Clinical and Preclinical Systematic Review of Astragalus Membranaceus for Viral Myocarditis

Table 1

The characteristic of clinical studies.

Study (years)

Number ( = male/female); mean age (years); course of disease (days)

Treatments

Duration of treatment

Adverse reactions

Outcome index

Intergroup differences

Experimental group

Control group

Experimental group

Control group

Du 2019

48 (25/23)

48 (26/22)

By intravenous drip infusion of AM injection (20 ml, qd) in 5% GS treatment

Antiviral drugs + nutritional myocardial drugs + sodium creatine phosphate for injection (1 g, qd)

2 weeks

Y

(1) Effective rate; (2) CK; (3) CK-MB; (4) cTnI

(1); (2); (3); (4)

NM

NM

Li et al. 2019

46 (25/21)

46 (26/20)

By intravenous drip infusion of AM injection (2 ml/kg, qd) in NS treatment

Antiviral drugs + nutritional myocardial drugs

2 weeks

Y

(1) Effective rate; (2) CK; (3) CK-MB; (4) cTnI; (5) TNF-α; (6) IL-6; (7) Effect of arrhythmia

(1); (2); (3); (4); (5); (6); (7)

NM

NM

Qi et al. 2019

60 (NM)

60 (NM)

By intravenous drip infusion of AM injection (20 ml, qd) in 5% GS treatment

Adenosine disodium triphosphate, coenzyme A and insulin for injection sodium diphosphate injection (5 g, bid)

4 weeks

N

(1) Effective rate; (2) hs-CRP; (3) CK-MB; (4) cTnI; (5) TNF-β; (6) IL-10; (7) IL-17; (8) IL-21; (9) miR-146b; (10) miR-155

(1); (2); (3); (4); (5); (6); (7); (8); (9); (10)

NM

NM

NM

NM

Zhang et al. 2019

46 (22/24)

45 (20/25)

By intravenous drip infusion of AM injection (20 ml, qd) in 5% GS treatment

Antiviral drugs (ribavirin) + vitamin C + Inosine injection + fructose 1,6-diphosphate injection

2 weeks

N

(1) Effective rate; (2) CD3^+; (3) CD4^+; (4) CD8^+; (5) CD4^+/CD8^+; (6) EF

(1); (2); (3); (4); (5); (6)

NM

NM

Zheng 2019

45 (21/24)

44 (23/21)

By intravenous drip infusion of AM injection (20 ml, qd) in NS treatment

Antiviral drugs + nutritional myocardial drugs + trimetazidine

6 weeks

Y

(1) Recover time of clinical symptoms; (2) Recovery time of arrhythmia; (3) CK-MB; (4) AST; (5) LDH

(1); (2); (3); (4); (5)

Liu et al. 2018

43 (20/23)

43 (24/19)

By intravenous drip infusion of AM injection (0.5 ml/kg, qd) in 5% GS treatment

Antiviral drugs + vitamin C + fructose + coenzyme Q10 + creatine phosphate injection (1.0 g, qd)

2 weeks

N

(1) Effective rate; (2) CK; (3) CK-MB; (4) LDH; (5) cTnI

(1); (2); (3); (4); (5)

NM

NM

Gui 2017

67 (34/33)

67 (35/32)

By oral administration of AM granule ( years 1 g, bid; years, 1.5 g, bid; years, 2 g, bid; years, 4 g, bid) + basic treatment

Vitamin C + energy mixture injection + vitamin E + coenzyme Q + coenzyme A

4 weeks

Y

(1) Effective rate

(1)

NM

NM

Zhang et al. 2017B

36 (20/16)

36 (14/22)

By intravenous drip infusion of AM injection (10 ml, qd) in 5% GS + basic treatment

Antiviral drugs (recombinant human interferon α2b injection) + vitamin C + coenzyme Q10

4 weeks

N

(1).Effective rate; (2) CK; (3) CK-MB; (4) TNF-α; (5) IL-10; (6) IL-6

(1); (2); (3); (4); (5); (6)

NM

NM

Zhou 2017

50 (26/24)

50 (28/22)

By intravenous drip infusion of AM injection (5-10 ml, qd) in 5% GS treatment

Antiviral drugs (ribavirin) + vitamin C + coenzyme Q10

15 days

N

(1) Effective rate; (2) CK; (3) CK-MB; (4)LDH

(1); (2); (3); (4)

