Traditional Chinese medicine for promoting mental health of patients with COVID-19: a scoping review

Abstract

Objective: This study aimed to systematically review and depict the current studies of traditional Chinese medicine for the mental health of patients with coronavirus disease 2019 (COVID-19).

Methods: A scoping review was conducted by searching PubMed, Web of Science, CNKI, Wanfang database, VIP database, and SinoMed, with the retrieval time being from the establishment of the database to April 18, 2022. The basic information of the included studies, objective, design, types of patients, interventions, outcomes, etc., was reviewed and summarized narratively.

Method:ological quality was assessed using the Cochrane Risk of Bias assessment tool, the methodological index for non-randomized studies or the Newcastle-Ottawa scale.

Results: We identified 30 traditional Chinese medicine (TCM) studies from six databases. Among them, finished randomized controlled trials (n = 16) accounted for most of the studies, followed by single-arm studies (n = 9). In terms of study theme, 20 studies defined the mental health of patients with COVID-19 as the research theme. Psychological assessment was included in the inclusion criteria (performed before participation) of nine studies, whereas the other studies only mentioned the mental outcomes. TCM interventions included TCM exercises (Yijinjing, Baduanjin, Liuzijue, Taichi), acupoint stimulation (auricular and body points), moxibustion, decoction, or granules based on TCM syndrome differentiation, decoction, or granules with fixed formulae (Baidu Jieduan granules, Xuanfei Baidu decoction, and Qingfei Paidu decoction), Chinese patent medicine (Jinhua Qinggan granules), TCM psychological therapy (TCM ideological therapy, TCM five-tone therapy, and TCM psychological sand table), and TCM nursing (dialectical care, dialectical diet, and psychological counseling). Anxiety and depression were the main outcomes evaluated in regard to mental health in patients with COVID-19. The limitations of methodological quality were predominantly from follow-up, blinding, and registration. Positive results were reported by 27 studies (90%, n = 30).

Conclusion: We summarized the existing literature about the impact of TCM on mental health in patients with COVID-19. The number of studies evaluating the impact of TCM on mental health is encouraging, but overall methodological quality was low. Several TCM interventions warrant further evaluation, particularly among populations outside of China, for the purpose of establishing supporting evidence. More importantly, research with stronger methodological quality needs to be developed.

Keywords

COVID-19 / Mental health / Psychological health / Scoping review / Traditional Chinese medicine

References

[[1]] World Health Organization. WHO coronavirus disease (COVID-19) dashboard. Available from: https://covid19.who.int.

[[2]] Pfefferbaum B, North CS. Mental health and the Covid-19 pandemic. N Engl [J] Med. 2020;383(6):510-512.

[[3]] Taquet M, Luciano S, Geddes JR, et al.Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62354 COVID-19 cases in the USA. Lancet Psychiatry. 2021;8(2):130-140.

[[4]] Vigo D, Thornicroft G, Atun R. Estimating the true global burden of mental illness. Lancet Psychiatry. 2016;3(2):171-178.

[[5]] Ginn S, Horder J. “One in four” with a mental health problem: the anatomy of a statistic. BMJ. 2012;344:e1302.

[[6]] Zachary S, Claire M, Changiz I, et al. The global prevalence of common mental disorders: a systematic review and meta-analysis 1980-2013. IJE. 2014;43(2):476-493.

[[7]] Lee SW, Yang JM, Moon SY, et al. Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study. Lancet Psychiatry. 2020;7(12):1025-1031.

[[8]] National Health Commission of the People’s Republic of China. Diagnosis and treatment protocol for COVID-19 (trial version 3). 2020. Available from: http://www.nhc.gov.cn/yzygj/s7653p/202001/f492c9153ea9437bb587ce2ffcbee1fa.shtml.

[[9]] National Health Commission of the People’s Republic of China. Diagnosis and treatment protocol for COVID-19 (trial version 9). 2022. Available from:http://www.nhc.gov.cn/jkj/s3577/202206/de224e7784fe4007b7189c1f1c9d5e85.shtml.

[[10]] Zhang Y, Jia YJ, Li XJ, et al. Psychological crisis of COVID-19 and intervention strategies of traditional Chinese medicine. Tianjin [J] Tradit Chin Med. 2020;37(6):638-644.

[[11]] Li XD, Liu BY, Wang Y, et al. Interpretation of the “guidance recommendations of traditional Chinese Medicine rehabilitation in the recovery period of COVID-19 (trial)”. J Tradit Chin Med. 2020;61(11):928-934.

[[12]] Munn Z, Tufanaru C, Aromataris E. JBI’s systematic reviews: data extraction and synthesis. Am [J] Nurs. 2014;114(7):49-54.

[[13]] The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual 2015: Methodology for JBI Scoping Reviews. Adelaide: Joanna Briggs Institute, 2015.

