AUTHOR=Rong Hong-guo , Zhang Xiao-wen , Han Mei , Sun Xin , Wu Xiao-dan , Lai Xiao-zhen , Shen Chen , Yu Wei-jie , Fang Hai , Fei Yu-tong , Liu Jian-ping 

TITLE=Evidence synthesis of Chinese medicine for monkeypox: Suggestions from other contagious pox-like viral diseases

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1121580

DOI=10.3389/fphar.2023.1121580

ISSN=1663-9812

ABSTRACT=Objective: The purpose of this study was to explore the evidence of Chinese medicine (CM) for contagious pox-like viral diseases, and provide suggestions for the multi-country outbreak management of monkeypox. Methods: Ancient classics in China and clinical trials involving RCTs, non-RCTs, and comparative observational studies of CM on the prevention and treatment of monkeypox, smallpox, measles, varicella, and rubella were retrieved from the Chinese Medical Code (Fifth edition), Database of China Ancient Medicine, PubMed, the Cochrane Library, China National Knowledge Infrastructure, Chongqing VIP, Wanfang, Google Scholar, International Clinical Trial Registry Platform, and Chinese Clinical Trial Registry until July 6, 2022. Both quantitative and qualitative methods were applied to present the data collected.
Results: The use of CM to control contagious pox-like viral diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic where the pathogen was recorded back to two thousand years. There were 85 articles (36 RCTs, 8 non-RCTs, 1 cohort study, and 40 case series) that met the inclusion criteria, of which 39 studies were for measles, 38 for varicella, and 8 for rubella. Compared with western medicine for contagious pox-like viral diseases, CM combined with western medicine showed significant improvements in fever clearance time [Mean difference (MD) -1.42 days, 95% CI -1.89 to -0.95, 10 RCTs], rash/pox extinction time (MD -1.71 days, 95% CI -2.65 to -0.76, 6 RCTs), and rash/pox scab time (MD -1.57 days, 95% CI -1.94 to -1.19, 5 RCTs). When compared with western medicine, CM alone could reduce the time of rash/pox extinction, and fever clearance. Chinese herbal formulae, including modified Yinqiao powder, modified Xijiao Dihaung decoction, modified Qingjie Toubiao decoction, and modified Shengma Gegen decoction, were frequently applied to treat pox-like viral diseases, and also showed significant effects in shortening the time of fever clearance, rash/pox extinction, and rash/pox scab. Conclusions: Based on historical records and clinical studies of CM in managing contagious pox-like viral diseases, some botanical drugs could be an alternative approach for treating and preventing monkeypox.