Efficacy and mechanism of Lianhua Qingwen Capsules(LHQW) on chemotaxis of macrophages in acute lung injury (ALI) animal model. Federal government websites often end in .gov or .mil. It is urgent to develop effective drugs to contain and treat COVID-19. 343, d5928. 327 (7414), 557560. Nervous system damage was described as an adverse event in 34 studies. 1: An overview of approach to pharmacokinetics-based identification of potential therapeutic compounds from LianhuaQingwen, a Chinese herbal used as treatment for COVID-19. 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]. Chinese Pharmacopoeia (2020). doi:10.1136/bmj.327.7414.557, Hu, C., Liang, M., Gong, F., He, B., Zhao, D., and Zhang, G. (2020). (2021). The research data were obtained from the academic databases (up to August 8, 2020) including Pubmed, CNKI and Web of Science, on ethnobotany and ethno medicines. Recent data also showed that LHQW played a vigorous role in COVID-19 treatment. Clinical Drug Safety of Lianhuaqingwen Preparation: a Systematic Evaluation. Adverse Drug Reactions to Antibiotics Observed in Two Pulmonology Divisions of Catanzaro, Italy: a Six-Year Retrospective Study. BMJ. The term adverse reaction represents any undesired and unintended response that occurs with normal drug use (Gallelli et al., 2002). 6 (26), 8485. Among the eight included studies on rheum therapy, six reported adverse reactions. In our meta-analysis, information on adverse reactions was clearly reported in 12 of the 17 studies while the remaining five studies provided no specific evidence of adverse reaction specifically, and the incidence of adverse reactions was lower in LHQW group than that in the conventional drug group. Systematic review of efficacy and safety of Lianhua Qingwen capsules in treatment of viral influenza. Retrospective clinical analysis on treatment of coronavirus disease 2019 with traditional Chinese medicine Lianhua Qingwen. Available at: http://m.news.cctv.com/2020/03/17/ARTIEYQ2aws8fPYWQxjnynzo200317.shtml?from=singlemessage (Accessed Apirl 29, 2021). For thousands of years, traditional Chinese medicine (TCM) plays an important role in treating human diseases [[9], [10], [11], [12], [13], [14]]. Theoretical research basis and clinical efficacy of Lianhua Qingwen in treating Novel Coronavious pneumonica. Efficacy and safety of Lianhua Qingwen capsule for influenza: a systematic review. Biometrics. doi:10.1590/1806-9282.66.6.771, Khan, Z., Karata, Y., and Rahman, H. (2020). Objectives: Lianhua Qingwen capsule/granule (LHQW) is an innovative patented traditional Chinese medicine with potential curative effects on respiratory diseases. Measuring Inconsistency in Meta-Analyses. Ephedra increases heartbeat and blood pressure. Traditional Chin. Yang C.X., Qu J., Liu Y.T., Meng S.W., Wang B.L., Feng M.Q., Sun Y. Pharmacol. Wang et al. Eleven studies reported the treatment of viral influenza and adverse reactions. Subgroup analysis revealed that LHQW group has a reduced incidence of rash than the conventional drug group (RR = 0.58, 95% CI = 0.390.86, p = 0.007), no statistical difference was detected for itchy skin. Both Lian-Hua-Qing-Wen Capsule (LHQWC) and Jin-Hua-Qing . Hsieh C.F., Lo C.W., Liu C.H., Lin S., Yen H.R., Lin T.Y., Horng J.T. government site. This study provides a basis for establishing the clinical safety profile of LHQW. The risk ratio (RR) and 95% confidence interval (CI) were calculated for categorical variables. Lianhua Qingwen Capsules of Yiling Pharmaceutical Approved in mauritius. A Trial of Lopinavir-Ritonavir in Covid-19. Other related clinical studies also revealed that LHQW significantly improved the symptoms in COVID-19 patients and reduced the duration of fever, fatigue and cough and so forth, which provide preliminary research evidence for clinical treatment of COVID-19 [45,46]. (2020). Drafting of the manuscript was done by CH and BH. [8] A January 2022 meta-analysis from China reports that it may cause GI discomfort, rashes and itches, dry mouth, and dizziness, but emphasizes that the effects are more common with "conventional treatment". Several limitations of our meta-analysis should be taken into consideration. In addition, LHQW capsules could inhibit both Victoria and Yamagata lineages of influenza B virus (IBV) with the 50 % inhibitive concentrations ranging from 0.2280.150 to 0.7540.161mg/mL [26]. doi:10.13412/j.cnki.zyyl.2010.06.026. Comprehensive analysis of influenza may provide a significant advantage in generalization of the conclusions. Percentage of risk of bias for all qualified studies. Research progress in use of traditional Chinese medicine for treatment of spinal cord injury. and transmitted securely. Lianhua Qingwen prescription for Coronavirus disease 2019 (COVID-19 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]. A multicenter retrospective study showed similar results, which revealed that combined application of LHQW granules (6g, tid) could notably improve the clinical symptoms of fever, fatigue, cough, expectoration, chest tightness, and