The use of maoto (Ma-Huang-Tang), a traditional Japanese Kampo medicine, to alleviate flu symptoms: a systematic review and meta-analysis

• Published in: BMC complementary and alternative medicine 2019-03, Vol.19 (1), p.68-11, Article 68
• Main Authors: Yoshino, Tetsuhiro, Arita, Ryutaro, Horiba, Yuko, Watanabe, Kenji
• Format: Article
• Language: English
• Subjects: Analysis; Antiviral agents; Antiviral Agents - therapeutic use; Associations; Chills; Clinical trials; Complications; Drug dosages; Drugs, Chinese Herbal - therapeutic use; Editors; Effectiveness; Epidemiology; Evidence-based medicine; Exo-a-sialidase; Fever; Headache; Health insurance; Herbal medicine; Humans; Infections; Influenza; Influenza viruses; Influenza, Human - drug therapy; Infrastructure (Economics); Japanese traditional herbal medicine; Laninamivir; Medical journals; Medical research; Medicine; Medicine, Kampo; Meta-analysis; Morbidity; Myalgia; Nausea; Neuraminidase inhibitors; Patient outcomes; Pediatrics; Periodical editors; Randomization; Safety; Side effects; Signs and symptoms; Swine flu; Symptomatic treatment; Systematic review; Viral infections; Virus diseases; Viruses
• ISSN: 1472-6882; 1472-6882
• DOI: 10.1186/s12906-019-2474-z

Influenza is a common viral infection worldwide. Maoto (ma-huang-tang) was developed in ancient China and is used to alleviate flu symptoms. Currently, no meta-analyses have evaluated the efficacy and safety of maoto for alleviating flu symptoms. In the present study, we searched MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, a Japanese database (Ichushi), two Chinese databases (China National Knowledge Infrastructure and VIP), and two Korean databases (Korean Medical database and Korean Association of Medical Journal Editors) for studies published in or before October 2017. Clinical studies that compared maoto plus neuraminidase inhibitors (NAIs) vs. NAIs alone, or maoto alone vs. NAIs alone, were included in the present analysis. The primary outcome measure (efficacy) was the length of time from the start of medication to resolution of influenza symptoms (fever, headache, malaise, myalgia, and chills) and virus isolation. The secondary outcome measures (safety) were as follows: (1) side effects and adverse reactions, such as nausea, abnormal behaviour, or discontinuation of symptomatic treatment; (2) morbidity (complications caused by influenza infection) or mortality; and (3) hospitalisation for any reason. Twelve relevant studies were identified, including two randomised controlled trials (RCTs, N = 60) and ten non-randomised studies (NRSs, N = 1110). We found that maoto plus NAIs was superior to NAIs alone in terms of the duration of fever in one RCT (P