Evaluation of the Effect of “Honey Zufa” Herbal Syrup on Cough in Hospitalized Patients With COVID-19: A Double Blind Randomized Clinical Trial
-
Marziyeh Heydari
,
Hossein Kazemi Zadeh
,
Soha Namazi
,
Hamid Emadi Koochak
,
Nasim Khajavi Rad
,
Mahnaz Khanavi
,
Arman Zargaran
Abstract
Cough is one of the most prevalent symptoms of COVID-19, affecting over 60% of patients. This symptom significantly diminishes quality of life, causing fatigue, insomnia, dysphonia, musculoskeletal pain, and urinary incontinence. Honey Zufa herbal syrup is a well-known antitussive remedy in the Iranian market and was evaluated for its potential to alleviate this symptom. This study aimed to assess the efficacy and safety of Honey Zufa herbal syrup in treating acute cough resulting from mild to moderate COVID-19. A randomized controlled trial was conducted with 200 patients assigned to either the treatment group, receiving Honey Zufa herbal syrup, or the placebo group, receiving a placebo. Both groups also received standard cough control medications. Cough severity was measured using three different scoring systems. The impact of Honey Zufa on cough severity, the influence of other medications, and changes in laboratory parameters were monitored over a 14-day period. Honey Zufa herbal syrup significantly reduced cough severity compared to the placebo across all scoring systems. The treatment group experienced a greater reduction in cough severity than the placebo group. However, there was no significant difference between the groups in terms of antitussive medication regimens. Laboratory parameters remained stable, and no significant side effects were observed. Honey Zufa herbal syrup effectively reduces cough severity in patients with mild to moderate COVID-19, suggesting it could serve as a useful complementary and alternative treatment option for COVID-19-induced cough.
1. Song WJ, Hui CK, Hull JH, Birring SS, McGarvey L, Mazzone SB, et al. Confronting COVID-19-associated cough and the post-COVID syndrome: role of viral neurotropism, neuroinflammation, and neuroimmune responses. Lancet Respir Med 2021;9:533-44.
2. Shi Y, Wang G, Cai XP, Deng JW, Zheng L, Zhu HH, et al. An overview of COVID-19. J Zhejiang Univ Sci B 2020;21:343-60.
3. Seghatoleslami Z, Zare M, Amini A, Majmasanaye M, Eshragh A. The Effect of Plasma Exchange on Recovery of Patients with Coronavirus Disease 2019 (COVID-19) Admitted to the Intensive Care Unit. Coronaviruses 2024;5. (In Press)
4. Pascarella G, Strumia A, Piliego C, Bruno F, Del Buono R, Costa F, et al. COVID‐19 diagnosis and management: a comprehensive review. J Intern Med 2020;288:192-206.
5. Wagner L, Cramer H, Klose P, Lauche R, Gass F, Dobos G, et al. Herbal medicine for cough: a systematic review and meta-analysis. Forsch Komplementmed 2015;22:359-68.
6. Aiyegbusi OL, Hughes SE, Turner G, Rivera SC, McMullan C, Chandan JS, et al. Symptoms, complications and management of long COVID: a review. J R Soc Med 2021;114:428-42.
7. Satia I, Badri H, Al-Sheklly B, Smith JA, Woodcock AA. Towards understanding and managing chronic cough. Clin Med (Lond) 2016;16:s92-7.
8. Šutovská M, Nosáľová G, Šutovský J, Fraňová S, Prisenžňáková L, Capek P. Possible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan in guinea pigs test system. Int J Biol Macromol 2009;45:27-32.
9. Rabini S, Fink C, Kelber O, Vinson B, Kraft K. Patient survey with Althaea officinalis L. root extract in dry cough. Eur J Integr Med 2015:46-7.
10. Gairola S, Gupta V, Bansal P, Singh R, Maithani M. Herbal antitussives and expectorants—a review. International J Pharm Sci Rev Res 2010;5:5-9.
11. Liu W, Jiang HL, Mao B. Chinese herbal medicine for postinfectious cough: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med 2013:2013:906765.
12. Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 2007;161:1140-6.
13. Paul IM, Yoder KE, Crowell KR, Shaffer ML, McMillan HS, Carlson LC, et al. Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents. Pediatrics 2004;114:e85-90.
14. Morice A, Kardos P. Comprehensive evidence-based review on European antitussives. BMJ Open Respir Res 2016;3:e000137.