NM

NM

Li et al. 2016A

34 (21/13)

34 (19/15)

By intravenous drip infusion of AM injection (5-10 ml, qd) in 5% GS treatment

Vitamin C + vitamin E + coenzyme Q10 + energy mixture injection

2 weeks

N

(1) Effective rate; (2) INF-γ; (3) IL-4; (4) INF-γ/IL-4

(1); (2); (3); (4)

Xing 2016

45 (29/16)

41 (28/13)

By intravenous drip infusion of AM injection (5-10 ml, qd) in 5% GS treatment

Antiviral drugs + vitamin C + coenzyme Q10

3 weeks

N

(1) Effective rate; (2) CK; (3) CK-MB; (4) LDH; (5) cTnI; (6) CD3^+; (7) CD4^+; (8) CD8^+

(1); (2); (3); (4); (5); (6); (7); (8)

Wu 2016

47 (21/26)

47 (24/23)

By intravenous drip infusion of AM injection (20 ml, qd) in 5% GS treatment

Antiviral drugs (recombinant human interferon α2b injection) + vitamin C + energy mixture injection

2 weeks

N

(1) Effective rate; (2) LDH; (3) cTnI; (4) CD3^+; (5) CD4^+; (6) CD8^+; (7) NK

(1); (2); (3); (4); (5); (6); (7)

NM

NM

Wu et al. 2016

40 (24/16)

40 (22/18)

By intravenous drip infusion of AM injection (10-20 ml, qd) in NS treatment

Antiviral drugs + fructose

2 weeks

Y

(1) Effective rate; (2) CD3^+; (3) CD4^+; (4) CD8^+; (5) NK

(1); (2); (3); (4); (5)

Gao 2015

60 (27/33)

60 (25/35)

By intravenous drip infusion of AM injection (20 g, qd) in 5% GS treatment

Polarization liquid + vitamin C + coenzyme Q10

2 weeks

N

(1) Effective rate; (2) CK; (3) CK-MB; (4) LDH; (5) AST

(1); (2); (3); (4); (5)

Lou 2015

48 (34/14)

48 (25/23)

By intravenous drip infusion of AM injection (20-30 ml, qd) in 5% GS 250 ml

Polarization liquid

2 weeks

Y

(1) Effective rate; (2) TNF-α; (3) INF-8; (4) INF-6; (5) CK; (6) CK-MB; (7) cTnI

(1); (2); (3); (4); (5); (6); (7)

NM

NM

Tao 2015

39 (22/17)

39 (24/15)

By intravenous drip infusion of AM injection (1 ml/kg, qd) in 5% GS treatment

Antiviral drugs (ribavirin) + coenzyme A + ATP + vitamin C

15 days

Y

(1) Effective rate; (2) Recover time of clinical symptoms; (3) Recover time of clinic syndrome myocardial enzyme

(1); (2); (3)

Zhao et al. 2015

89 (51/38)

89 (44/45)

By intravenous drip infusion of AM injection (20-30 ml, qd) in 5% GS treatment

Antiviral drugs (ribavirin) + vitamin C + coenzyme Q10 + inosine tablets + polarization liquid

2 weeks

N

(1) Effective rate; (2) SOD; (3) MDA; (4) GST; (5) NO; (6) TNF-α; (7) INF-γ; (8) IL-8; (9) IL-6

(1); (2); (3); (4); (5); (6); (7); (8); (9)

NM

NM

Ban 2014

34 (20/14)

34 (18/16)

By intravenous drip infusion of AM injection (2 g/kg, qd) in 5% GS treatment

Coenzyme Q10 + ATP + vitamin C

4 weeks

N

(1) CK; (2) CK-MB; (3) LDH; (4) AST; (5) α-HBDH

(1); (2); (3); (4); (5)

NM

NM

Wang et al. 2014

30 (16/14)

30 (18/12)

By intravenous drip infusion of AM injection (20 ml, qd) in 10% GS treatment

Antiviral drugs (acyclovir) + vitamin C + coenzyme A

46 days

Y

(1) Effective rate

(1)

NM

NM

Liang 2014

25 (14/11)

25 (13/12)

