J. Nanjing Univ. In the COVID-19 pneumonia epidemic of China, traditional Chinese medicine plays a critical role in preventing mild or ordinary COVID-19 patients from developing into serious or critical patients (China Central Television News, 2020). Duan Z.P., Jia Z.H., Zhang J., Liu S., Chen Y., Liang L.C., Zhang C.Q., Zhang Z., Sun Y., Zhang S.Q., Wang Y.Y., Wu Y.L. First, the quality of qualified studies was generally medium, randomization procedures and blinding information were lacking in most studies. Zhang, R. X., and Liu, W. W. (2014). As adverse reactions in COVID-19 pneumonia and chronic obstructive pulmonary disease treatment were only reported for a limited number of studies, no sensitivity analysis for these diseases was conducted. Qualitative and Quantitative Analysis of the Major Constituents in Chinese Medical Preparation Lianhua-Qingwen Capsule by UPLC-DAD-QTOF-MS. ScientificWorldJournal. Res. 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". FIGURE 2. doi:10.11954/ytctyy.201608076, Chan, K. W., Wong, V. T., and Tang, S. C. W. (2020). Med. Alternat Med. Finally, 217 experimental studies on the Chinese population were included for study featuring 1759 cases of adverse reactions following clinical treatment (publication years ranging from 2005 to 2021). The Cochrane Collaboration risk of bias tool comprising seven items was applied to assess the risk of bias of each eligible study (Higgins et al., 2011). Analysis of curative effects of 51 patients with COVID-19 treated with Chinese medicine Lianhua Qingwen: a multicentre retrospective study. Li J.Y., You Z., Wang Q., Zhou Z.J., Qiu Y., Luo R., Ge X.Y. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. Given the small number of documents included and the low quality, the efficacy and safety of Lianhua Qingwen Capsules shall be confirmed by more high-quality clinical studies. Copyright 2022 Hu, He, Gong, Liang, Zhao and Zhang. It argued that there was thus no reasonable basis for the mass distribution of the medication to healthy individuals to begin with, let alone doing so in a way that took up transportation capacity and resources that were urgently needed elsewhere. Drug Discov. government site. (10), 100. The recent meta analysis reported 22 studies with a total of 2,007 patients, showing that the adjuvant therapy of LHQW with western medicine could improve the clinical efficiency and C-reactive protein index, shorten the time of antifebrile, cough time, rhondros duration and imaging time, as well as speed up the recovery of pneumonia patients [39]. The majority of studies lacked sufficient description of allocation concealment and therefore, the project was predominantly evaluated as unclear risk of bias. Although the blinding method was not reported, since some symptom indicators needed measurement with instruments, assessment of symptom indicators was unlikely to be affected by the lack of blinding. The collected evidence demonstrated that LHQW exhibited benefits against COVID-19. Drafting of the manuscript was done by CH and BH. Effect of Maxing Shigan Tang on H1N1 influenza A virus-associated acute lung injury in mice. Secondly, separate evaluations were further performed for different diseases and types of adverse reactions. These above ingredients are decocted, distilled, filtered, refrigerated, mixed well with powdered sugar, dextrin or starch, dried and finally made into LHQW (Chinese Pharmacopoeia, 2020). DerSimonian, R., and Laird, N. (1986). The post-marketing monitoring data incorporated information on the following gastrointestinal adverse reactions: nausea, diarrhea, vomiting, abdominal pain, abdominal distension, dry mouth; as well as skin rash, itching, dizziness (Yiling Pharmaceutical, 2021). 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]. Pharmacokinetics-based identification of pseudoaldosterogenic compounds Careers, Unable to load your collection due to an error. "It's the first time in the world that we have enough evidence to prove Lianhua Qingwen capsule is effective and can help . Fujian J. Zhao P., Yang H.Z., Lv H.Y., Wei Z.M. Chinese Pharmacopoeia (2020). 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). Accessibility The official monograph of LHQW states that the adverse effects are "unclear". Data analysis were done by CH and DZ. Seven of the studies showed that adverse reactions improved or healed spontaneously without any treatment, five reported that adverse reactions healed spontaneously after discontinuation of medication, eight showed that adverse reactions improved or healed with medication after meals and ten showed that adverse reactions improved or recovered after symptomatic treatment, while in the remaining eight studies, adverse reactions were not disposed or treated. CONTRAINDICATIONS Uncertainty. School of Pharmacy, Faculty of Life Sciences, University College London, United Kingdom. Finally, our data showed that LHQW reduces the incidence of a number of adverse reactions compared with conventional drugs. Royal Botanic Gardens, Kew science (2021). The risk ratio (RR) and 95% confidence interval (CI) were calculated for categorical variables. (2015). Med. Lianhua Qingwen capsule and Lianhua Qingwen granules were approved to add "functional indications" to the originally approved indications: "In the conventional treatment of novel. Objectives: Lianhua Qingwen capsule/granule (LHQW) is an innovative patented