Upper Respiratory tract infection
Shufeng Jiedu is widely used in China for acute upper respiratory tract infections (AURTIs) caused by common cold or influenza.
In a systematic review with meta-analysis, 25 randomized controlled trials (RCTs) involving 3410 patients were included in the analysis. SFJD in combination with conventional drugs was associated with :
- For common cold, reduction in duration of fever by 1.54 days and cough by 1.22 days (n = 385, 3 studies).
- For herpangina, shortening of duration of fever by 0.68 days (n = 140, 2 studies) and blistering by 1 day (n = 386, 3 studies)
- For acute tonsillitis and acute pharyngitis, shortening of duration of fever by 1.13 days (n = 688, 7 studies) and sore throat by 1.13 days (n = 1194, 10 studies).
- The analyzed 25 studies further showed that cure rates improved in groups that used a combination of SFJDC with conventional drugs by 1-5 days, vs. Compared with the groups treated with conventional drugs alone, shortened.
No serious adverse events were reported.
40. Zhang YY, Xia RY, Liang SB, Hu XY, Dai MY, Li YL, Zhao LY, Moore M, Fei YT, Liu JP. Chinese patent herbal medicine (Shufeng Jiedu capsule) for acute upper respiratory tract infections: A systematic review and meta-analysis. Integr Med Res. 2021 Sep;10(3):100726. doi: 10.1016/j.imr.2021.100726. Epub 2021 Apr 2. PMID: 33996460; PMCID: PMC8099504.
During the COVID-19 pandemic the “World Health Organization” collects important publication concerning the research on potential drugs for the treatment of the virus infection in a “Global literature on coronavirus disease”-Database. Up to now 23 publications about the effect of Shufeng Jiedu are listed in this database:
Until now four clinical studies were conducted for the treatment of COVID-19 patients with Shufeng Jiedu [41-44]. The studies included patients with mild to moderate COVID-19 symptoms. Patients were divided into 2 groups in all studies. The control group received standard antiviral medication (arbidol or lopinavir/ritonavir) and the SFJDC group received SFJDC along with standard antiviral medication. The results showed that:
- patients in the SFJDC group were free of fever on average 2.2 ± 1.1 days earlier than patients in the control group;
- treatment with SFJDC + standard antiviral therapy reduced clinical recovery time and fatigue (from 3.55 ± 4.09 to 1.19 ± 2.28 days, respectively), as well as cough duration (from 5.76 ± 5.64 to 3.47 ± 3.75 days), significantly compared to the control group;
- After 7 days of treatment, the number of patients who had no longer showed signs of pneumonia on the CT of the chest was significantly higher in the SFJDC group than in the control group (87% SFJDC group vs. 72% control group).
- During the course of treatment, a total of 12 patients experienced adverse drug reactions. The overall frequency of adverse drug reactions was 6% in both groups. The symptoms in the SFJDC group included nausea (2%), allergic reaction (1%), Abdominal pain (2%), and diarrhea (1%).
In conclusion the results of the clinical studies indicate that Shufeng Jiedu might be a promising treatment option for mild and moderate COVID-19 infection. Furthermore, the results showed that the treatment success was higher if Shufeng Jiedu was given right after the onset of the symptoms. However, to scientifically fully prove the effect of Shufeng Jiedu for the treatment of COVID-19, high quality randomized clinical trials are needed.
41. Xia L, Shi Y, Su J, Friedemann T, Tao Z, Lu Y, Ling Y, Lv Y, Zhao R, Geng Z, Cui X, Lu H, Schröder S. Shufeng Jiedu, a promising herbal therapy for moderate COVID-19: Antiviral and anti-inflammatory properties, pathways of bioactive compounds, and a clinical real-world pragmatic study. Phytomedicine. 2021 May;85:153390. doi: 10.1016/j.phymed.2020.153390.
42. Chen J, Lin S, Niu C, Xiao Q. Clinical evaluation of Shufeng Jiedu Capsules combined with umifenovir (Arbidol) in the treatment of common-type COVID-19: a retrospective study. Expert Rev Respir Med. 2021 Feb;15(2):257-265. doi: 10.1080/17476348.2020.1822741. Epub 2020 Sep 17. PMID: 32941741; PMCID: PMC7544967.
43. Qu, X., et al., 2020. Observation on the clinical effect of Shufeng Jiedu Capsule combined with Arbidol Hydrochloride Capsules in the treatment of COVID-19.pdf. Chinese Tradit. Herb. Drugs CN 12–1108.
44. Wang, Z. et al., Clinical characteristics and therapeutic procedure for four cases with 2019 novel coronavirus pneumonia receiving combined Chinese and Western medicine treatment. BioScience Trends. 2020; 14(1):64-68. DOI: 10.5582/bst.2020.01030
From the outbrake of COVID-19 in January 2020 until now a variety of basic research studies concerning the effect of Shufeng Jiedu for the treatment of COVID 19 were published. The results of those studies revealed that:
- SFJDC has a strong anti-inflammatory effect and supports immune defense [41, 45-47]
- The viral load in the lungs of corona-virus infected mice decreased significantly (from 1109.29 ± 696.75 to 0 ± 0 copies/ml) .
- Network analysis revealed that SFJDC modulates anti-inflammatory and immunomodulatory signaling pathways, thus supports the defense of the body against viral infections via the regulation of various signaling pathways [45- 47].
- SFJDC decreases inflammatory factors (IL-6, IL-10, TNF-α and IFN-γ) in the lung and increases the number of CD4+ and CD8+ cells, which are important for the immune response, in the blood compared to corona-virus infected mice which received no treatment .
