Anti-Fatigue Effects of Lycium barbarum Polysaccharide and Effervescent Tablets by Regulating Oxidative Stress and Energy Metabolism in Rats

Shenqi Funeng Xingnao Prescription Alleviates Exercise-Induced Fatigue by Regulating the HIF-1/FoxO Signaling Pathway

ETHNOPHARMACOLOGICAL RELEVANCE

Shenqi Funeng Xingnao Prescription (SQFNXNP) is a traditional Chinese medicine that has been used successfully to treat exercise-induced fatigue in clinical therapy. However, the pharmacological effects and underlying mechanisms of action of SQFNXNP on exercise-induced fatigue remain unexplored.

AIM OF THE STUDY

We performed a preliminary investigation of the therapeutic effects of SQFNXNP in alleviating exercise-induced fatigue.

METHODS

An exercise-induced fatigue model was used to evaluate the antifatigue effects of SQFNXNP. UPLC-MS analysis identified compounds with prototype structures in plasma after SQFNXNP administration. Network pharmacology predicted potential targets of SQFNXNP in exercise-induced fatigue. Genes obtained via weighted gene co-expression network analysis in transcriptomics were integrated with those identified via network pharmacology to reveal the targets and pathways of SQFNXNP activity against exercise-induced fatigue. Differential metabolites of SQFNXNP against exercise-induced fatigue were discovered via correlation analysis of genes in the Hypoxia-inducible factor 1 (HIF-1) and Forkhead box O (FoxO) signaling pathways and differential metabolites of SQFNXNP vs. Model. The CytoHubba plugin and virtual screening were used to further screen core genes and proteins. The potential targets of SQFNXNP in exercise-induced fatigue were verified using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and Western blotting (WB).

RESULTS

SQFNXNP improved fatigue symptoms, enhanced athletic ability, delayed glycogen consumption, inhibited excessive metabolite accumulation, increased antioxidant enzyme levels, inhibited lipid peroxidation, relieved muscle fiber contraction caused by excessive fatigue or exercise, increased the number of mitochondria, and improved the pathological morphology of the gastrocnemius muscle. A total of 38 compounds with prototype structures in the plasma were identified in SQFNXNP. The potential HIF-1 and FoxO signaling pathways were identified via the integrated results of network pharmacology and transcriptomics. The top 15 hub genes in the HIF-1 and FoxO signaling pathways were screened using the CytoHubba plugin and verified by RT-qPCR. Key protein targets, including IFNG, IL-6, MAPK14, and CCND1, were obtained via virtual screening and verified by WB.

CONCLUSION

This study suggests that SQFNXNP, a potential anti-fatigue TCM prescription, alleviates exercise-induced fatigue, addressing the lack of anti-fatigue drugs in clinical therapy.

Integrated meta-analysis, network pharmacology, computational biology, and in vitro experimental verification to reveal the anti-fatigue mechanism of Lycium barbarum

This study aims to elucidate Lycium barbarum (LB)'s anti-fatigue mechanisms. Meta-analysis confirmed LB's anti-fatigue capacity, while network pharmacology, molecular docking, and molecular dynamics simulations identified key targets (SRC, HSP90AA1, EGFR, PRKACA, MAPK1). Furthermore, validation experiments in C2C12 cells demonstrated that LB mitigates H2O2-induced reactive oxygen species (ROS) accumulation and restores cell viability. qPCR analysis further revealed that LB downregulates the mRNA expression of CAT, IL-6 and TNF-α, while modulating the expression of these target genes. In summary, our data confirm the anti-fatigue effects of LB and elucidate that LB exerts multi-component, multi-target, and multi-pathway mechanisms in combating fatigue.

