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. 2010 Jul 7:(7):CD003711.
doi: 10.1002/14651858.CD003711.pub3.

Herbal medicines for viral myocarditis

Zhao Lan Liu  1 , Zhi Jun Liu, Jian Ping Liu, Min Yang, Joey Kwong
Affiliations

Herbal medicines for viral myocarditis

Zhao Lan Liu et al. Cochrane Database Syst Rev. .

Update in

Abstract

Background: Herbal medicines are being used for treating viral diseases including viral myocarditis, and many controlled trials have been done to investigate their efficacy.

Objectives: To assess the effects of herbal medicines on clinical and indirect outcomes in patients with viral myocarditis.

Search strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library Issue 3, 2009, MEDLINE (January 1966 - July 2009), EMBASE (January 1998 - July 2009), Chinese Biomedical Database (1979 - 2009), China National Knowledge Infrastructure (1979 - 2009), Chinese VIP Information (1989 - 2009), Chinese Academic Conference Papers Database and Chinese Dissertation Database (1980 - 2009), AMED (1985 - 2009), LILACS accessed in July 2009 and the trials register of the Cochrane Complementary Medicine Field. We handsearched Chinese journals and conference proceedings. No language restrictions were applied.

Selection criteria: Randomised controlled trials of herbal medicines (with a minimum of seven days treatment duration) compared with placebo, no intervention, or conventional interventions were included. Trials of herbal medicine plus conventional drug versus drug alone were also included. Only trials that reported adequate description of allocation sequence generation were included.

Data collection and analysis: Two review authors independently extracted data and evaluated trial quality. Adverse effects information was collected from the trials.

Main results: Fourteen randomised trials involving 1463 people were included. All trials were conducted and published in China. Quality of the trials was assessed to be low. No trial had diagnosis of viral myocarditis confirmed histologically, and only a few trials attempted to establish viral aetiology. Nine different herbal medicines were tested in the included trials. The trials reported electrocardiogram results, level of myocardial enzymes, cardiac function, symptoms, and adverse effects.Astragalus membranaceus (either as an injection or granules) showed significant positive effects in symptom improvement, normalisation of electrocardiogram results, CPK levels, and cardiac function. Shengmai injection also showed significant effects in symptom improvement. Shengmai decoction triggered significant improvement in quality of life measured by SF-36. No serious adverse effects were reported.

Authors' conclusions: Some herbal medicines may lead to improvement of symptoms, ventricular premature beat, electrocardiogram, level of myocardial enzymes, and cardiac function in viral myocarditis. However, interpretation of these findings should be taken with care due to the low methodological quality, small sample size, and limited number of trials on individual herbs. Further robust trials are needed to explore the use of herbal medicines in viral myocarditis.

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Conflict of interest statement

Declarations of interest: None known.

Figures

Figure 1
Figure 1. QUOROM flow chart
Figure 2
Figure 2
Methodological quality graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.
Figure 3
Figure 3
Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
See this image and copyright information in PMC

Update of

References

References to studies

    1. * Chen PY, Zhou F, Ceng Y, Li G, Luo LY. Clinical observation on the effect of Xinshu Capsule (XC) in treating frequent ventricular extrasystoles due to viral myocarditis and the influence on ET, MDA AND CRP [in Chinese] Shanxi Journal of Traditional Chinese Medicine. 2006;22(3):13–5.
    1. Chen PY, Zhou F, Chen WL, Ceng Y, Luo LY. Clinical observation on the effect of Xinshu Capsule (XC) in treating frequent ventricular extrasystoles due to viral myocarditis and the influence on NO, NOS AND SOD [in Chinese] Chinese Journal of Current Traditional and Western Medicine. 2005;3(10):893–5.
    1. Li L, Zhang SL, Zhong XL, Xu LL, Duan AY. Observation on therapeutic effect of Qingxinkangyan Yin Decoction in treating patients with CVB myocarditis and nursing strategy. Journal of Nursing (China) 2006;13(3):59–60.
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Excluded studies

    1. An XF. 50 cases of viral myocarditis complicated with arrhythmia treated with Radix Salviae miltiorrhizae [in Chinese] Tianjin Medical Journal. 1997;25(8):502–3.
    1. Cao GM, Zhang SF, Hu YH, Lu JZ, Wang JC, Li LS, et al. Clinical observation on acute viral myocarditis treated with Xinyikang oral liquid [in Chinese] Chinese Journal of Traditional Chinese Medical Science and Technology. 1996;3(6):35–7.
    1. Chen BY, Zhang XL, Ying XZ, Dong YQ, Liu H, Qiao WP, et al. Clinical research on treatment of children viral myocarditis by the principle of nourishing Qi and Yin and promoting blood circulation by removing blood stasis [in Chinese] Chinese Journal of Traditional Chinese Medicine and Pharmacy. 1993;8(5):20–2.
    1. Chen BY, Yin XZ, Hu SY, Liu H, Qiao WP, He AY. Controlled observation on 65 infantile acute viral myocarditis treated with traditional and western medicine [in Chinese] Chinese Journal of Integrated Traditional and Western Medicine. 1994;14(4):216–9. - PubMed
    1. Chen H. 104 cases of acute viral myocarditis treated with Huangqi injection [in Chinese] Chinese Journal of Information on Traditional Chinese Medicine. 1999;6(4):49.

Other references

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    1. Baughman KL. Diagnosis of myocarditis: death of Dallas criteria. Circulation. 2006;113(4):593–5. - PubMed
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