFJDC for COVID-19 treatment. PROSPERO REGISTRATION NUMBER: CRD42020185764.


Subject(s)
COVID-19/drug therapy , Drugs, Chinese Herbal/therapeutic use , Drugs, Chinese Herbal/administration & dosage , Drugs, Chinese Herbal/adverse effects , Humans , Randomized Controlled Trials as Topic , Research Design
12.
Phytomedicine ; 85: 153390, 2021 May.
Article in English | MEDLINE | ID: covidwho-912536

ABSTRACT

BACKGROUND: Shufeng Jiedu capsules (SFJDC), a patented herbal drug composed of eight medicinal plants, is used for the treatment of different viral respiratory tract infectious diseases. Based on its antiviral, anti-inflammatory and immunoregulatory activity in acute lung injury, SFJDC might be a promising candidate for the treatment of COVID-19. PURPOSE: To evaluate the antiviral and anti-inflammatory properties and to discover the mechanism of action of SFJDC as a potential drug for the treatment of COVID-19. Furthermore, the study should determine the clinical effectiveness of SFJDC for the treatment of COVID-19. DESIGN: We analyzed the antiviral and anti-inflammatory effects of SFJDC in a HCoV-229E mouse model on lung index, virus load in the lung, the release of cytokines, and on T- and B-lymphocytes. The mechanism of action was further investigated by network analysis. Additionally, we investigated data from a clinical pragmatic real-world study for patients with confirmed COVID-19, to evaluate the clinical effect of SFJDC and to determine the best time to start the treatment. RESULTS: SFJDC significantly reduced the virus load in the lung of HCoV-229E mice (from 1109.29 ± 696.75 to 0 ± 0 copies/ml), decreased inflammatory factors IL-6, IL-10, TNF-α, and IFN-γ in the lung, and increased the amount of CD4+ and CD8+ cells in the blood compared to the model group. Network analysis revealed that SFJDC reduces the activity of NFκB via several signaling pathways. Quercetin, wogonin, and polydatin bind directly to the main protease (Mpro) of SARS-CoV-2. Clinical data showed that SFJDC, added to standard antiviral therapy (AVD), significantly reduced the clinical recovery time of COVID-19 and fatigue (from 3.55 ± 4.09 to 1.19 ± 2.28 days) as well as cough (from 5.67 ± 5.64 to 3.47 ± 3.75) days compared to AVD alone. SFJDC therapy was significantly more effective when used within the first 8 days after the onset of symptoms. CONCLUSION: SFJDC might be a promising drug for the treatment of COVID-19, but large-scale randomized, double-blinded, placebo-controlled clinical trials are needed to complement the real-world evidence. It might be beneficial to start SFJDC treatment as early as possible in suspected cases of COVID-19.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Drugs, Chinese Herbal/therapeutic use , Adult , Animals , Anti-Inflammatory Agents , Coronavirus 229E, Human/drug effects , Coronavirus 3C Proteases/antagonists & inhibitors , Drug Combinations , Female , Humans , Indoles/therapeutic use , Lopinavir/therapeutic use , Lung/virology , Male , Mice , Mice, Inbred BALB C , Middle Aged , Molecular Docking Simulation , NF-kappa B , Ritonavir/therapeutic use , SARS-CoV-2/drug effects , Signal Transduction , Viral Load
13.
Comb Chem High Throughput Screen ; 24(9): 1377-1394, 2021.
Article in English | MEDLINE | ID: covidwho-902235

ABSTRACT

OBJECTIVE: Shufeng Jiedu capsule (SFJDC) is a well-known Chinese patent drug that is recommended as a basic prescription and applied widely in the clinical treatment of COVID-19. However, the exact molecular mechanism of SFJDC remains unclear. The present study aims to determine the potential pharmacological mechanisms of SFJDC in the treatment of COVID-19 based on network pharmacology. METHODS: The network pharmacology-based strategy includes collection and analysis of active compounds and target genes, network construction, identification of key compounds and hub target genes, KEGG and GO enrichment, recognition and analysis of main modules, as well as molecule docking. RESULTS: A total of 214 active chemical compounds and 339 target genes of SFJDC were collected. Of note, 5 key compounds (ß -sitosterol, luteolin, kaempferol, quercetin, and stigmasterol) and 10 hub target genes (TP53, AKT1, NCOA1, EGFR, PRKCA, ANXA1, CTNNB1, NCOA2, RELA and FOS) were identified based on network analysis. The hub target genes mainly enriched in pathways including MAPK signaling pathway, PI3K-Akt signaling pathway and cAMP signaling pathway, which could be the underlying pharmacological mechanisms of SFJDC for treating COVID-19. Moreover, the key compounds had high binding activity with three typical target proteins including ACE2, 2OFZ, and 1SSK. CONCLUSION: By network pharmacology analysis, SFJDC was found to effectively improve immune function and reduce inflammatory responses based on its key compounds, hub target genes, and the relevant pathways. These findings may provide valuable evidence for explaining how SFJDC exerting the therapeutic effects on COVID-19, providing a holistic view for further clinical application.