Blending polysaccharides from three edible mushrooms represents a promising approach for augmenting their anti-oxidant and anti-fatigue activities

It has been well documented that a number of polysaccharides with potent free-radical scavenging capability possess notable anti-fatigue activity. Interestingly, recent evidence also suggested mixed polysaccharides derived from multiple sources may yield augmented bioactivities compared to the polysaccharides from a single source. Therefore, in the current study, we investigated the anti-oxidant and anti-fatigue activities of a blend of polysaccharides isolated from three mushrooms. The optimal ratio of Pleurotus eryngii polysaccharide, Agrocybe aegerita polysaccharide, and Agaricus bisporus polysaccharide was firstly screened out by in vitro antioxidant assays with a Z-score comprehensive evaluation method. Then, the fatigue-reducing effects of the polysaccharide mixture at optimal ratio (1:2:2) were studied in mice. The results showed that the polysaccharide mixture exerted desirable fatigue-reducing effect evidence by significantly extended exhaustion time in the weight-loaded swimming assay (from 9.45 ± 3.06 min to 27.65 ± 19.84 min). Moreover, the observed fatigue-reducing effect may be attributed to its capacity to decrease fatigue-related metabolites, increase muscle glycogen reserves, and regulate energy metabolism-related transcripts in muscle tissue. Taken together, these findings highlighted the potential application of blending polysaccharides from multiple mushroom sources in mitigating fatigue.

Twenty years of research on exercise-induced fatigue: A bibliometric analysis of hotspots, bursts, and research trends

Data from the Web of Science Core Collection (2004-2023) on "exercise-induced fatigue" were analyzed using bibliometric tools to explore research trends across countries, institutions, authors, journals, and keywords. The analysis was limited to "Article" and "Review" literature types. Among 4531 publications, the United States contributed the most articles (1005), followed by England (559) and China (516). The most influential institution was Universidade de São Paulo, while the most productive was Institut National de la Santé et de la Recherche Médicale with 103 papers. The European Journal of Applied Physiology ranked as the top journal with 233 articles. Millet Guillaume Y. emerged as the most prolific author, and Amann Markus was the most cited. Recent keyword trends showed a surge in terms like "physical activity" and "aerobic exercise," while "fatigue" and "exercise" remained dominant. Notable findings were observed in oncology, engineering, and multidisciplinary studies, indicating potential research trends. Oxidative stress was identified as the most commonly mentioned mechanism in exercise-induced fatigue studies. This bibliometric analysis highlights current research trends and gaps, suggesting that future studies should focus on understanding the mechanisms of exercise-induced fatigue, developing objective measurement criteria, and exploring strategies for its alleviation.

Effects of natural source polysaccharides on neurological diseases: A review

With the aging of society and changes in lifestyle, the incidence of neurological diseases (NDs) has been increasing year by year, bringing a heavy burden to patients and society. Although the efficacy of chemical drugs in the treatment of NDs is remarkable, there are problems such as high side effects and high costs. Therefore, finding mild and efficient drugs for NDs treatment has become an urgent clinical need. Natural source polysaccharides (NSPs) are macromolecules with unique bioactivity and low toxicity characteristics, which have great potential to become novel therapeutic agents for NDs. In the present study, the pharmacological activities and potential molecular mechanisms of NSPs to alleviate NDs are systematically reviewed from the perspectives of inflammation, oxidative stress, apoptosis, neuronal cell autophagy, neurotoxicity, and sedation-hypnosis. In addition, the limitations of the existing studies were analyzed and discussed, and the future research direction was suggested. This study may provide scientific basis for the research and development of therapeutic agents for NDs based on NSPs.

Anti-Fatigue Activity of Corn Protein Hydrolysate Fermented by Lactic Acid Bacteria

OBJECTIVES

This study aimed to clarify the effect of lactic acid bacteria-fermented corn protein hydrolysate (FCH) on fatigue in mice and explore the connection between fatigue-related indicators and intestinal microbial flora.

METHODS

The fatigue model of mice was constructed by exercise endurance experiment. The anti-fatigue level of FCH was evaluated by measuring physiological and biochemical indexes in mouse serum, liver and skeletal muscle. The relationship between FCH, intestinal flora and fatigue was explored through the analysis of intestinal microbial diversity in mice, and the anti-fatigue mechanism of FCH was further analyzed.