45. Xiong H, Dong Z, Lou G, Gan Q, Wang J, Huang Q. Analysis of the mechanism of Shufeng Jiedu capsule prevention and treatment for COVID-19 by network pharmacology tools. Eur J Integr Med. 2020 Dec;40:101241. doi: 10.1016/j.eujim.2020.101241. Epub 2020 Oct 30. PMID: 33520015; PMCID: PMC7836709.
46. Ying Zhang, Yi Xie, Bing Yu, et al. Network Pharmacology Integrated Molecular Docking Analysis of Potential Common Mechanisms of Shu-Feng-Jie-Du Capsule in the Treatment of SARS, MERS, and COVID-19. Natural Product Communications. 2020, Vol.15, No.11, p.1934578X2097291.
47. Tao Z, Zhang L, Friedemann T, Yang G, Li J, Wen Y, Wang J, Shen A. Systematic analyses on the potential immune and anti-inflammatory mechanisms of Shufeng Jiedu Capsule against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)-caused pneumonia. J Funct Foods. 2020 Dec;75:104243. doi: 10.1016/j.jff.2020.104243. Epub 2020 Oct 12. PMID: 33072190; PMCID: PMC7550105.
Chronic obstructive pulmonary disease (COPD)
Chronic obstructive pulmonary disease (COPD) is associated with a high disease burden and is one of the leading causes of death worldwide. 6.4% of all people in the United States suffer from the disease and its accompanying symptoms.
Shufeng Jiedu is commonly used in combination with usual care for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in China. AECOPD is defined as an acute worsening of respiratory symptoms that require additional therapy and the patients often need to be hospitalized .
A systematic review included thirteen randomized controlled trials (RCTs) with a total of 1036 AECOPD patients who received SFJDC as a single intervention or as an add-on treatment to usual care in the analysis .
The trials compared SFJDC in combination with usual care (including antibiotics) with usual care alone.
The group receiving additional SFJDC showed a significant reduction in treatment failure from 20.1% to 8.3% (11 studies; 815 patients) and significantly shorter hospital stay (2 studies; 79 patients; mean difference – 4.32 days).
No significant difference in adverse events was observed between the SFJD and control groups was observed.
Based on the evaluation of the results from 25 randomized controlled clinical trials it can be concluded that Shufeng juedu has a positive effects in combination of antibiotics and symptomatic treatments on reducing treatment failure, duration of hospitalisation, symptoms.
48. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global strategy for diagnosis, management and prevention of chronic obstructive lung disease: the GOLD science committee report 2019. Eur Respir J. 2019; 53:1900164.
48. Xia RY, Hu XY, Fei YT, Willcox M, Wen LZ, Yu MK, Zhang LS, Dai MY, Fei GH, Thomas M, Francis N, Wilkinson T, Moore M, Liu JP. Shufeng Jiedu capsules for treating acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis. BMC Complement Med Ther. 2020 May 24;20(1):151. doi: 10.1186/s12906-020-02924-5. PMID: 32448238; PMCID: PMC7245765.
Sepsis can be a life-threatening complication of a wide range of infectious diseases like pneumonia, influenza, COVID-19 or a urinary tract infection. It is one of the most common causes of death in intensive care units. Sepsis occurs when the body’s immune response to inflammation gets out of control, damaging organs and leading to organ failure.
According to data from the United States more than 230,000 cases of septic shock and 40,000 death occur annually in the US [49, 50]. If sepsis is not treated early during the onset phase it can develop quickly to a severe sepsis which leads in the most cases to a septic shock. Worldwide, approximately 30% of the people with a sepsis die . Therefore, sepsis needs to be treated as soon as it is diagnosed.
In China Shufeng jiedu is commonly used to treat infectious disease and a recently published randomized controlled clinical trial evaluated the effect of Shufeng jiedu for the treatment of sepsis . Hospitalized patients with diagnosed sepsis were randomly assigned to the control group (63 people) which received standard antibiotics treatment and a Shufeng Jiedu group (66 people) which received Shufeng Jiedu together with antibiotics. The success of the treatment was evaluated with the Chronic Health Evaluation II (APACHE II) score. The results of the study revealed that:
- Patients of the Shufeng Jiedu group had a significant better APACHE II score than the control group
- The overall healing rate was significant higher in the Shufeng Jiedu group
- Mortality after 28 days was significantly lower in the Shufeng Jiedu group (3.03%) than in the single antibiotics control group (7.93%)
- There was no difference in recorded adverse events between the two groups
Based on the results of this study a combination treatment of standard antibiotic treatment with Shufeng Jiedu might be a promising treatment option to reduce the inflammatory response and to improve the survival as well as recovery prognosis for septic patients.
49. Seymour CW and Rosengart MR, Septic shock: Advances in diagnosis and treatment,JAMA. 314(2015)708-717. https://doi:10.1001/jama.2015.7885
50. Alperstein A, Fertig RM, Feldman M, Watford D, Nystrom S, Delva G and Muddassir S. Septic thrombophlebitis of the internal jugular vein, a case of Lemierre’s syndrome, Intractable Rare Dis Res.6(2017)137-140. https://doi:10.5582/irdr.2017.01021
51. Prescott HC and Angus DC, Enhancing recovery from sepsis: A Review, JAMA. 319(2018)62-75. https://doi: 10.1001/jama.2017.17687
52. Yuqi Liu, Yun Yu, Hui Dai, Aihua Fei. Efficacy of Shufeng Jiedu Capsules in the treatment of sepsis: A prospective, randomized, placebo-controlled trial. European Journal of Integrative Medicine, Volume 38, 2020, https://doi.org/10.1016/j.eujim.2020.101172.