15. Jabbari M, Daneshfard B, Emtiazy M, Khiveh A, Hashempur MH. Biological effects and clinical applications of dwarf elder (Sambucus ebulus L): A review. J Evid Based Complementary Altern Med 2017;22:996-1001.
16. Kazemi M, Eshraghi A, Yegdaneh A, Ghannadi A. “Clinical pharmacognosy”-A new interesting era of pharmacy in the third millennium. Daru 2012;20:18.
17. Sultana S, Khan A, Safhi MM, Alhazmi HA. Cough suppressant herbal drugs: A review. Int J Pharm Sci Inv 2016;5:15-28.
18. Puodziūniene G, Janulis V, Milasius A, Budnikas V. Development of cough-relieving herbal teas. Medicina (Kaunas) 2005;41:500-5.
19. Abdolahinia A, Naseri M, Eslaminejad A, Ghaffari F, Velayati A. Effect of Nepeta bracteata benth. on chronic obstructive pulmonary disease: a triple-blinded, randomized clinical trial. Iran Red Crescent Med J 2018;20:1-9.
20. Bahmani M, Zargaran A. Ethno-botanical medicines used for urinary stones in the Urmia, Northwest Iran. Eur J Integr Med 2015;7:657-62.
21. Kordafshari G, Kenari HM, Esfahani MM, Ardakani MRS, Keshavarz M, Nazem E, et al. Nutritional aspects to prevent heart diseases in traditional Persian medicine. J Evid Based Complementary Altern Med 2015;20:57-64.
22. Bahramsoltani R, Rahimi R. An evaluation of traditional Persian medicine for the management of SARS-CoV-2. Front Pharmacol 2020;11:571434.
23. Aghili Shirazi. MakhzanaL Advieh [Storehouse of Medicaments]. Tehran: Tehran university of medical sciences; 2008.
24. Hakim Momen Tonekaboni Deilami. Tohfe Momenin (in Persian). Qom: Noore Vahy; 2011.
25. Borujerdi R, Adeli SH, Mohammadbeigi A, Aliasl F, Asghari A, Hormati A, et al. Effects of Iranian Polyherbal Syrup (Zufa syrup) on oxygen saturation and clinical symptoms in suspected patients with COVID-19: a triple-blinded, randomized, placebo-controlled trial. Med Gas Res 2022;12:44-50.
26. Quddus A, Siddiqui M, Siddiqui M, Aleem S. Clinical evaluation of the efficacy of Qurs Sartan Kafoori and Sharbat Zoofa Murakkab in chronic bronchitis. Indian J Tradit Knowledge 2009;8;417-20.
27. Siddiqui N, Rauf A, Latif A, Mahmood Z. Spectrophotometric determination of the total phenolic content, spectral and fluorescence study of the herbal Unani drug Gul-e-Zoofa (Nepeta bracteata Benth). J Taibah Univ Med Sci 2017;12:360-3.
28. Ang L, Song E, Lee HW, Lee MS. Herbal medicine for the treatment of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis of randomized controlled trials. J Clin Med 2020;9:1583.
29. Chen YB, Shergis JL, Wu ZH, Guo XF, Zhang AL, Wu L, et al. Herbal Medicine for Adult Patients with Cough Variant Asthma: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med 2021:2021:5853137.
30. Luo X, Ni X, Lin J, Zhang Y, Wu L, Huang D, et al. The add-on effect of Chinese herbal medicine on COVID-19: A systematic review and meta-analysis. Phytomedicine. 2021;85:153282.
31. Xiong X, Wang P, Su K, Cho WC, Xing Y. Chinese herbal medicine for coronavirus disease 2019: a systematic review and meta-analysis. Pharmacological research. 2020;160:105056.
32. Gandhi RT, Lynch JB, Del Rio C. Mild or moderate Covid-19. N Engl J Med 2020;383:1757-66.
33. Zargaran A, Borhani-Haghighi A, Salehi-Marzijarani M, Faridi P, Daneshamouz S, Azadi A, et al. Evaluation of the effect of topical chamomile (Matricaria chamomilla L.) oleogel as pain relief in migraine without aura: a randomized, double-blind, placebo-controlled, crossover study. Neurol Sci 2018;39:1345-53.
34. Shergis JL, Wu L, May BH, Zhang AL, Guo X, Lu C, et al. Natural products for chronic cough: Text mining the East Asian historical literature for future therapeutics. Chron Respir Dis 2015;12:204-11.