RESULTS

The results showed that the weight-bearing swimming time of mice was prolonged by 1.96 times, and the running time of mice was prolonged by 2.63 times in the high-dose FCH (FCH-H) group. Moreover, the lactic acid contents in the blood were reduced by 16.00%, and lactate dehydrogenase activity and urea nitrogen contents basically returned to the normal level. Meanwhile, the malondialdehyde contents were reduced by 31.24%, and superoxide dismutase activity and glutathione contents were increased by 1.84 times and 1.72 times, respectively. In addition, the glycogen contents of the body were restored, and the muscle glycogen and liver glycogen were increased by 1.81 and 5.81 times, respectively. Analysis of intestinal microbial flora diversity in mice showed that the highest relative abundance was Lactobacillus, and the FCH group could recover and even increase its relative abundance. Lactobacillus was significantly positively correlated with muscle glycogen and SOD.

CONCLUSIONS

FCH can alleviate fatigue by regulating fatigue-related indicators and improving the intestinal microbial flora of the organism.

Plant polysaccharides and antioxidant benefits for exercise performance and gut health: from molecular pathways to clinic

In the last three decades, our understanding of how exercise induces oxidative stress has significantly advanced. Plant polysaccharides, such as dietary fibers and resistant starches, have been shown to enhance exercise performance by improving energy metabolism, reducing fatigue, increasing strength and stamina, mitigating oxidative stress post-exercise, facilitating muscle recovery, and aiding in detoxification. Moreover, antioxidants found in plant-based foods play a crucial role in protecting the body against oxidative stress induced by intense physical activity. By scavenging free radicals and reducing oxidative damage, antioxidants can improve exercise endurance, enhance recovery, and support immune function. Furthermore, the interaction between plant polysaccharides and antioxidants in the gut microbiota can lead to synergistic effects on overall health and performance. This review provides a comprehensive overview of the current research on plant polysaccharides and antioxidants in relation to exercise performance and gut health.

Metal-ion-binding properties of glycyrrhiza polysaccharide extracted from Licorice: Structural characterization and potential application in drug delivery

Licorice is not only a widely used food, but also a classic tonic Chinese medicine, which mainly contains glycyrrhiza polysaccharides (GP) and flavonoids with excellent anti-inflammatory and antioxidant pharmacological activities. In this study, a neutral homogeneous polysaccharide (GP1-2) was isolated from Glycyrrhiza uralensis Fisch. However, its gelation behavior and properties have yet to be comprehensively studied. In this study, a Ca2+ cross-linked physical hydrogel based on neutral GP1-2 (GP1-2-Ca2+) is fabricated. The ability of metal ions to cross-linked gelation with GP1-2 is explored with respect to the polysaccharide concentrations, ion species, and pH environments. The pH range of Ca2+ cross-linked with GP1-2 to form hydrogel is 8 to 10, and the gelation concentration ranges from 20.0 % to 50.0 % w/v. Subsequently, the properties of the GP1-2-Ca2+ hydrogels are investigated using rheological measurements, scanning electron microscopy, free radical scavenging, MTT assays, healing capability, and enzyme-linked immunosorbent assays. The results reveal that the structure of GP1-2 presents an irregular porous structure, however, the physical gel formed after cross-linking with Ca2+ microscopically showed a globular porous structure with uniform distribution, suggesting that this structure characteristic may be used as a carrier material for drug delivery. Meanwhile, the GP1-2-Ca2+ hydrogel also possessed extraordinary viscoelasticity, cytocompatibility, antioxidant properties, anti-inflammatory activity, and ability to promote wound healing. Furthermore, the potential of GP1-2-Ca2+ hydrogels as drug delivery materials was validated by using rhein as a model drug for encapsulation, it is demonstrated that its cumulative release behavior of GP1-2-Ca2+ is pH-dependent. All in all, this study reveals the potential application of natural polysaccharides in drug delivery, highlighting its dual roles as carrier materials and bioactive ingredients.