By intravenous drip infusion of AM injection (10-20 ml, qd) in 5% GS treatment

Antiviral drugs + vitamin C + coenzyme Q10

4 weeks

N

(1) Effective rate; (2) SOD; (3) MDA; (4) NO

(1); (2); (3); (4)

Kang 2014

43 (22/21)

43 (21/22)

By intravenous drip infusion of AM injection (30 ml, qd) in 10% GS 250 ml

NM

15 days

N

(1) Effective rate; (2) Effect of arrhythmia

(1); (2)

NM

NM

NM

NM

Zhang 2014

57 (32/25)

56 (32/24)

By oral administration of AM granule ( years, 1 g, bid; years, 1.5 g, bid; years, 2 g, bid; years, 4 g, bid) + basic treatment

Antiviral drugs (ribavirin) + fructose + coenzyme Q10 + vitamin C + gamma globulin

2 weeks

N

(1) Effective rate; (2) CK-MB; (3) LDH; (4) AST

(1); (2); (3); (4)

Liu et al. 2013

32 (18/14)

32 (20/12)

By intravenous drip infusion of AM injection (5-10 ml, qd) in 5% GS treatment

NM

2 weeks

N

(1) Effective rate; (2) IL-23; (3) IL-17; (4) Th17 cell

(1); (2); (3); (4)

Zhang et al. 2013

34 (17/17)

34 (17/17)

By intravenous drip infusion of AM injection (50 ml, qd) in 5% GS treatment

Energy mixture injection + vitamin C + coenzyme Q10 + polarization liquid

2 weeks

N

(1) Effective rate; (2) CK-MB; (3) ESR; (4) AST; (5) ALT

(1); (2); (3); (4); (5)

NM

NM

NM

NM

Wang 2012

35 (18/17)

35 (20/15)

By intravenous drip infusion of AM injection (50 ml, qd) + basic treatment

Antiviral drugs + vitamin C + coenzyme Q10 + polarization liquid + Trimetazidine

4 weeks

Y

(1) Effective rate; (2) Arrhythmia; (3) cTnI; (4) Cardiac function

(1); (2); (3); (4)

Dong 2011

60 (34/26)

50 (28/22)

By intravenous drip infusion of AM injection (5-20 ml, qd) + basic treatment

Antiviral drugs (ribavirin) + vitamin C + fructose + energy mixture injection

30 days

N

(1) Effective rate; (2) Recovery rate of CK-MB; (3) Recovery rate of CK; (4) Recovery rate of LDH; (5) Recovery rate of AST

(1); (2); (3); (4); (5)

6.5

6.9

NM

NM

Hu 2009

50 (26/24)

50 (27/23)

By intravenous drip infusion of AM injection (60 ml, bid) in 5% GS treatment

Coenzyme Q10 + polarization liquid

2 weeks

Y

(1) Effective rate; (2) Effect of arrhythmia; (3) AST; (4) CK-MB; (5) LDH; (6) cTnI; (7) NK; (8) TNF-α; (9) IL-1; (10) IL-6

(1); (2); (3); (4); (5); (6); (7); (8); (9); (10)

months

months

Zhang et al. 2006B

33 (20/13)

20 (14/6)

By intravenous drip infusion of AM injection (5-10 ml, qd) in 5% GS treatment

Antiviral drugs (ribavirin) + vitamin C + vitamin E + energy mixture injection

2 weeks

N

(1) Effective rate; (2) CK; (3) AST; (4) LDH

(1); (2); (3); (4)

NM

NM

Note: α-HBDH: α-hydroxybutyric dehydrogenase; hs-CRP: hypersensitive C-reactive protein; miR: microRNA; ALT: alanine aminotransferase; AM: Astragalus membranaceus; AST: aspartate aminotransferase; ATP: adenosine triphosphate; Bid: bis in die; cTnI: cardiac troponin I; CD: cluster of differentiation; CK: creatine kinase; CK-MB: creatine kinase isoenzyme; EF: ejection fraction; ESR: erythrocyte sedimentation rate; GS: glucose injection; GST: glutathione transferase; IL: interleukin; INF-γ: interferon-γ; LDH: lactic dehydrogenase; MDA: malondialdehyde; N: no; NK: natural killer cell; NM: not mentioned; NO: nitric oxide; NS: normal saline; Qd: quaque die; SOD: superoxide dismutase; Th: T helper cell; TNF: tumor necrosis factor; Y: yes.