Herbal medicines for viral myocarditis

Area of Science:

• Integrative Medicine
• Cardiology
• Pharmacology

Background:

• Viral myocarditis is a significant cardiovascular disease.
• Herbal medicines are increasingly explored for treating viral diseases, including viral myocarditis.
• Previous reviews have not definitively established the role of herbal medicines in viral myocarditis treatment.

Purpose of the Study:

• To systematically assess the efficacy of herbal medicines in treating viral myocarditis.
• To evaluate the impact of herbal medicines on clinical and indirect outcomes in viral myocarditis patients.
• To update previous evidence on herbal medicine use for viral myocarditis.

Main Methods:

• Searched multiple databases (CENTRAL, MEDLINE, EMBASE, Chinese databases, AMED, LILACS) for randomized controlled trials (RCTs).
• Included RCTs of herbal medicines (≥7 days treatment) versus placebo, no intervention, or conventional treatments, including add-on therapy.
• Two authors independently extracted data, assessed trial quality, and collected adverse event information.

Main Results:

• Twenty RCTs with 2177 participants were included, all conducted in China; trials were at high risk of bias.
• No trials reported mortality outcomes.
• Astragalus membranaceus and Shengmai injections showed significant improvements in electrocardiogram (ECG) abnormalities, creatine phosphate kinase (CPK), and lactate dehydrogenase (LDH) levels. Shengmai decoction improved quality of life.

Conclusions:

• Certain herbal medicines may improve ECG, myocardial enzyme levels, and cardiac function in viral myocarditis.
• Findings must be interpreted cautiously due to high risk of bias and small sample sizes.
• Further high-quality randomized controlled trials are necessary to validate the therapeutic role of herbal medicines in viral myocarditis.