35. Mallow. Natural Products [database on the Internet]. Waltham (MA): UpToDate Inc.; 2022 (Accessed 6 Jan; 2022; at http://online.lexi.com).
36. Al-Snafi AE. The chemical constituents and pharmacological effects of Adiantum capillus-veneris-A review. Asian J Pharmac Sci Technol 2015;5:106-11.
37. Hyssopus. Natural Products [database on the Internet]. Waltham (MA): UpToDate Inc.; 2022 (Accesse 6 Jan; 2022; at http://online.lexi.com).
38. Jujube. Natural Products [database on the Internet]. Waltham (MA): UpToDate Inc.; 2022 (Accessed 6 Jan; 2022; at http://online.lexi.com).
39. Garred P, Brygge K, Sørensen C, Madsen H, Thiel S, Svejgaard A. Mannan-binding protein—levels in plasma and upper-airways secretions and frequency of genotypes in children with recurrence of otitis media. Clin Exp Immunol 1993;94:99-104.
40. Fathiazad F, Hamedeyazdan S. A review on Hyssopus officinalis L.: Composition and biological activities. Afr J Pharm Pharmacol; 2011;5:1959-66
41. Wang N, Yang XW. Two new flavonoid glycosides from the whole herbs of Hyssopus officinalis. J Asian Nat Prod Res 2010;12:1044-50.
42. Ma X, Ma X, Ma Z, Sun Z, Yu W, Wang J, et al. The effects of uygur herb Hyssopus officinalis L. on the process of airway remodeling in asthmatic mice. Evid Based Complement Alternat Med 2014;2014:710870.
43. Wang J, Li FS, Pang NN, Tian G, Jiang M, Zhang HP, et al. Inhibition of Asthma in OVA Sensitized Mice Model by a Traditional Uygur Herb Nepeta bracteata Benth. Evid Based Complement Alternat Med 2016;2016:5769897.
44. Mawa S, Husain K, Jantan I. Ficus carica L. (Moraceae): phytochemistry, traditional uses and biological activities. Evid Based Complement Alternat Med 2013:2013:974256.
45. Badgujar SB, Patel VV, Bandivdekar AH, Mahajan RT. Traditional uses, phytochemistry and pharmacology of Ficus carica: A review. Pharm Biol 2014;52:1487-503.
46. Mukhtar HM, Ansari S, Ali M, Naved T. New compounds from Zizyphus vulgaris. Pharmac Biol 2004;42:508-11.
47. Mukhtar HM, Ansari S, Ali M, Naved T, Bhat Z. New ursane-type triterpenes from Zizyphus vulgaris. roots. Pharmac Biol 2005;43:392-5.
48. Qasemzadeh MJ, Sharifi H, Hamedanian M, Gharehbeglou M, Heydari M, Sardari M, et al. The effect of Viola odorata flower syrup on the cough of children with asthma: a double-blind, randomized controlled trial. J Evid Based Complementary Altern Med 2015;20:287-91.
49. Ebadi N, Farjadmand F, Mehri M, Mohajerani F, Raies-Dana A, Shahpiri Z, et al. Adiantum Capillus Veneris L.: From Iranian Traditional Medicine to Modern Phytotherapy. Tradit Integr Med 2016;1:129-31.
50. Haider S, Nazreen S, Alam MM, Gupta A, Hamid H, Alam MS. Anti-inflammatory and anti-nociceptive activities of ethanolic extract and its various fractions from Adiantum capillus veneris Linn. J Ethnopharmacol 2011;138:741-7.
51. Kumari A, Dora J, Kumar A, Kumar A. Pomegranate (Punica granatum)—overview. Int J Pharm Chem Sci 2012;1:1218-22.
52. Ahmed N, Sutcliffe A, Tipper C. Feasibility study: honey for treatment of cough in children. Pediatr Rep 2013;5:31.
53. Oduwole O, Udoh EE, Oyo‐Ita A, Meremikwu MM. Honey for acute cough in children. Cochrane Database Syst Rev 2018;4:CD007094.
54. Cohen HA, Rozen J, Kristal H, Laks Y, Berkovitch M, Uziel Y, et al. Effect of honey on nocturnal cough and sleep quality: a double-blind, randomized, placebo-controlled study. Pediatrics 2012;130:465-71.
55. Nazari S, Rameshrad M, Hosseinzadeh H. Toxicological effects of Glycyrrhiza glabra (licorice): a review. Phytother Res 2017;31:1635-50.