Subject(s)
COVID-19/drug therapy , Drugs, Chinese Herbal/pharmacology , Drugs, Chinese Herbal/therapeutic use , Adjuvants, Immunologic/pharmacology , Adjuvants, Immunologic/therapeutic use , Anti-Inflammatory Agents/pharmacology , Anti-Inflammatory Agents/therapeutic use , Computer Simulation , Gene Regulatory Networks/drug effects , Gene Targeting , Humans , MAP Kinase Signaling System/drug effects , Medicine, Chinese Traditional , Molecular Docking Simulation , Protein Binding , SARS-CoV-2/chemistry , SARS-CoV-2/drug effects , Signal Transduction/drug effects
14.
J Funct Foods ; 75: 104243, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-882603

ABSTRACT

The outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-caused pneumonia (Coronavirus disease -19, COVID-19), has resulted in a global health emergency. However, there is no vaccine or effective antiviral treatment against the newly emerged coronavirus and identifying the available therapeutics as soon as possible is critical for the response to the spread of SARS-CoV-2. Shufeng Jiedu Capsule (SFJDC), a well-known prescription of Traditional Chinese Medicine (TCM) in China, has been widely used in treating upper respiratory tract infections and acute lung injury, owing to its immunomodulatory and anti-inflammatory effects. Despite the definite evidence of effective use of SFJDC in the diagnosis and treatment of pneumonia caused by SARS-CoV-2, the underlying action mechanism remains unknown. Currently, a systematic study integrated with absorption, distribution, metabolism and excretion (ADME) evaluation, target prediction, network construction and functional bioinformatics analyses is proposed to illustrate the potential immune and anti-inflammatory mechanisms of SFJDC against SARS-CoV-2. Additionally, to further validate the reliability of the interactions and binding affinities between drugs and targets, docking, Molecular dynamics Simulations (MD) simulations and Molecular Mechanics/Poisson-Boltzmann Surface Area approach (MM-PBSA) calculations were carried out. The results demonstrate that SFJDC regulates the immunomodulatory and anti-inflammatory related targets on multiple pathways through its active ingredients, showing the potential anti-novel coronavirus effect. Overall, the work can provide a better understanding of the therapeutic mechanism of SFJDC for treating SARS-CoV-2 pneumonia from multi-scale perspectives, and may also offer a valuable clue for developing novel pharmaceutical strategies to control the current coronavirus.

15.
Int J Med Sci ; 17(16): 2511-2530, 2020.
Article in English | MEDLINE | ID: covidwho-823620

ABSTRACT

ShuFeng JieDu capsule (SFJDC), a traditional Chinese medicine, has been recommended for the treatment of COVID-19 infections. However, the pharmacological mechanism of SFJDC still remains vague to date. The active ingredients and their target genes of SFJDC were collected from TCMSP. COVID-19 is a type of Novel Coronavirus Pneumonia (NCP). NCP-related target genes were collected from GeneCards database. The ingredients-targets network of SFJDC and PPI networks were constructed. The candidate genes were screened by Venn diagram package for enrichment analysis. The gene-pathway network was structured to obtain key target genes. In total, 124 active ingredients, 120 target genes of SFJDC and 251 NCP-related target genes were collected. The functional annotations cluster 1 of 23 candidate genes (CGs) were related to lung and Virus infection. RELA, MAPK1, MAPK14, CASP3, CASP8 and IL6 were the key target genes. The results suggested that SFJDC cloud be treated COVID-19 by multi-compounds and multi-pathways, and this study showed that the mechanism of traditional Chinese medicine (TCM) in the treatment of disease from the overall perspective.


