LHQW is recommended by the National Health Commission of the Peoples Republic of China as a traditional Chinese medicine appropriate for COVID-19 pneumonia (trial version from Fourth to the Eighth Edition). FIGURE 1. [7] In the United States, the FDA is advising consumers not to purchase or use Lianhua Qingwen, stating that it has not been approved or authorized by FDA and is being misleadingly represented as safe and/or effective for the treatment or prevention of COVID-19. Liu, X. Y. Academician Yiling Wu systematically constructs the theory of collateral disease, provides theoretical guidance for the formulation of Lianhua Qingwen, and gives . (2002). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). 161, 105126. doi:10.1016/j.phrs.2020.105126, Yang, C., Wang, Y., He, J., Yan, W., Jiang, H., Chen, Q., et al. Race to Find Covid-19 Treatments Accelerates. Lu Z.J., Wu L.Y., Mou Y.Y., Duan H.M., Chen R.C., Xiao Y., Zheng W.J. Lian Hua Qing Wen capsules (LHQW) is the most effective and commonly-used clinical formula in treating respiratory infection for thousands of years in China. After 7 days of treatment, the main TCM syndrome scores (fever, fatigue, cough, dry throat, chest tightness), C-reactive protein and procalcitonin levels in the LHQW group were significantly lower, and the white blood cell and lymphocyte counts were obviously higher than those in abidor group [44]. Seven studies reported the adverse reactions of hepatobiliary system damage. Exploring material basis and mechanism of Lianhua Qingwen prescription against coronavirus based on network pharmacology. In a lipopolysaccharide (LPS)-induced acute lung injury animal model, LHQW could efficiently decrease the chemotaxis of monocytes toward the pulmonary infection foci, and thus blocked the disease development by down-regulating MCP-1 expression [33]. Nevertheless, there are also potential limitations that need to be improved for future challenges. Recent clinical evidence also showed that LHQW in combination with western medicines, such as the other antiviral drugs, is better than that not using LHQW during COVID-19 treatment, suggesting it would be beneficial as a supplementary strategy for treating COVID-19 [41,[44], [45], [46]]. Our findings support the adverse reactions recorded by Yiling Pharmaceutical, and compare the incidence risk of gastrointestinal system damage and rash with the control group. Based Complement. 2015, 731765. doi:10.1155/2015/731765, Jin, L., Xu, Y., and Yuan, H. (2020). School of Pharmacy, Faculty of Life Sciences, University College London, United Kingdom. Cui L.F., Xu H.R., Li F.Z., Wang C.X. Subgroup analysis showed a lower level of nausea or vomiting in LHQW group (RR = 0.60, 95% CI = 0.480.74, p < 0.001), no statistical difference was detected for other symptoms of gastrointestinal system damage. While the results from our study showed that LHQW has a potentially reduced incidence of adverse reactions in certain diseases and symptoms to a greater extent than conventional treatment, efficacy is an important consideration that should not be overlooked. The China National Medical Products Administration agency has officially approved LHQW for the treatment of mild or ordinary COVID-19 pneumonia (Ahsan et al., 2020; Cao et al., 2020; Chan et al., 2020; Khan et al., 2020; Kupferschmidt and Cohen, 2020). Before Hu K., Guan W.J., Bi Y., Zhang W., Li L., Zhang B., Liu Q., Song Y., Li X., Duan Z., Zheng Q., Yang Z., Liang J., Han M., Ruan L., Wu C., Zhang Y., Jia Z.H., Zhong N.S. It has approved by China Food and Drug Administration (CFDA). Available at: http://www.theplantlist.org/(Accessed December 18, 2021). Twelve representative compounds were further quantified as chemical markers, including amygdalin, forsythoside E, salidroside, glycyrrhizic acid, chlorogenic acid, hyperin, rutin, forsythoside A, cryptochlorogenic acid, sweroside, phillyrin, and rhein (Jia et al., 2015). The current meta-analysis was performed to evaluate the safety profile of LHQW in relation to conventional drugs (PROSPERO CRD-42020224180). Lianhua Qingwen Capsules has a better therapeutic effect on viral influenza, but the incidence of adverse reactions is high, and its safety must be taken seriously. Effect of Lianhua Qingwen capsule on immunity of mice infected with flu virus. The basic clinical treatments for COVID-19 include anti-infectious, anti-proinflammatory cytokines, nonspecific antiviral as well as life support therapies [[6], [7], [8]]. 