Chinese Herbs Do Not Decrease Death from SARS

Newswise — The addition of Chinese herbs to current Western therapy in treating SARS does not decrease the number of deaths among people with the virus, according to a new systematic review of studies. Herbal therapy may, however, improve symptoms associated with SARS.

SARS was first reported in Asia in February 2003, and then spread to more than two dozen countries in North America, South America, Europe and Asia before being contained. According to the World Health Organization, 8,098 people worldwide became sick with SARS during the 2003 outbreak and 774 died. Eight confirmed cases were identified in the United States, with no deaths.

"Chinese herbs combined with Western medicines made no difference in decreasing morbidity versus Western medicines alone," the review's authors, led by Dr. Xuemei Liu of the West China Hospital in Sichuan, concluded. "It is possible that Chinese herbs combined with Western medicines may improve symptoms and quality of life," for SARS patients, and may reduce their need for steroids and decrease the inflammatory cells in their lungs, the reviewers found.

SARS, or severe acute respiratory syndrome, is marked by high fever, body aches, difficulty breathing and shortness of breath, and is spread by close human contact. There is no definitive treatment for or vaccine to prevent SARS.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The review comprised 12 randomized controlled trials of 654 patients with SARS. They were treated with Chinese medicines — either a single herb or various combinations of 12 Chinese herbs — combined with Western therapy such as oxygen, antibiotics, corticosteroids and ribavirin (an antiviral drug) or they were given Western therapy alone.

In some patients treated with Chinese herbs along with Western medicine, fever, cough and breathing difficulty lasted a shorter length of time. SARS patients receiving both types of treatment also had smaller collections of inflammatory cells on chest x-ray.

Dose and duration of corticosteroid use and length of hospital stay were also decreased for those on both types of treatment, and quality of life was improved in those on combined treatment, according to some of the studies included in the review. None of the studies showed significant side effects from taking herbal therapy.

Liu said that the review shows further study is needed on the role of Chinese herbs in treating SARS. "Chinese herbs have served millions of Chinese patients, including SARS patients," he said, "I hope we don't see another SARS outbreak, but [more] research on this disease is needed."

The specific herbs that worked to effect changes in symptoms, hospital stay or corticosteroid treatment varied widely across the studies included in the review, and the authors caution that many of the trials included were of poor quality.

According to the U.S. Institute of Medicine, complementary and alternative treatments such as the Chinese herbs studied in the review should be held to the same standards in demonstrating clinical effectiveness as currently accepted medical therapies.

"Health professionals and patients should have sufficient information about safety and efficacy to take advantage of all useful therapies, both conventional and complementary and alternative," said Stuart Bondurant, M.D., interim executive vice president for health sciences at Georgetown University Medical Center.

"Because evidence is a key element of prudent decision-making, we need to change the current regulation of dietary supplements in this country to encourage more studies of these widely used products and to ensure their quality," Bondurant said.

"Long-term studies of effectiveness of Chinese herbs combined with Western medicines for SARS patients should be conducted," the review authors concluded. "Adverse events should be a necessary outcome measure in all future trial reports."

Liu X. Chinese herbs combined with Western medicine for severe acute respiratory syndrome (SARS). The Cochrane Database of Systematic Reviews 2006, Issue 1.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.