[[14]] Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-473.

[[15]] Hu HY, Ji ZC, Feng CN, et al.PROSPERO’s systematic review protocols of traditional Chinese medicine for COVID-19: an overview. Integr Med Res. 2021;10(S):100774.

[[16]] Ji ZC, Zhang JH, Menniti-Ippolito F, et al.The quality of Cochrane systematic reviews of acupuncture: an overview. BMC Complement Med Ther. 2020;20(1):307.

[[17]] Higgins JP, Altman DG, Gøtzsche PC, et al.The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928.

[[18]] Slim K, Nini E, Forestier D, et al. Methodological Index for Non-randomized Studies (MINORS): development and validation of a new instrument. ANZ J Surg. 2003;73(9):712-716.

[[19]] Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta analyses. Ottawa: Ottawa Hospital Research Institute. 2021. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp.

[[20]] Chen SX, Zhang DX, Jia YS, et al.Traditional Chinese medicine nursing intervention psychological changes of PATIENTS with COVID-19 treated by Traditional Chinese medicine. Lingnan [J] Emer Med. 2020;25(1):14-15.

[[21]] Chen XY, Chen YP, Pan XJ.Effects of Baduanjin in bed on mental health of COVID-19 patients. Chin [J] Convalescent Med. 2020;29(11):1137-1139.

[[22]] Duan C, Xia GW, Zheng CJ, et al.Clinical Observation on Jinhua Qinggan granule combined with conventional western medicine therapy in treating medicine of coronavirus disease 2019. [J] Tradit Chin Med. 2020;61(17):1473-1477.

[[23]] Gao XY. Discussion on the psychological rehabilitation guidance of patients in makeshift hospital by acupoint massage and traditional Chinese medicine Baduanjin. World Latest Med Info (Electronic Version). 2020;20(74):222-223.

[[24]] Huang XB, Xie DY, Qi Q, et al.Clinical observation of heat-sensitive moxibustion treatment for coronavirus disease 2019. Chin Acupuncture Moxibustion. 2020;40(6):576-580.

[[25]] Ju WX, Shang D, Liu ZY, et al.Intervention of traditional chinese medicine psychotherapy on negative emotion of COVID-19 patients. Shandong [J] Tradit Chin Med. 2022;41(1):44-49.

[[26]] Li YZ, Yao YJ, Chen AQ, et al. Clinical observation on 374 cases of novel coronavirus infection with anxiety and depression treated by psychological sand table of traditional Chinese medicine. Med diet health. 2020;18(24):208-209.

[[27]] Li ZL. Rehabilitation with integrated traditional Chinese and western medicine on COVID-19: a clinical research. Wuhan: Hubei Univ Chin Med,. 2021.

[[28]] Li AJ, Yao C, Kuang CY, et al.Effects of baduanjin combined with auricular plaster therapy on anxiety and depression of COVID-19 patients during rehabilitation period. [J] Nurs. 2021;28(6):48-52.

[[29]] Li L, Ni J, Jiao J, et al.Clinical nursing observation of five elements music combined with six words formula on improving negative emotion of patients with novel coronavirus pneumonia. [J] Hunan Univ Chin Med. 2021;41(5):765-769.

[[30]] Li J, Jing J, Xie XL, et al.Effectiveness of auricular point pressing with bean on insomnia in patients with COVID-19. Modernization TCM Mater Med World Sci Tech. 2021;23(6):2086-2091.

[[31]] Li LL, Song YY, Hu XY, et al.A preliminary study of traditional Chinese medicine promoting health recovery after COVID-19. Pharmacol Clin Chin Mater Med. 2021;37(1):2-6.

[[32]] Luo YH, Luo YF, Hu SF.Observation on the improvement of stress affective disorder in patients with mild COVID-19 by ear acupoint pressing bean and Yijinjing. Practical Clin Med. 2021;22(1):57-59.

[[33]] Luo Y, Ling C, Liu Y, et al.The beneficial role of auricular point pressure in insomnia and anxiety in isolated COVID-19 patients. Evid Based Complementary Altern Med. 2021;2021:6611942.

[[34]] Shi QY, Yuan YH, Miao CY, et al.Clinical study of emotional nursing on negative emotions in PATIENTS with COVID-19 during treatment. World Latest Med Info (Electronic Version). 2020;20(87):278-280.

[[35]] Wu HY, Pan L, Li L, et al.Effects of Baduanjin training on anxiety of COVID-19 patients in makeshift hospitals. Special Health Issue. 2020;34:120-121.

[[36]] Wu X, Lu W, Guo Q, et al. Novel coronavirus pneumonia (COVID-19) combined with Chinese and Western medicine based on “Internal and External Relieving -Truncated Torsion” strategy. Medicine. 2020;99(51):e23874e23874.