38 studies reported dispose or outcomes of adverse reactions. Lianhua Qingwen Capsules/granules Product Details. (2020) identified 38 randomized controlled trials (RCTs) comparing LHQW with antivirals or other Chinese medicines for treating influenza and reported a lower risk of adverse reactions in the LHQW group compared to oseltamivir (RR = 0.29, 95%CI = 0.110.80), and ribavirin groups (RR = 0.29, 95%CI = 0.110.80). In the Philippines, its Food and Drug Administration approved Lianhua Qingwen on 7 August 2020 as a traditional herbal product that helps remove "heat-toxin invasion of the lungs, including symptoms such as fever, aversion to cold, muscle soreness, stuffy and runny nose". Study on treatment of "cytokine storm" by anti-2019-nCoV prescriptions based on arachidonic acid metabolic pathway. Hence, the researches on specific active components of LHQW are still important and the reduction of irrelevant ingredients may be related to less adverse reactions. doi:10.13260/j.cnki.jfjtcm.012210, Jia, W., Wang, C., Wang, Y., Pan, G., Jiang, M., Li, Z., et al. BMJ. Some composition of LHQW can cause damage to the stomach and intestines, supporting the possibility of injurious effects on the gastrointestinal system: for thia suspensa (Thunb.) Data from our meta-analysis also failed to compare the security of LHQW with conventional drugs for treatment of COVID-19 pneumonia, which requires further investigation. Asia-Pacific Traditional Med. The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. In addition, LHQW treatment efficiently impaired the nuclear export of the viral RNPl [24]. The group reported significantly lower incidence of adverse reactions (RR = 0.62, 95% CI = 0.460.82) and lower incidence of gastrointestinal system damage in the LHQW group (RR = 0.65, 95% CI = 0.460.92) relative to the control group. 25 (4), 727790728729. 28 (1), 1332. Traditional Chinese medicine Lianhua Qingwen capsule has been proven effective for the treatment of COVID-19, China's top respiratory expert Zhong Nanshan said in a webinar with overseas Chinese students on Monday. Available at: http://www.plantsoftheworldonline.org (Accessed December 18, 2021). Mechanism by which ma-xing-shi-gan-tang inhibits the entry of influenza virus. [16][17] A Filipino TCM physician interviewed by ABS-CBN clarified that although the medicine can be used for symptomatic treatment of flu-like symptoms in COVID-19 patients, it is not an antibiotic nor anti-viral, and cannot cure the disease itself. Pract. During the study, no serious adverse events were reported. Although the data were far from adequate, the latest advances had shown the benefits of LHQW in COVID-19, especially in combination with other antiviral drugs. 7 (3), 177188. System-Organ Code Retrieval Involved. Inhibitorv Effect of Lianhua Oingwen Water Extract on Methicillin-Resistant staphylococcus Aureus Biofilm In Vitro. Results of publication bias and sensitivity analysis. Niu Q.Q., Chen Y., Liu Y., Mao S.Z., Wang H., Zheng W.K., Zhang J.H. Lu Y., Yang J., Wang X., Ma Z., Li S., Liu Z., Fan X. LHQW had been proven to accelerate the improvement of acute exacerbation of COPD (AECOPD) patients, especially for the high-risk subgroup, due to the decreased release of inflammatory mediators including IL-8, TNF- , IL-17, and IL-23 [38]. J. Ethnopharmacol. Study design was done by CH and BH. Chin. Results were reported as risk ratio (RR) with 95% confidence interval (CI). Subgroup, sensitivity and meta-regression analyses were conducted to explore the possible sources of heterogeneity across eligible studies. Subgroup, sensitivity and meta-regression analyses were conducted to determine the potential sources of heterogeneity. 228 (2), 8390. Potential publication bias was assessed using Funnel plot, Beggs and Eggers test. Lianhua Qingwen Prescription is approved for the treatment of fever, cough, and fatigue caused by light and common type of COVID-19 . Similar results were obtained in subgroup analysis of hepatic function abnormal and transaminase increased. Subgroup analysis showed the incidence of dizziness or headache was significantly reduced with LHQW group (RR = 0.54, 95% CI = 0.340.84, p = 0.006), no statistical difference was detected for drowsiness and legacy neuralgia. Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19. Since the outbreak of COVID-19, Lianhua Qingwen Capsules have been recommended by the official Chinese "Diagnosis and Treatment Protocol for COVID-19" and widely used in designated admission hospitals for COVID-19. Chinese Herbal Medicine ("3 Medicines and 3 Formulations") for COVID 19: Rapid Systematic Review and MetaanalysisChinese Herbal Medicine ("3 Medicines and 3 Formulations") for COVID-19: Rapid Systematic Review and Meta-Analysis. [Caprifoliaceae; Lonicerae Japonicae Flos] (255g), Ephedra sinica Stapf [Ephedraceae; Ephedrae Botanical drug] (85g), Prunus armeniaca L. [Rosaceae; Armeniacae Semen Amarum] (85g), Gypsum Fibrosum (255g), Isatis indigotica Fort. Avoid alcohol and tobacco and spicy,cold, greasy food during taking this product. LHQW also decreased the influenza viral titers in the lungs of mice, with decreased inflammatory cytokine levels in the early stages of infection [24]. Herald. The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fphar.2022.764774/full#supplementary-material, Ahsan, W., Javed, S., Bratty, M. A., Alhazmi, H. A., and Najmi, A. The incidence of nervous system damage was lower in the LHQW group compared to the conventional drug group (RR = 0.24, 95% CI = 0.180.32, p < 0.001). COVID-19 has led to a great case fatality. the contents by NLM or the National Institutes of Health. official website and that any information you provide is encrypted Plants of the World Online. Two studies reported psychiatric disorders as the adverse reaction. 04:26. There was no statistically significant difference in the incidence of adverse reactions during treatment of other diseases between the LHQW group and the conventional drug group (RR = 0.95, 95% CI = 0.651.39, p = 0.780). Methods: Comprehensive document retrieval was performed from both English and Chinese databases. Lianhua Qingwen (LHQW) is a classical Chinese medical preparation, while one of its prescription compositions Maxingshigan Decoction has a history of more than thousand years to treat plague, and exhibits antiviral and lung protection actions [15,16]. What Is in a Name? Secondly, separate evaluations were further performed for different diseases and types of adverse reactions. doi:10.11816/cn.ni.2015-134443. Reply. A total of 2,511 citations were identified, among which 1,796 irrelevant, animal studies or duplicate studies were excluded, for screen of titles and abstracts. Pharmacol. However, both groups did not differ in the rate of conversion to severe cases or viral assay findings. 2017ZYY07). Finally, our data showed that LHQW reduces the incidence of a number of adverse reactions compared with conventional drugs. Conclusion: The current study provides potential a reference for the security of LHQW. For rheum, sample size could partially explain heterogeneity (p = 0.005), but not year of publication (p = 0.658) and treatment of the control group (p = 0.712). (2021). Our meta-analysis was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement (Moher et al., 2009), and registered with PROSPERO (CRD42020224180). Finally, all adverse reactions were described solely based on grouping of patients into treatment and control categories and no data were obtained according to gender stratification, which limited further analysis. Am. Careers, Unable to load your collection due to an error. The authors report no declarations of interest. Recently, a single center retrospective study showed that LHQW granules (6g, tid) combined with conventional therapy (nutritional support therapy, symptomatic therapy, antiviral and antibiotic medication) could significantly relieve the symptoms like fever, cough, weakness and short breath in COVID-19 suspected cases with good safety [40]. 6 (01), 6364. Nevertheless, pressing researches should be conducted to illuminate the unconfirmed effects, regulatory mechanisms and adverse reactions of LHQW in treating COVID-19. (Guanghuoxiang), Rheum palmatum L. (Dahuang), Rhodiola rosea Linn. Therefore, further attention should be paid to the occurrence of adverse reaction with LHQW among different age groups in the future. (Jinyinhua), Ephedra sinica Stapf (Mahuang), Armeniacae Amarum Semen (Kuxingren), Gypsum Fibrosuum (Shigao), Isatis tinctoria L. (Banlangen), Dryopteridis Crassirhizomatis Rhizoma (Mianmaguanzhong), Houttuynia cordata Thunb. There was no statistically significant difference in the incidence of adverse reactions during treatment of respiratory tract infection between the LHQW group and the conventional drug group (RR = 0.78, 95% CI = 0.581.03, p = 0.083). China Central Television News (2020). The duration of sputum was shorter in the Lianhua Qingwen group than in the conventional drug group (WMD = 1.10, 95% CI = 1.50 to 0.70, < 0.001). Guo H., Zhang Q.H., Yang J., Gong J.N., Zhao Y.S., Zhou X.P. Analysis of curative effects of 51 patients with COVID-19 treated with Chinese medicine Lianhua Qingwen: a multicentre retrospective study.
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