Astragalus membranaceus (AM) is a traditional Chinese medicine, which possesses a variety of biological activities in the cardiovascular systems. We conducted a clinical and preclinical systematic review of 28 randomized clinical control studies with 2522 participants and 16 animal studies with 634 animals to evaluate the efficacy, safety, and possible mechanisms of AM for viral myocarditis (VM). The search strategies were performed in 7 databases from inception to January 2020. Application of the Cochrane Collaboration’s tool 7-item checklist, SYRCLE’s tool 10-item checklist, and Rev-Man 5.3 software to analyze the risk of bias of studies and data. The results show the score of clinical study quality ranged from 3 to 7 points with an average of 3.32, and the score of animal study quality ranged from 2 to 5 points with an average of 3. In clinical study, AM significantly reduced serum myocardial enzymes and cardiac troponin I levels and improved the clinical treatment efficiency in VM patients compared with the control group (). There was no significant difference in the incidence of adverse reactions (). Significant increase of the survival rate and decrease of the cardiac cardiology score, cardiac enzymes, and cardiac troponin I were compared with the placebo group in animal studies (). The possible mechanisms of AM are largely through antivirus and antivirus receptors, anti-inflammatory, antioxidation, antiapoptotic, antifibrosis, and reducing cardiac calcium load. In conclusion, the findings suggested that AM is a cardioprotection candidate drug for VM.

中文翻译：

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黄芪治疗病毒性心肌炎的临床和临床前系统评价

黄芪（AM）是一种传统中药，在心血管系统中具有多种生物活性。我们对25个参与者的28个随机临床对照研究和634个动物的16个动物研究进行了临床和临床前系统评价，以评估AM对病毒性心肌炎（VM）的疗效，安全性和可能的​​机制。从开始到2020年1月，在7个数据库中执行了搜索策略。应用Cochrane Collaboration的工具7项清单，SYRCLE的工具10项清单和Rev-Man 5.3软件来分析研究和数据存在偏差的风险。结果表明，临床研究质量得分在3至7分之间，平均为3.32；动物研究质量得分在2至5分之间，平均为3。）。不良反应发生率无明显差异（）。在动物研究中，与安慰剂组相比，存活率显着提高，心脏心脏病评分，心脏酶和心肌肌钙蛋白I降低（）。AM的可能机制主要是通过抗病毒和抗病毒受体，抗炎，抗氧化，抗凋亡，抗纤维化和减少心脏钙负荷。总之，研究结果表明AM是VM的心脏保护候选药物。