anorexia, and reduce the proportion of common to severe cases in COVID-19 patients with common type [20]. doi:10.1126/science.367.6485.1412, Lei, X. Chinese supplement Lianhua Qingwen: What you need to know 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). (2020). Lianhua Qingwen capsule and Lianhua Qingwen granules were approved to add "functional indications" to the originally approved indications: "In the conventional treatment of novel. There was no statistically significant difference in the incidence of hepatobiliary system damage between the LHQW group and the conventional drug group (RR = 0.86, 95% CI = 0.581.28, p = 0.461). Pharmacological Action, Clinical Application and Adverse Reactions of Houttuynia Cordata. For drowsiness of nervous system damage, sample size (p = 0.500), year of publication (p = 0.157), and treatment of the control group (p = 0.599) were not linked with heterogeneity. A number of advantages of our study should additionally be mentioned. Its effects are partly due to its regulation on immunity functions, and inhibitory effects on virus replication and pro-inflammatory cytokines release. Further long-term high-quality studies are essential to validate our conclusions. Res. LQ15H280003), the Clinical Research Projects of Zhejiang Medical Association (No. It has approved by China Food and Drug Administration (CFDA). Adv. No adverse treatment-related effects were reported in all the included publications (from 2009 to 2011). Zhang, R. X., and Liu, W. W. (2014). Therefore, further attention should be paid to the occurrence of adverse reaction with LHQW among different age groups in the future. [citation needed]. Role of LHQW in the treatment of COVID-19. [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. Zhi-Hui Zhang and Wen-Cheng Zhou collected literatures and made the illustration. Chin. Few reports of adverse reactions in the course of treating COVID-19 pneumonia with LHQW are available. In addition to western medicine, the potential adverse drug reactions (ADRs) can not be ignored. There was no statistically significant difference in the incidence of heart rate and arrhythmia between the LHQW group and the conventional drug group (RR = 0.67, 95% CI = 0.231.93, p = 0.454). Lianhuaqingwencaps.com - 608667 - 07/06/2020 | FDA Notably, the stomach is full after a meal, and LHQW does not directly contact the gastric mucosa, which reduces the risk of irritation of stomach mucous membrane and thus the occurrence of side-effects. "It's the first time in the world that we have enough evidence to prove Lianhua Qingwen capsule is effective and can help . Inhibitory effects of three prescriptions of traditional Chinese medicine on SARS-associated coronavirus, http://kns.cnki.net/kcms/detail/11.2162.R.20200422.1429.002.html. Traditional Chinese medicine, such as Lianhua Qingwen, has achieved some curative effect in many countries, but its effect is not clear. Science. Furthermore, we also found that LHQW group has a reduced incidence of respiratory system damage compared to the conventional drug group. Declaration of competing interest. Tradit. Lianhua Qingwen(Forsythiae fructus 225 mg, Lonicerae japonicae flos 225 mg, Ephedrae herba (processed w/ honey) 85 mg, Armeniacae semen amarum (stir-baked) . doi:10.1007/s12325-020-01351-9, Kupferschmidt, K., and Cohen, J. 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]. On March 27, 2019, Yiling Pharmaceutical Co. Ltd. amended the LHQW drug manual to include adverse reactions related to its clinical application. Advances in Pharmacology and Clinical Research of Lianhua Qingwen Capsules. The mechanisms were mainly involved the antiviral activity, and regulation of inflammation response as well as immune function. Though no specific drug has been developed so far, emerging agents have been confirmed effective or potentially beneficial to restrain it. Among the 13 included studies on treatment of hand-foot-mouth disease, eight reported adverse reactions. High-quality randomized controlled trials conducted over the long-term from multiple countries are warranted to further validate the efficacy and safety of LHQW. Evid. 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. Future related studies will provide accumulated evidence to clarify it. Cui L.F., Xu H.R., Li F.Z., Wang C.X. Similar results were obtained in subgroup analysis of hepatic function abnormal and transaminase increased. Protection against COVID-19 injury by qingfei paidu decoction via anti-viral, anti-inflammatory activity and metabolic programming. (2016). Case reports, unrelated studies, those with duplicate data, reviews, commentaries and animal-based studies were excluded from the current meta-analysis. LHQW group has a reduced incidence of respiratory system damage compared to the conventional drug group (RR = 0.46, 95% CI = 0.290.74, p = 0.001). "This medicine has a cooling effect so if you take this, lalo kang magchi -chill," he cautions. Wu, L., Chen, Y., Ma, Y., Yang, Z., Yang, N., Deng, W., et al. A Working List of All Plant Species. Recently, Yu et al. 2020, 5157089. doi:10.1155/2020/5157089, Huang, N. L., Huang, H. M., Zhang, B. Y., and Xie, J. Received 2020 Jul 3; Revised 2020 Aug 9; Accepted 2020 Aug 16. doi:10.3969/j.issn.1672-2809.2020.13.020, Liu, C. Y., Li, X. Q., and Cai, S. Q. [Lamiaceae; 1-Menthol] (7.5g), Glycyrrhiza uralensis Fisch. Trim and Fill: a Simple Funnel-Plot-Based Method of Testing and Adjusting for Publication Bias in Meta-Analysis. 