traditional Chinese medicine with potential curative effects on respiratory diseases. TABLE 1. During the study, no serious adverse events were reported. ). Traditional Chinese medicine has accumulated substantial clinical experience over thousands of years. Pharmacopoeia of Peoples Republic of China. The basic clinical treatments for COVID-19 include anti-infectious, anti-proinflammatory cytokines, nonspecific antiviral as well as life support therapies [[6], [7], [8]]. Frontiers | The Adverse Reactions of Lianhua Qingwen Capsule/Granule 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. A systematic review on the efficacy of Traditional Chinese Medicine on influenza. Efficacy and safety of Lianhua Qingwen combined with - PubMed Pregnancy & lactation. Gao D., Niu M., Wei S.Z., Zhang C.E., Zhou Y.F., Yang Z.W., Li L., Wang J.B., Zhang H.Z., Zhang L., Xiao X.H. Tian S., Song X., Wang Y., Wang X., Mou Y., Chen Q., Zhao H., Ma K., Wu Z., Yu H., Han X., Wang H., Wang S., Ji X., Zhang Y. Chinese herbal medicine Baoyuan Jiedu decoction inhibits the accumulation of myeloid derived suppressor cells in pre-metastatic niche of lung via TGF-/CCL9 pathway. Analysis of the molecular mechanism of Pudilan (PDL) treatment for COVID-19 by network pharmacology tools. Trials. Methods: Comprehensive document retrieval was performed from both English and Chinese databases. It is urgent to develop effective drugs to contain and treat COVID-19. Shi, M., Peng, B., Li, A., Li, Z., Song, P., Li, J., et al. 8600 Rockville Pike J. Chin. [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. It is not registered as a COVID-19 medication, and a doctor's prescription is required for its use. ADVERSE REACTION Uncertainty. These data indicate that LHQW prescription protects against the virus attack, and it has been recommended in the treatment of COVID-19 in China [47]. Med. Li Q., Yin J., Ran Q.S., Yang Q., Liu L., Zhao Z., Li Y.J., Chen Y., Sun L.D., Wang Y.J., Weng X.G., Cai W.Y., Zhu X.X. However, no consensus has been reached on the security of LHQW to date. Kong Q., Wu Y., Gu Y., Lv Q., Qi F., Gong S., Chen X. Clin. the Need for Accurate Scientific Nomenclature for Plants. Received: 27 August 2021; Accepted: 06 January 2022;Published: 27 January 2022. It may benefit the treatment of COVID-19 by the signaling pathways such as advanced glycation end products (AGE)-receptor of AGE (RAGE), TNF, sarcoma-associated herpesvirus infection, IL-17 and human cytomegalovirus infection [41]. [Lamiaceae; 1-Menthol] (7.5g), Glycyrrhiza uralensis Fisch. Modern pharmacological studies have shown that Lianhua Qingwen Prescription, as a traditional Chinese medicine prescription, has extensive antiviral and immunomodulatory effects on a series of influenza viruses. Science. Materia Med. Avoid alcohol and tobacco and spicy,cold, greasy food during taking this product. Its effects are partly due to its regulation on immunity functions, and inhibitory effects on virus replication and pro-inflammatory cytokines release. Subgroup analysis additionally revealed a reduced incidence of some adverse reactions in the LHQW group compared to the conventional drug group (Rash of skin and its appendage damage, dizziness or headache owing to nervous system damage, nausea or vomiting from gastrointestinal system damage and resurgence of disease from other adverse reactions). Wang C., Horby P.W., Hayden F.G., Gao G.F. A novel coronavirus outbreak of global health concern. Compared with oseltamivir, LHQW achieved a similar therapeutic effectiveness with reduction of the duration of illness and duration of influenza A virus H1N1 shedding [36]. Furthermore, they identified two important metabolites, prostaglandin F2 and arachidonic acid, and their arachidonic acid metabolism pathway, as vital indicators of LHQW in treating influenza by using serum metabolomics analysis [19]. Language links are at the top of the page across from the title. National Library of Medicine Clinical Drug Safety of Lianhuaqingwen Preparation: a Systematic Evaluation. In addition to western medicine, the potential adverse drug reactions (ADRs) can not be ignored. As Chinese Pharmacopoeia records, LHQW consists of 13 ingredients: Forsythia suspensa (Thunb.) These in vivo data further demonstrate the antiviral effects of LHQW as well as its lung protection role. Second, one purposes of this study was to retrieve information on adverse reactions from different countries, due to language barriers, only English and Chinese articles were retrieved, and adverse reactions in the Chinese population were specifically analyzed, the effects on populations from other countries therefore require further investigation. ACE2, angiotensin-converting enzyme 2; ADRs, adverse drug reactions; AECOPD, acute exacerbation of chronic obstructive pulmonary disease; AGE, advanced glycation end products; ALI, acute lung injury; COPD, chronic obstructive pulmonary disease; COVID-19, Coronavirus Disease 19; EC50, median effective concentrations; HPLC, high performance liquid chromatography; IBV, influenza B virus; IFN, interferon; IL, interleukin; LHQW, Lianhua Qingwen; LPS, lipopolysaccharide; IP, interferon-inducible protein; MCP, monocyte chemoattractant protein; MIP, macrophage inflammatory protein; NF-B, nuclear factor-kappa B; RAGE, receptor of advanced glycation end products; SARS, Severe Acute Respiratory Syndrome; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; TCM, traditional