56. Bazzaz B, Haririzadeh G. Screening of Iranian plants for antimicrobial activity. Pharmac Biol 2003;41:573-83.
57. Javid A, Haghi NM, Emami SA, Ansari A, Zojaji SA, Khoshkhui M, et al. Short-course administration of a traditional herbal mixture ameliorates asthma symptoms of the common cold in children. Avicenna J Phytomed 2019;9:126-33.
2. Shi Y, Wang G, Cai XP, Deng JW, Zheng L, Zhu HH, et al. An overview of COVID-19. J Zhejiang Univ Sci B 2020;21:343-60.
3. Seghatoleslami Z, Zare M, Amini A, Majmasanaye M, Eshragh A. The Effect of Plasma Exchange on Recovery of Patients with Coronavirus Disease 2019 (COVID-19) Admitted to the Intensive Care Unit. Coronaviruses 2024;5. (In Press)
4. Pascarella G, Strumia A, Piliego C, Bruno F, Del Buono R, Costa F, et al. COVID‐19 diagnosis and management: a comprehensive review. J Intern Med 2020;288:192-206.
5. Wagner L, Cramer H, Klose P, Lauche R, Gass F, Dobos G, et al. Herbal medicine for cough: a systematic review and meta-analysis. Forsch Komplementmed 2015;22:359-68.
6. Aiyegbusi OL, Hughes SE, Turner G, Rivera SC, McMullan C, Chandan JS, et al. Symptoms, complications and management of long COVID: a review. J R Soc Med 2021;114:428-42.
7. Satia I, Badri H, Al-Sheklly B, Smith JA, Woodcock AA. Towards understanding and managing chronic cough. Clin Med (Lond) 2016;16:s92-7.
8. Šutovská M, Nosáľová G, Šutovský J, Fraňová S, Prisenžňáková L, Capek P. Possible mechanisms of dose-dependent cough suppressive effect of Althaea officinalis rhamnogalacturonan in guinea pigs test system. Int J Biol Macromol 2009;45:27-32.
9. Rabini S, Fink C, Kelber O, Vinson B, Kraft K. Patient survey with Althaea officinalis L. root extract in dry cough. Eur J Integr Med 2015:46-7.
10. Gairola S, Gupta V, Bansal P, Singh R, Maithani M. Herbal antitussives and expectorants—a review. International J Pharm Sci Rev Res 2010;5:5-9.
11. Liu W, Jiang HL, Mao B. Chinese herbal medicine for postinfectious cough: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med 2013:2013:906765.
12. Paul IM, Beiler J, McMonagle A, Shaffer ML, Duda L, Berlin CM. Effect of honey, dextromethorphan, and no treatment on nocturnal cough and sleep quality for coughing children and their parents. Arch Pediatr Adolesc Med 2007;161:1140-6.
13. Paul IM, Yoder KE, Crowell KR, Shaffer ML, McMillan HS, Carlson LC, et al. Effect of dextromethorphan, diphenhydramine, and placebo on nocturnal cough and sleep quality for coughing children and their parents. Pediatrics 2004;114:e85-90.
14. Morice A, Kardos P. Comprehensive evidence-based review on European antitussives. BMJ Open Respir Res 2016;3:e000137.
15. Jabbari M, Daneshfard B, Emtiazy M, Khiveh A, Hashempur MH. Biological effects and clinical applications of dwarf elder (Sambucus ebulus L): A review. J Evid Based Complementary Altern Med 2017;22:996-1001.
16. Kazemi M, Eshraghi A, Yegdaneh A, Ghannadi A. “Clinical pharmacognosy”-A new interesting era of pharmacy in the third millennium. Daru 2012;20:18.
17. Sultana S, Khan A, Safhi MM, Alhazmi HA. Cough suppressant herbal drugs: A review. Int J Pharm Sci Inv 2016;5:15-28.
18. Puodziūniene G, Janulis V, Milasius A, Budnikas V. Development of cough-relieving herbal teas. Medicina (Kaunas) 2005;41:500-5.
19. Abdolahinia A, Naseri M, Eslaminejad A, Ghaffari F, Velayati A. Effect of Nepeta bracteata benth. on chronic obstructive pulmonary disease: a triple-blinded, randomized clinical trial. Iran Red Crescent Med J 2018;20:1-9.