[[37]] Wei L, Mao QC, Yang JF.Retrospective study of 34 cases of COVID-19 patients treated by integrated TCM and western medicine. J emer TCM. 2021;30(11):1947-1949,1965.

[[38]] Xu SP. The effects of Baduanjin on anxiety and depression of COVID-19 patients in makeshift hospital. Guidelines Health Care. 2020(46):269.

[[39]] Xu X. Effect of TaiChi on depression and hope level of COVID-19 patients in makeshift hospitals. Chin General Nursing. 2020;18(7):829-830.

[[40]] Yan BH, Tang JY, Ding H, et al. Clinical research program of traditional chinese medicine to promote recovery of corona virus disease 2019 in recovery period. [J] Chengdu Univ TCM. 2020;43(1):1-6.

[[41]] Yang X, Luo Y, Zhou CM, et al. Application of Baduanjin combined with acupressure to relieve anxiety and depression in COVID-19 patients. World Latest Med Info (Electronic Version). 2020;20(71):97-98,100.

[[42]] Yang ZC. Analysis of the influence of traditional Chinese medicine nursing combined with acupoint massage on anxiety and depression of patients in Shelter Hospital. World Latest Med Info (Electronic Version). 2021;21(4):287-289.

[[43]] Yang C, Ma Y, Mei JH, et al. Observation of therapeutic effect on coronavirus disease 2019 with insomnia in treatment with Baduanjin and auricular point sticking therapy. Chin Acupuncture Moxibustion. 2021;41(3):243-246.

[[44]] Zeng XH, Ma WH, Wang J. Effect of Qingfei Paidu decoction on clinical efficacy of COVID-19 pneumonia with Phlegm heat blocking lung. Med [J] West Chin. 2020;32(12):1799-1801,1806.

[[45]] Zhang JC, Liu F, Wang L, et al. Application experience of traditional Chinese medicine nursing program in rehabilitation period of COVID-19. Tianjin [J] TCM. 2021;38(7):838-842.

[[46]] Zheng YY, Chen SF, Lai XH, et al. Application of humanistic care with TCM characteristics in the treatment of novel coronavirus (2019-nCOV) pneumonia patients. J Med Theory Pract. 2021;34(10):1760-1762.

[[47]] Zheng YY, Tang FR, Chen SF, et al. Traditional chinese medicine humanistic care for COVID-19 patients. [J] Practical Med Tech. 2021;28(2):251-252.

[[48]] Zhou LR, Lu WB, Ou JZ, et al. Observation on the effect of Chinese and western combined treatment of COVID-19. World Latest Med Info (Electronic Version). 2021;21(2):235-236.

[[49]] Zhao HY, Fu LR, Xie CC, et al.Observation of the effect of moxibustion intervention on discharged COVID-19 patients based on Internet model. Jiangxi [J] Tradit Chin Med. 2022;53(2):46-49.

[[50]] General Administration of Sport of China. Fitness Qigong·Yijinjing. Beijing: Peoples Sports Publishing House, 2003.

[[51]] General Administration of Sport of China. Fitness Qigong·Baduanjin. Beijing: Peoples Sports Publishing House, 2003.

[[52]] Xiao CM, Zhuang YC.Efficacy of Liuzijue Qigong in individuals with chronic obstructive pulmonary disease in remission. [J] Am Geriatrics Soc. 2015;63(7):1420-1425.

[[53]] Hui L, Ming Y, Qlt C, et al. Characteristics of registered clinical trials on traditional Chinese medicine for coronavirus disease 2019 (COVID-19): a scoping review. Eur J Integr Med. 2020;41(7):101251.

[[54]] Kuo SY, Tsai SH, Chen SL, et al.Auricular acupressure relieves anxiety and fatigue, and reduces cortisol levels in post-caesarean section women: a single-blind, randomised controlled study. Intl [J] Nurs Stds. 2016;53:17-26.

[[55]] China Institute of Acupuncture and Moxibustion. Guiding opinions on acupuncture-moxibustion intervention for COVID-19 (version 2). 2020. Available from: http://www.caam.cn/article/2193.

[[56]] National Administration of Traditional Chinese Medicine. Notice on recommending the use of Qingfei Paidu Decoction in the treatment of coronavirus disease 2019. 2020. Available from: Available from:http://yzs.satcm.gov.cn/zhengcewenjian/2020-02-07/12876.html.

[[57]] Wang Y, Li X, Zhang JH, et al.Mechanism of Xuanfei Baidu Tang in treatment of COVID-19 based on network pharmacology. Chin [J] Chin Materia Medica. 2020;45(10):2249-2256.

[[58]] National Administration of Traditional Chinese Medicine. Diagnosis and Treatment Protocol for COVID-19 (Trial Version 5). 2020 Available from: http://bgs.satcm.gov.cn/zhengcewenjian/2020-02-06/12847.html.