Subject(s)
Antiviral Agents/pharmacology , Betacoronavirus , Coronavirus Infections/drug therapy , Drugs, Chinese Herbal/chemistry , Drugs, Chinese Herbal/pharmacology , Pneumonia, Viral/drug therapy , Protein Interaction Maps/drug effects , Antiviral Agents/chemistry , COVID-19 , Capsules/pharmacology , Caspase 3/genetics , Caspase 8/genetics , Coronavirus Infections/genetics , Gene Expression/drug effects , Humans , Interleukin-6/genetics , Mitogen-Activated Protein Kinase 1/genetics , Pandemics , Pneumonia, Viral/genetics , Protein Interaction Maps/genetics , SARS-CoV-2 , Transcription Factor RelA/genetics
16.
Expert Rev Respir Med ; 15(2): 257-265, 2021 02.
Article in English | MEDLINE | ID: covidwho-780247

ABSTRACT

OBJECTIVE: To understand the clinical effectiveness and safety of Shufeng Jiedu Capsules combined with umifenovir (Arbidol) in the treatment of common-type COVID-19. METHODS: A retrospective cohort study was used to analyze the case data of 200 inpatients diagnosed with common-type COVID-19 at Wuhan Hospital. Participants were divided into a control group and an experimental group. The control group was treated with Arbidol hydrochloride capsules while the experimental group was treated with combination Arbidol hydrochloride capsules and Shufeng Jiedu Capsules (SFJDC) for 14 days. RESULTS: Defervescence was achieved more rapidly in the experimental group (P < 0.05). The white blood cell count and the lymphocyte percentage in the experimental group were higher than that of the control group (P < 0.05). CRP and IL-6 levels in the experimental group were significantly lower than those in the control group (P < 0.05). The proportion of chest CT studies showing resolution of pneumonia in the experimental group was significantly higher than that in the control group (P < 0.05). CONCLUSIONS: A treatment regimen of Shufeng Jiedu Capsules combined with Arbidol to treat common-type COVID-19, combining traditional Chinese and western allopathic medicine, improves time to recovery, has better clinical effectiveness, and is safe.


Subject(s)
Antiviral Agents/therapeutic use , COVID-19/drug therapy , Drugs, Chinese Herbal/therapeutic use , Indoles/therapeutic use , Aged , C-Reactive Protein/analysis , Case-Control Studies , China , Cohort Studies , Drug Therapy, Combination , Female , Humans , Interleukin-6/blood , Leukocyte Count , Lung/diagnostic imaging , Lymphocyte Count , Male , Middle Aged , Retrospective Studies , Tomography, X-Ray Computed
17.
Medicine (Baltimore) ; 99(32): e21615, 2020 Aug 07.
Article in English | MEDLINE | ID: covidwho-706032

ABSTRACT

BACKGROUND: From the end of 2019 to the present, coronavirus disease 2019 (COVID-19) has put considerable pressure on the worlds medical system and caused significant mortality and economic losses around the world. In China, the Shufeng Jiedu capsule has been widely used in the treatment of COVID-19, but there is still a lack of evidence-based medical evaluation. METHODS: According to the retrieval strategies, randomized controlled trials (RCTs) on the Shufeng Jiedu capsule for COVID-19 were obtained from CNKI, WanFang, VIP, PubMed, Embase and Cochrane Library, regardless of publication date, or language. Studies were screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool was used to evaluate the quality of the studies. The meta-analysis was performed using RevMan 5.3 and STATA 14.2 software. Ultimately, the evidentiary grade for the results will be evaluated. RESULTS: This study will evaluate the efficacy and safety of the Shufeng Jiedu capsule in the treatment of COVID-19 and provide a more reasonable choice of medication in clinical practice. CONCLUSION: Our findings will provide references for future clinical decision and guidance development. REGISTRATION: INPLASY registration number: INPLASY202070024.


Subject(s)
Coronavirus Infections/drug therapy , Drugs, Chinese Herbal/administration & dosage , Patient Safety , Pneumonia, Viral/drug therapy , Severe Acute Respiratory Syndrome/drug therapy , COVID-19 , China , Coronavirus Infections/diagnosis , Coronavirus Infections/mortality , Female , Humans , Male , Pandemics , Pneumonia, Viral/diagnosis , Pneumonia, Viral/mortality , Randomized Controlled Trials as Topic , Risk Assessment , Severe Acute Respiratory Syndrome/diagnosis , Severe Acute Respiratory Syndrome/mortality , Treatment Outcome
18.
Front Pharmacol ; 11: 1066, 2020.
Article in English | MEDLINE | ID: covidwho-698305