20. Bahmani M, Zargaran A. Ethno-botanical medicines used for urinary stones in the Urmia, Northwest Iran. Eur J Integr Med 2015;7:657-62.
21. Kordafshari G, Kenari HM, Esfahani MM, Ardakani MRS, Keshavarz M, Nazem E, et al. Nutritional aspects to prevent heart diseases in traditional Persian medicine. J Evid Based Complementary Altern Med 2015;20:57-64.
22. Bahramsoltani R, Rahimi R. An evaluation of traditional Persian medicine for the management of SARS-CoV-2. Front Pharmacol 2020;11:571434.
23. Aghili Shirazi. MakhzanaL Advieh [Storehouse of Medicaments]. Tehran: Tehran university of medical sciences; 2008.
24. Hakim Momen Tonekaboni Deilami. Tohfe Momenin (in Persian). Qom: Noore Vahy; 2011.
25. Borujerdi R, Adeli SH, Mohammadbeigi A, Aliasl F, Asghari A, Hormati A, et al. Effects of Iranian Polyherbal Syrup (Zufa syrup) on oxygen saturation and clinical symptoms in suspected patients with COVID-19: a triple-blinded, randomized, placebo-controlled trial. Med Gas Res 2022;12:44-50.
26. Quddus A, Siddiqui M, Siddiqui M, Aleem S. Clinical evaluation of the efficacy of Qurs Sartan Kafoori and Sharbat Zoofa Murakkab in chronic bronchitis. Indian J Tradit Knowledge 2009;8;417-20.
27. Siddiqui N, Rauf A, Latif A, Mahmood Z. Spectrophotometric determination of the total phenolic content, spectral and fluorescence study of the herbal Unani drug Gul-e-Zoofa (Nepeta bracteata Benth). J Taibah Univ Med Sci 2017;12:360-3.
28. Ang L, Song E, Lee HW, Lee MS. Herbal medicine for the treatment of coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis of randomized controlled trials. J Clin Med 2020;9:1583.
29. Chen YB, Shergis JL, Wu ZH, Guo XF, Zhang AL, Wu L, et al. Herbal Medicine for Adult Patients with Cough Variant Asthma: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med 2021:2021:5853137.
30. Luo X, Ni X, Lin J, Zhang Y, Wu L, Huang D, et al. The add-on effect of Chinese herbal medicine on COVID-19: A systematic review and meta-analysis. Phytomedicine. 2021;85:153282.
31. Xiong X, Wang P, Su K, Cho WC, Xing Y. Chinese herbal medicine for coronavirus disease 2019: a systematic review and meta-analysis. Pharmacological research. 2020;160:105056.
32. Gandhi RT, Lynch JB, Del Rio C. Mild or moderate Covid-19. N Engl J Med 2020;383:1757-66.
33. Zargaran A, Borhani-Haghighi A, Salehi-Marzijarani M, Faridi P, Daneshamouz S, Azadi A, et al. Evaluation of the effect of topical chamomile (Matricaria chamomilla L.) oleogel as pain relief in migraine without aura: a randomized, double-blind, placebo-controlled, crossover study. Neurol Sci 2018;39:1345-53.
34. Shergis JL, Wu L, May BH, Zhang AL, Guo X, Lu C, et al. Natural products for chronic cough: Text mining the East Asian historical literature for future therapeutics. Chron Respir Dis 2015;12:204-11.
35. Mallow. Natural Products [database on the Internet]. Waltham (MA): UpToDate Inc.; 2022 (Accessed 6 Jan; 2022; at http://online.lexi.com).
36. Al-Snafi AE. The chemical constituents and pharmacological effects of Adiantum capillus-veneris-A review. Asian J Pharmac Sci Technol 2015;5:106-11.
37. Hyssopus. Natural Products [database on the Internet]. Waltham (MA): UpToDate Inc.; 2022 (Accesse 6 Jan; 2022; at http://online.lexi.com).
38. Jujube. Natural Products [database on the Internet]. Waltham (MA): UpToDate Inc.; 2022 (Accessed 6 Jan; 2022; at http://online.lexi.com).
39. Garred P, Brygge K, Sørensen C, Madsen H, Thiel S, Svejgaard A. Mannan-binding protein—levels in plasma and upper-airways secretions and frequency of genotypes in children with recurrence of otitis media. Clin Exp Immunol 1993;94:99-104.