Inverse association between uric acid levels and muscle quality index in adults: a cross-sectional analysis of NHANES 2011-2014

OBJECTIVE

The objective of this study was to delineate the association between serum uric acid (UA) levels and Muscle Quality Index (MQI), assessing muscle strength relative to mass, in adults aged 20 to 59 years.

METHODS

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014, this study examined the association between UA levels and MQI-a ratio of muscle strength to mass. Weighted linear models, adjusted for potential confounders, assessed the relationship, with a generalized additive model (GAM) probing for non-linear patterns. Subgroup analyses and interaction effects were conducted using weighted linear regression across diverse demographic and clinical groups to ensure the robustness and reliability of our findings.

RESULTS

Among 5,277 participants, a significant inverse association was observed between UA levels and MQI, with a 0.08 decrease in MQI per 1 mg/dL increase in UA (95% CI: -0.11 to -0.06, p < 0.001). The negative trend was dose-dependent across UA quartiles, which was most pronounced in the highest quartile (Q4: -0.28, 95% CI: -0.36 to -0.19, p < 0.001). Curve-fitting analysis revealed a consistent inverse relationship without evidence of non-linearity. Stratified analyses reinforced the core findings across all examined subgroups, highlighting the universal relevance of the observed association.

CONCLUSION

Our findings demonstrate a significant inverse association between elevated serum UA levels and MQI, highlighting the potential importance of uric acid management in enhancing muscle quality among young and middle-aged adults. The consistency of this relationship across different subgroups underscores the need for targeted strategies and interventions to manage UA levels. Future research should explore longitudinal impacts and intervention outcomes to further elucidate the potential benefits of uric acid management on muscle health.

Structure characterization and immunological activity of capsular polysaccharide from live and heat-killed Lacticaseibacillus paracasei 6235

Capsular polysaccharide (CPS) as a probiotic component has the ability to regulate the function of the host's immune system. However, how the structure and function of heat-killed CPS are altered remains unclear. In the present study, CPS were isolated and purified from live (LCPS) and heat-killed (HCPS) Lacticaseibacillus paracasei 6235. The differences in structure and immunomodulation between LCPS and HCPS were compared and analyzed. The results demonstrate that after heat killed, the molecular weight of CPS decreased from 23.4 kDa to 17.5 kDa, with the disappearance of galactosamine in the monosaccharide composition, and changes in the microstructure. Methylation analysis and nuclear magnetic resonance analysis revealed that the LCPS and HCPS are similar in structure, which main units of →3,4)-α-D-Glcp-(1→4)-α-D-Galp-(1→3)-β-L-Rhap-(1→6)-β-D-Galp-(1→, and repeating units of →3,4)-α-D-Glcp-(1→, →3)-β-L-Rhap-(1→, and →4)-α-D-Galp-(1→ residues. Furthermore, both LCPS and HCPS significantly downregulated the expression of pro-inflammatory cytokines in RAW264.7 cells induced by LPS. Specifically, HCPS reduced the levels of IL-6 and IL-1β by 79.38 % and 88.42 %, respectively, compared to LCPS. Concurrently, both LCPS and HCPS effectively mitigated inflammatory responses through the NF-κB and MAPK signaling pathways. Moreover, compared to LCPS, HCPS increased the protein expression levels of NF-κB/p-NF-κB and IκB/p-IκB by 26.14 % and 28.92 %, respectively. These results suggest that CPS has a role in modulating immune responses and that HCPS is more effective. This study can be further developed into new products related to postbiotics.