Chinese medicine; UPLC-DAD-QTOF-MS, ultraperformance liquid chromatography coupled with diode-array detector and quadrupole time-of-flight mass spectrometry, Coronavirus, SARS-CoV-2, Lianhua Qingwen, Antiviral activity, Complementary strategy, {"type":"clinical-trial","attrs":{"text":"NCT02867358","term_id":"NCT02867358"}}. Lianhua Qingwen capsules have been proven to speed up symptoms recovery but no effect in preventing infections from worsening. Subgroup analysis additionally demonstrated LHQW group has a reduced incidence of rash, nausea or vomiting, and resurgence of disease. Recent study then showed that the main components of LHQW included chlorogenic acid, caffeic acid, isochlorogenic acid B, isochlorogenic acid C, phillyrin, forsythiaside A, and rutin by high performance liquid chromatography (HPLC) analysis [19]. CFDA has recently approved adding a new indication for LHQW in mild and common COVID-19 patients, but whether it would bring benefits for the severe cases is unclear. From SARS to COVID-19: pathogens, receptor, pathogenesis and principles of the treatment. Contraindications . [2] In the practice of TCM, LHQW is considered to have the effects of clearing excessive heat, removing toxins, improving lung ventilation, and discharging heat. 17 (13), 6264. Firstly, to our knowledge, this meta-analysis provides the most comprehensive evaluation of the clinical safety of LHQW. 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. 56 (2), 455463. (2020). Frontiers | Lian Hua Qing Wen Capsules, a Potent Epithelial Protector The control and improvement of the present COVID-19 situation in China could not be separated from the extensive participation of TCM, which has been proven effective by the clinical studies in COVID-19 patients [41,44,48,49]. 37 (6), 25752579. Covid-19: an Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease. Drugs and Clinic. 28 (1), 1332. [Cruciferae; Isatudus Radix], Dryopteris crassirhizoma Nakai [Polypodiaceae; Dryopteris Crassirhizomatis Rhizoma], Houttuynia cordata Thunb. Among the 13 included studies on treatment of hand-foot-mouth disease, eight reported adverse reactions. Warning 1. Wu, L., Chen, Y., Ma, Y., Yang, Z., Yang, N., Deng, W., et al. The most common adverse reactions in our analysis were gastrointestinal system damage, skin and its appendage damage. The quadruple combination therapy including Ribavirin, Lopinavir/ritonavir, Umifenovir, and LHQW, could markedly improve the abnormal coagulation and leukocyte of severe COVID-19 patients with a better prognosis [42]. The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author. Lianhua Qingwen Jiaonang with Chinese Characters; As per continuing post-marketing surveillance, there is still incessant sale and distribution even through social media platforms, such as Facebook, of Lianhua Qingwen Jiaonang with Chinese characters, which were verified as unregistered by the FDA. Broad Anti-viral Capacities of Lian-Hua-Qing-Wen Capsule and Jin-Hua-Qing-gan Granule and Rational Use against Covid-19 Based on Literature Mining. The site is secure. Statistical analysis was performed with Stata 14 software (Stata Corporation, College Station, TX, USA). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Front. Retrospective Clinical Analysis on Treatment of Novel Coronavirus-Infected Pneumonia with Traditional Chinese Medicine Lianhua Qingwen. The following aspects were assessed for each study: random sequence generation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other sources of bias. Clinical applications and pharmacological research progress of Lianhua A study by Lei (2020) on childhood influenza treatment revealed no statistical difference of adverse effects between LHQW group and conventional drug group (p = 0.751), inconsistent with our meta-analysis. First, the data indicated that LHQW combined with conventional therapies could markedly improve the clinical symptoms, quality of life and absorption of lung infiltration during anti-viral therapy, but the level of evidence is weak due to the included small sample trial and lacking the classification of disease severity. Efficacy and safety of Lianhuaqingwen for mild or moderate : Medicine This review has introduced the advances of LHQW in anti-viral treatment, intending to provide ideas for the timely treatment of COVID-19 patients. There was no statistically significant difference in the incidence of adverse reactions during treatment of COVID-19 pneumonia between the LHQW group and the conventional drug group (RR = 0.51, 95% CI = 0.141.82, p = 0.297). 52 (3), 5860. Heterogeneity was evaluated using I2 statistic. Pract. Alternat Med. Niu Q.Q., Chen Y., Liu Y., Mao S.Z., Wang H., Zheng W.K., Zhang J.H. Efficacy and mechanism of Lianhua Qingwen Capsules(LHQW) on chemotaxis of macrophages in acute lung injury (ALI) animal model. Chin. Runfeng L., Yunlong H., Jicheng H., Weiqi P., Qinhai M., Yongxia S., Chufang L., Jin Z., Zhenhua J., Haiming J. Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARS-CoV-2). While LHQW has recently been approved for marketing by CFDA, its safety is yet to be conclusively established. Study design was done by CH and BH. doi:10.1142/S0192415X20500378. (2020). Chin. Subgroup, sensitivity and meta-regression analyses were conducted to determine the potential sources of heterogeneity.
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