40. Fathiazad F, Hamedeyazdan S. A review on Hyssopus officinalis L.: Composition and biological activities. Afr J Pharm Pharmacol; 2011;5:1959-66
41. Wang N, Yang XW. Two new flavonoid glycosides from the whole herbs of Hyssopus officinalis. J Asian Nat Prod Res 2010;12:1044-50.
42. Ma X, Ma X, Ma Z, Sun Z, Yu W, Wang J, et al. The effects of uygur herb Hyssopus officinalis L. on the process of airway remodeling in asthmatic mice. Evid Based Complement Alternat Med 2014;2014:710870.
43. Wang J, Li FS, Pang NN, Tian G, Jiang M, Zhang HP, et al. Inhibition of Asthma in OVA Sensitized Mice Model by a Traditional Uygur Herb Nepeta bracteata Benth. Evid Based Complement Alternat Med 2016;2016:5769897.
44. Mawa S, Husain K, Jantan I. Ficus carica L. (Moraceae): phytochemistry, traditional uses and biological activities. Evid Based Complement Alternat Med 2013:2013:974256.
45. Badgujar SB, Patel VV, Bandivdekar AH, Mahajan RT. Traditional uses, phytochemistry and pharmacology of Ficus carica: A review. Pharm Biol 2014;52:1487-503.
46. Mukhtar HM, Ansari S, Ali M, Naved T. New compounds from Zizyphus vulgaris. Pharmac Biol 2004;42:508-11.
47. Mukhtar HM, Ansari S, Ali M, Naved T, Bhat Z. New ursane-type triterpenes from Zizyphus vulgaris. roots. Pharmac Biol 2005;43:392-5.
48. Qasemzadeh MJ, Sharifi H, Hamedanian M, Gharehbeglou M, Heydari M, Sardari M, et al. The effect of Viola odorata flower syrup on the cough of children with asthma: a double-blind, randomized controlled trial. J Evid Based Complementary Altern Med 2015;20:287-91.
49. Ebadi N, Farjadmand F, Mehri M, Mohajerani F, Raies-Dana A, Shahpiri Z, et al. Adiantum Capillus Veneris L.: From Iranian Traditional Medicine to Modern Phytotherapy. Tradit Integr Med 2016;1:129-31.
50. Haider S, Nazreen S, Alam MM, Gupta A, Hamid H, Alam MS. Anti-inflammatory and anti-nociceptive activities of ethanolic extract and its various fractions from Adiantum capillus veneris Linn. J Ethnopharmacol 2011;138:741-7.
51. Kumari A, Dora J, Kumar A, Kumar A. Pomegranate (Punica granatum)—overview. Int J Pharm Chem Sci 2012;1:1218-22.
52. Ahmed N, Sutcliffe A, Tipper C. Feasibility study: honey for treatment of cough in children. Pediatr Rep 2013;5:31.
53. Oduwole O, Udoh EE, Oyo‐Ita A, Meremikwu MM. Honey for acute cough in children. Cochrane Database Syst Rev 2018;4:CD007094.
54. Cohen HA, Rozen J, Kristal H, Laks Y, Berkovitch M, Uziel Y, et al. Effect of honey on nocturnal cough and sleep quality: a double-blind, randomized, placebo-controlled study. Pediatrics 2012;130:465-71.
55. Nazari S, Rameshrad M, Hosseinzadeh H. Toxicological effects of Glycyrrhiza glabra (licorice): a review. Phytother Res 2017;31:1635-50.
56. Bazzaz B, Haririzadeh G. Screening of Iranian plants for antimicrobial activity. Pharmac Biol 2003;41:573-83.
57. Javid A, Haghi NM, Emami SA, Ansari A, Zojaji SA, Khoshkhui M, et al. Short-course administration of a traditional herbal mixture ameliorates asthma symptoms of the common cold in children. Avicenna J Phytomed 2019;9:126-33.
| Files | ||
| Issue | Vol 62 No 3 (2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/acta.v62i3.17116 | |
| Keywords | ||
| Persian medicine COVID-19 Cough Herbal medicine | ||
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How to Cite
1.
Heydari M, Kazemi Zadeh H, Namazi S, Emadi Koochak H, Khajavi Rad N, Khanavi M, Zargaran A. Evaluation of the Effect of “Honey Zufa” Herbal Syrup on Cough in Hospitalized Patients With COVID-19: A Double Blind Randomized Clinical Trial. Acta Med Iran. 2024;62(3):144-154.