A review of Lycium barbarum polysaccharides: Extraction, purification, structural-property relationships, and bioactive molecular mechanisms

Lycium barbarum L. is of great significance medicinal and edible plant, which is native to N. & Central China. The extensive health benefits of L. barbarum have earned it great respect in traditional medicine for centuries. Lycium barbarum polysaccharides (LBPs) being recognized as one of the most crucial bioactive compounds found within this plant, with it exhibit a diverse range of pharmacological activities and nutritional functions, thereby generating substantial market demand and broad application prospects. To gain a more comprehensive understanding of LBPs, the review discussed the extraction, purification and structural-property relationships of these compounds. In addition, this review provides a comprehensive summary of the potential mechanisms underlying various biological activities attributed to LBPs, including immune modulation, antioxidant effects, neuroprotection, hepatoprotection, and antitumor properties. The application status and the future research directions of LBPs were subsequently presented. This review will establish a robust foundation and serve as an invaluable resource for future research and advancements in the field of LBPs.

A review of the polysaccharides against fatigue and the underlying mechanism

Fatigue is a common physiological state that affects normal human activities. Prolonged fatigue induces a variety of diseases and seriously affects human health, so it is imperative to discover nutritional dietary supplements and treatments without side effects, among which natural anti-fatigue polysaccharides have shown great potential. Polysaccharides, a class of biomolecules produced by a variety of organisms such as plants, animals, bacteria and algae, have attracted much attention in recent years due to their anti-fatigue activity and fewer side effects. This review summarizes the classification, dosage and experimental models of polysaccharides with anti-fatigue activity obtained from different natural sources. We also review the fatigue-relieving effects of these polysaccharides through mechanisms such as modulating oxidative damage, regulating energy metabolism and influencing intestinal flora, as well as the effects of molecular weights, monosaccharide compositions, structural features and chemical modifications of the polysaccharides on their anti-fatigue activities to support their potential application value in functional foods and pharmaceuticals. New valuable insights for future research on natural polysaccharides are also presented in the field of natural production of bio-based functional materials, functional foods and therapeutic agents.

Structural characterization and mechanisms of macrophage immunomodulatory activity of a novel polysaccharide with a galactose backbone from the processed Polygonati Rhizoma

A purified polysaccharide with a galactose backbone (SPR-1, Mw 3,622 Da) was isolated from processed Polygonati Rhizoma with black beans (PRWB) and characterized its chemical properties. The backbone of SPR-1 consisted of [(4)-β-D-Galp-(1]9 → 4,6)-β-D-Galp-(1 → 4)-α-D-GalpA-(1 → 4)-α-D-GalpA-(1 → 4)-α-D-Glcp-(1 → 4,6)-α-D-Glcp-(1 → 4)-α/β-D-Glcp, with a branch chain of R1: β-D-Galp-(1 → 3)-β-D-Galp-(1→ connected to the →4,6)-β-D-Galp-(1→ via O-6, and a branch chain of R2: α-D-Glcp-(1 → 6)-α-D-Glcp-(1→ connected to the →4,6)-α-D-Glcp-(1→ via O-6. Immunomodulatory assays showed that the SPR-1 significantly activated macrophages, and increased secretion of NO and cytokines (i.e., IL-1β and TNF-α), as well as promoted the phagocytic activities of cells. Furthermore, isothermal titration calorimetry (ITC) analysis and molecular docking results indicated high-affinity binding between SPR-1 and MD2 with the equilibrium dissociation constant (K D) of 18.8 μM. It was suggested that SPR-1 activated the immune response through Toll-like receptor 4 (TLR4) signaling and downstream responses. Our research demonstrated that the SPR-1 has a promising candidate from PRWB for the TLR4 agonist to induce immune response, and also provided an easily accessible way that can be used for PR deep processing.