ABSTRACT

Background: Coronavirus Disease 2019 (COVID-19) is an emerging and rapidly evolving disease, with no recommended effective anti-coronavirus drug treatment. Traditional Chinese Patent Medicines (CPMs) have, however, been widely used to treat COVID-19 in China, and a number of clinical practice results have shown them to have a significant role in its treatment. Consequently, numerous guidelines and expert consensus have recommended the use of CPMs to treat COVID-19. Aim of the Study: The objectives of this review are to provide up-to-date information on the pharmacology and clinical research on CPMs in the treatment of COVID-19, discuss the research findings, and to better guide clinical application and scientific research on CPMs in the treatment of COVID-19. Methods: The frequencies of CPM recommendations by guidelines and expert consensus for treatment of COVID-19 in China were ranked. This report identifies the top 10 CPMs, which include Huoxiang Zhengqi capsule (HXZQC), Lianhua Qingwen capsule (LHQWC), Jinhua Qinggan granule (JHQGG), Shufeng Jiedu capsule (SFJDC), Tanreqing injection (TRQI), Xiyanping injection (XYPI), Xuebijing injection (XBJI), Shenfu injection (SFI), Shengmai injection (SMI), and Angong Niuhuang pill (AGNHP). Relevant studies from 2000 to 2020 on these top 10 CPMs, covering usage, dosage, mechanism, curative effect, and precautions, were collected from pharmacopoeia, reports, and theses via library and digital databases (including PubMed, CNKI, Google Scholar, Web of Science, and Elsevier). Results: The properties of the top 10 CPMs included antiviral, antibacterial, anti-inflammatory, antipyretic and analgesic, anti-acute lung injury, anti-shock, immune regulation, and enhancement of pulmonary function. In addition, clinical research results and Chinese treatment data showed that the CPMs had good therapeutic efficacy in the treatment of COVID-19, and adverse reactions were minimal. Conclusions: Knowledge of the characteristics of the top 10 CPMs and precautions that should be taken may help clinicians to rationally improve therapeutic efficacy, and promote the role of Chinese Medicine in the control of the COVID-19 global epidemic.

19.
Chin. Trad. Herbal Drugs ; 9(51): 2273-2282, 20200512.
Article in Chinese | ELSEVIER | ID: covidwho-684116

ABSTRACT

Coronavirus disease 2019 (COVID-19) has become a major global epidemic, and traditional Chinese medicine (TCM) has played an important role in the prevention and control of major epidemics. Taking Shufeng Jiedu Capsule as an example, this paper summarized the ideas and research practice of TCM in early intervention, blocking disease progression, improving symptoms, anti-inflammation and immunoregulation, suppressing "cytokine storm", syndrome differentiation and playing the advantages of compatibility based on the understanding of COVID-19. The idea of establishing a scientific model for the research and development of new drugs of TCM was put forward.

20.
Chin. Trad. Herbal Drugs ; 9(51): 2283-2296, 20200512.
Article in Chinese | ELSEVIER | ID: covidwho-681504

ABSTRACT

Objective: To explore the novel coronavirus disease 2019 (COVID-19) treatment mechanism and active ingredients of Shufeng Jiedu Capsule by network pharmacology and molecular docking. Methods: TCMSP databases were used to search the chemical composition and target of Shufeng Jiedu Capsule, which was composed of Isatidis Radix, Polygonum cuspidatum, Forsythia suspensa, Phragmitis Rhizoma, Patrinia, Verbena officinalis, Bupleurum chinense, and Glycyrrhiza uralensis. The Swiss target prediction database was used to remove the target with possibility of 0. The corresponding targets of the disease were searched in the GeneCards and OMIM databases with the key words of "coronavirus", "pneumonia", "cough", and "fever". Through the UniProt databases to correct the name of the target point, take the intersection of Shufeng Jiedu Capsule and the disease target point, then use the software of Cytoscape 3.7.2 to build the network of traditional Chinese medicine-compound-target for visualization, through DAVID databases to carry out the GO function enrichment analysis and KEGG pathway enrichment analysis, predict the interaction mechanism of the target, and draw the column and bubble chart for visualization. The novel coronavirus (SARS-CoV-2) 3CL hydrolase was then docking with all compounds and the first five compounds with the least binding energy were selected for docking with angiotensin-converting enzyme II (ACE2). Results: The traditional Chinese medicine-compound-target compound target network contains eight kinds of traditional Chinese medicine-compound-target, 157 compounds and 260 corresponding targets. The key targets were PTGS2, ESR1, AR, etc. There were 393 items in GO functional enrichment analysis (P < 0.05), and 139 signaling pathways in KEGG pathway enrichment analysis. Molecular docking results showed that SARS-CoV-2 3CL hydrolase and ACE2 binding energy of the five core compounds, including 6-(3-oxoindolin-2-ylidene) indolo [2,1-b] quinazolin-12-one, bicuculline, physciondiglucoside, dihydroverticillatine, and licoisoflavanone, was smaller than that of recommended chemical drugs, and the binding energy to ACE2 was similar to that of the recommended chemical drug. Conclusion: The compounds in Shufeng Jiedu Capsule can regulate the signaling pathway of human cytomegalovirus infection, Kaposi's sarcoma associated herpesvirus infection, IL-17 signaling pathway, small cell lung cancer, etc. to treat COVID-19 by binding with SARS-CoV-2 3CL hydrolase and ACE2.

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