COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?

被引:155
作者
Silveira, Damaris [1 ]
Prieto-Garcia, Jose Maria [2 ]
Boylan, Fabio [3 ,4 ]
Estrada, Omar [5 ]
Fonseca-Bazzo, Yris Maria [1 ]
Jamal, Claudia Masrouah [6 ]
Magalhaes, Perola Oliveira [1 ]
Pereira, Edson Oliveira [1 ]
Tomczyk, Michal [7 ]
Heinrich, Michael [8 ]
机构
[1] Univ Brasilia, Fac Hlth Sci, Dept Pharm, Brasilia, DF, Brazil
[2] Liverpool John Moores Univ, Sch Pharm & Biomol Sci, Liverpool, Merseyside, England
[3] Trinity Coll Dublin, Sch Pharm & Pharmaceut Sci, Dublin, Ireland
[4] Trinity Coll Dublin, Trinity Biomed Sci Inst, Dublin, Ireland
[5] Venezuelan Inst Sci Res, Biophys & Biochem Ctr, Caracas, Venezuela
[6] Univ Fed Espirito Santo, Ctr Hlth Sci, Vitoria, ES, Brazil
[7] Med Univ Bialystok, Fac Pharm, Bialystok, Poland
[8] UCL, Sch Pharm, Pharmacognosy & Phytotherapy, London, England
关键词
herbal medicine; coronavirus (2019-nCoV); COVID-19; benefit; risk assessment; respiratory diseases; MIKANIA-GLOMERATA SPRENGEL; PERFORMANCE LIQUID-CHROMATOGRAPHY; ZINGIBER-OFFICINALE ROSCOE; PREGNANCY-INDUCED NAUSEA; PLANTAGO-LANCEOLATA L; WILLOW BARK EXTRACT; POLYGALA-TENUIFOLIA WILLDENOW; OREGANO LIPPIA-GRAVEOLENS; ESSENTIAL OIL COMPOSITION; THISTLE SILYBUM-MARIANUM;
D O I
10.3389/fphar.2020.581840
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Background Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. Aims To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for "respiratory diseases" within the current frame of the COVID-19 pandemic as an adjuvant treatment. Method The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified aspositive,promising,negative, andunknown. Results A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, andSambucus nigra), promising in 12 cases (Allium sativum,Andrographis paniculata,Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulusessential oil, Justicia pectoralis, Magnolia officinalis,Mikania glomerata,Pelargonium sidoides,Pimpinella anisum,Salixsp,Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. Conclusions Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches.
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相关论文
共 538 条
[1]  
AANA, 2020, HERB PROD YOUR AN
[2]   On line characterization of 58 phenolic compounds in Citrus fruit juices from Spanish cultivars by high-performance liquid chromatography with photodiode-array detection coupled to electrospray ionization triple quadrupole mass spectrometry [J].
Abad-Garcia, Beatriz ;
Garmon-Lobato, Sergio ;
Berrueta, Luis A. ;
Gallo, Blanca ;
Vicente, Francisca .
TALANTA, 2012, 99 :213-224
[3]   METABOLITES OF MEDICINAL-PLANTS .5. FURANOEREMOPHILANES AND OTHER CONSTITUENTS FROM SENECIO-CANESCENS [J].
ABDO, S ;
DEBERNARDI, M ;
MARINONI, G ;
MELLERIO, G ;
SAMANIEGO, S ;
VIDARI, G ;
FINZI, PV .
PHYTOCHEMISTRY, 1992, 31 (11) :3937-3941
[4]  
Abdollahi Fard M., 2012, ISRN PHARM, V2012, DOI 10.5402/2012/510795
[5]  
Abu-Dahab R, 2014, REC NAT PROD, V8, P136
[6]   Comprehensive analysis of commercial willow bark extracts by new technology platform: Combined use of metabolomics, high-performance liquid chromatography-solid-phase extraction-nuclear magnetic resonance spectroscopy and high-resolution radical scavenging assay [J].
Agnolet, Sara ;
Wiese, Stefanie ;
Verpoorte, Robert ;
Staerk, Dan .
JOURNAL OF CHROMATOGRAPHY A, 2012, 1262 :130-137
[7]   Survey of medicinal plants used in the region Northeast of Brazil [J].
Agra, Maria de Fatima ;
Silva, Kiriaki Nurit ;
Lima Diniz Basilio, Ionaldo Jose ;
de Freitas, Patricia Franca ;
Barbosa-Filho, Jose Maria .
REVISTA BRASILEIRA DE FARMACOGNOSIA-BRAZILIAN JOURNAL OF PHARMACOGNOSY, 2008, 18 (03) :472-508
[8]  
Aisa H.A., 2019, BIOACTIVE FOOD DIETA, DOI [10.1016/B978-0-12-813822-9.00040-0, DOI 10.1016/B978-0-12-813822-9.00040-0]
[9]   Ocimum gratissimum L. leaf flavonoid-rich fraction suppress LPS-induced inflammatory response in RAW 264.7 macrophages and peritonitis in mice [J].
Ajayi, Abayomi Mayowa ;
de Oliveira Martins, Domingos Tabajara ;
Balogun, Sikiru Olaitan ;
de Oliveira, Ruberlei Godinho ;
Ascencio, Sergio Donizeti ;
Soares, Ilsamar Mendes ;
Barbosa, Robson dos Santos ;
Ademowo, Olusegun George .
JOURNAL OF ETHNOPHARMACOLOGY, 2017, 204 :169-178
[10]  
Akbar S., 2020, HDB 200 MEDICINAL PL, DOI [10.1007/978-3-030-16807-0_74, DOI 10.1007/978-3-030-16807-0_74]