The Medicinal Species of the Lycium Genus (Goji Berries) in East Asia: A Review of Its Effect on Cell Signal Transduction Pathways

Natural plants contain numerous chemical compounds that are beneficial to human health. The berries from the Lycium genus are widely consumed and are highly nutritious. Moreover, their chemical constituents have attracted attention for their health-promoting properties. In East Asia, there are three varieties of the Lycium genus (Lycium barbarum L., Lycium chinense Miller, and L. ruthenicum Murray) that possess medicinal value and are commonly used for treating chronic diseases and improving metabolic disorders. These varieties are locally referred to as "red Goji berries" or "black Goji berries" due to their distinct colors, and they differ in their chemical compositions, primarily in terms of carotenoid and anthocyanin content. The pharmacological functions of these berries include anti-aging, antioxidant, anti-inflammatory, and anti-exercise fatigue effects. This review aims to analyze previous and recent studies on the active ingredients and pharmacological activities of these Lycium varieties, elucidating their signaling pathways and assessing their impact on the gut microbiota. Furthermore, the potential prospects for using these active ingredients in the treatment of COVID-19 are evaluated. This review explores the potential targets of these Lycium varieties in the treatment of relevant diseases, highlighting their potential value in drug development.

The Improvement and Related Mechanism of Microecologics on the Sports Performance and Post-Exercise Recovery of Athletes: A Narrative Review

The diversity and functionality of gut microbiota may play a crucial role in the function of human motor-related systems. In addition to traditional nutritional supplements, there is growing interest in microecologics due to their potential to enhance sports performance and facilitate post-exercise recovery by modulating the gut microecological environment. However, there is a lack of relevant reviews on this topic. This review provides a comprehensive overview of studies investigating the effects of various types of microecologics, such as probiotics, prebiotics, synbiotics, and postbiotics, on enhancing sports performance and facilitating post-exercise recovery by regulating energy metabolism, mitigating oxidative-stress-induced damage, modulating immune responses, and attenuating bone loss. Although further investigations are warranted to elucidate the underlying mechanisms through which microecologics exert their effects. In summary, this study aims to provide scientific evidence for the future development of microecologics in athletics.

Hepatoprotective effects of peach gum polysaccharides against alcoholic liver injury: moderation of oxidative stress and promotion of lipid metabolism

Natural polysaccharides extracted from plants have received increasing attention due to their rich bioactivity. In our study, peach gum polysaccharides (PGPs) were extracted by water extraction-alcohol precipitation method. PGPs are typical pyranose polysaccharides with a mean molecular weight of 3.68 × 106 g/mol. The antioxidant activity and hepatoprotective capacity of PGPs were studied. In vitro, assays showed that PGPs scavenged DPPH, OH, and O2- in a dose-dependent manner. PGPs exhibited antioxidative properties against alcohol-induced HL7702 cells, as evidenced by the normalization of MDA, SOD, ROS, and GSH levels. To further elucidate the hepatoprotective mechanism of PGPs, we carried out in vivo experiments in male mice. PGPs exerted hepatoprotective effects in alcohol liver disease (ALD) mice by exerting antioxidant effects, decreasing the inflammatory response and modulating lipid metabolism. In addition, metabolomic analysis indicated that PGPs mainly regulate D-glutamine and D-glutamate metabolism, alanine, aspartate and glutamate metabolism, and arginine biosynthesis to promote hepatic metabolism and maintain body functions. Overall, this study revealed that the hepatoprotective mechanism of PGPs against ALD might be associated with the regulation of oxidative stress and lipid metabolism.

Signaling pathways regulated by natural active ingredients in the fight against exercise fatigue-a review

Exercise fatigue is a normal protective mechanism of the body. However, long-term fatigue hinders normal metabolism and exercise capacity. The generation and recovery from exercise fatigue involves alterations in multiple signaling pathways, mainly AMPK, PI3K/Akt, Nrf2/ARE, NF-κB, PINK1/Parkin, and BDNF/TrkB, as well as MAPK signaling pathways that mediate energy supply, reduction of metabolites, oxidative stress homeostasis, muscle fiber type switching, and central protective effects. In recent studies, a rich variety of natural active ingredients have been identified in traditional Chinese medicines and plant extracts with anti-fatigue effects, opening up the field of research in new anti-fatigue drugs. In this review we give an overview of the signaling pathways associated with the activity of natural food active ingredients against exercise fatigue. Such a comprehensive review is necessary to understand the potential of these materials as preventive measures and treatments of exercise fatigue. We expect the findings highlighted and discussed here will help guide the development of new health products and provide a theoretical and scientific basis for future research on exercise fatigue.

Dietary Polysaccharides Exert Anti-Fatigue Functions via the Gut-Muscle Axis: Advances and Prospectives

Due to today's fast-paced lifestyle, most people are in a state of sub-health and face "unexplained fatigue", which can seriously affect their health, work efficiency, and quality of life. Fatigue is also a common symptom of several serious diseases such as Parkinson's, Alzheimer's, cancer, etc. However, the contributing mechanisms are not clear, and there are currently no official recommendations for the treatment of fatigue. Some dietary polysaccharides are often used as health care supplements; these have been reported to have specific anti-fatigue effects, with minor side effects and rich pharmacological activities. Dietary polysaccharides can be activated during food processing or during gastrointestinal transit, exerting unique effects. This review aims to comprehensively summarize and evaluate the latest advances in the biological processes of exercise-induced fatigue, to understand dietary polysaccharides and their possible molecular mechanisms in alleviating exercise-induced fatigue, and to systematically elaborate the roles of gut microbiota and the gut-muscle axis in this process. From the perspective of the gut-muscle axis, investigating the relationship between polysaccharides and fatigue will enhance our understanding of fatigue and may lead to a significant breakthrough regarding the molecular mechanism of fatigue. This paper will provide new perspectives for further research into the use of polysaccharides in food science and food nutrition, which could help develop potential anti-fatigue agents and open up novel therapies for sub-health conditions.

Efficacy and safety of Qi and Blood Tonic Chinese Medicines in the treatment of COVID-19: A protocol for systematic review and meta-analysis

BACKGROUND

Coronavirus disease in 2019 (COVID-19) is a sudden public event affecting all human beings, with the rapid transmission, extensive groups affected, many complications, and high mortality. Traditional Chinese Medicine has a long history of preventing and treating infectious diseases, and numerous studies have shown that Traditional Chinese Medicine, especially herbal medicine, has a positive effect on the prevention, treatment, and post-healing recovery of this COVID-19, and herbal medicines to supplement qi and blood often occupy a certain proportion of it. However, there is no relevant meta-analysis to date. Therefore, this study aims to evaluate the efficacy and safety of qi and blood tonic herbal medicines in the treatment of COVID-19 through Systematic Review and meta-analysis to provide a reference basis for widespread clinical application.

METHODS

We will search from the following databases for the period from the time of database construction to March 1st, 2023. The English databases include: PubMed, MEDLINE, EMBASE, Cochrane library, WOS, Google Scholar, and CENTRAL; The Chinese databases include: China National Knowledge Infrastructure, China Biomedical Literature Database, Technology Journal Database, and Wanfang. Randomized controlled trials in English or Chinese that include Chinese herbal medicines for tonifying Qi and Blood in the treatment of patients with COVID-19 will be included. Data were independently screened and collected by 2 investigators. The risk of bias for each trial was assessed using the Cochrane Risk of Bias Tool 2.0. RevMan 5.3 software was used for the meta-analysis of the data. Primary outcome indicators included cure, mortality, and exacerbation rates (change in disease severity category, patient admission to ICU, etc.). Secondary outcome indicators included recovery rate or duration of major symptoms (e.g., fever, cough, fatigue, and weakness, etc.), rate or duration of nucleic acid conversion for severe acute respiratory syndrome coronavirus-2, improvement or recovery of chest CT performance, length of hospital stay, and other adverse events.

RESULTS

This protocol adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-P guidelines to ensure clarity and completeness of reporting in all phases of the systematic review.

CONCLUSION

This study will provide evidence regarding the efficacy and safety of Qi and Blood Tonic Chinese Medicines for the treatment of COVID-19.

PROSPERO REGISTRATION NUMBER

CRD42022361822 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022361822).