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). J. Chin. No statistical difference was detected for sleepy. Second, the herbs in LHQW are mostly grown in specific areas, the varied origin of herbs are usually together with different content of bioactive ingredients, thus the quality standard control of the included crude drugs should be encouraged [12]. Med. Frontiers | Lian Hua Qing Wen Capsules, a Potent Epithelial Protector As the Financial Times report showed, these appeared to be serious conflicts of interest as the investments benefited from the PRC and HK governments' rapid approval and then widespread national & international promotion of Lianhua Qingwen and other suspect treatments for purportedly helping COVID-19 sufferers. Batlle D., Wysocki J., Satchell K. Soluble angiotensin-converting enzyme 2: a potential approach for coronavirus infection therapy? Front. Systematic review of traditional Chinese medicine Lianhua Qingwen in Lianhua Qingwen capsule (granule) was approved as an additional In the evaluation of treating disease, the incidence of adverse reactions during treatment of influenza A (H1N1) and influenza were lower in the LHQW group compared to the conventional drug group. 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.) Recent advances have discovered that COVID-19 is a systematic disease targeting the lungs, vasculatures, and immune system, and involves severe lung inflammation and immune deficiency in terms of cytokine storm, neutrophil extracellular traps, as well as imbalance of lymphocyte subsets and so forth [[4], [5], [6]]. Mechanism by which ma-xing-shi-gan-tang inhibits the entry of influenza virus. Pharmacol. Common side effects are heart palpitations, nausea, and vomiting. (2020). [19], Although the medicine has been allowed to be sold in Canada since 2012, Health Canada has cautioned against the use of the Chinese traditional medicine to prevent, treat, and cure COVID-19. 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 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. The discovery of potential effective drugs on the market becomes one of the principal means to develop antiviral drugs for COVID-19. However, no consensus has been reached on the security of LHQW to date. 13 (08), 676681. Individuals w/ cold deficiencies in spleen & stomach or w/ qi. For pooled studies, the incidence of adverse reactions was lower in the LHQW group than the conventional drug group (RR = 0.63, 95% CI = 0.580.69, p < 0.001). Methods and analysis : We systematically searched the Medline (OVID), Embase, the Cochrane Library, and 4 Chinese databases from inception to July 2020 to include the RCTs that evaluated the . Assoc. 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). Alternat Med. 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]]. Zhu S.Y., Li X.Y., Wei Y.L., Yang P.Y., Qin E.D. Ther. Nevertheless, none of the in vivo studies are directly focused on Corona virus or COVID-19. Inhibitorv Effect of Lianhua Oingwen Water Extract on Methicillin-Resistant staphylococcus Aureus Biofilm In Vitro. Due to the inclusion of Ephedra people with high blood pressure, anxiety, history of seizures, irregular heart beats, or other heart heart conditions, should avoid taking Linhua Quingwen. We hope this review will not only present comprehensive evidence for LHQW use in COVID-19 therapy, but also fuel antiviral researches and put forward promising insights for further antiviral drug development. The original contributions presented in the study are included in the article/Supplementary Material, further inquiries can be directed to the corresponding author. Literature analysis of Chinese patent medicine treatment in the observation period of Clinical Management of Corona Virus Disease 2019 (trial 6th edition). This study was supported by the COVID-19 Pneumonia of Traditional Chinese Medicine Emergency Project, State Administration of Traditional Chinese Medicine of the Peoples Republic of China (2020ZYLCYJ02-1). ADVERSE REACTION Uncertainty. Meanwhile, the network pharmacology analysis confirmed that its effects were mainly focused on the biological processes such as the response to LPS, the molecular response to bacterial origin, the response to metal ions and cell biological stimulation [41]. 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. The inconsistent use of conventional drugs in individual studies, along with individual differences in drug absorption, may be factors underlying high heterogeneity. doi:10.13260/j.cnki.jfjtcm.012210, Jia, W., Wang, C., Wang, Y., Pan, G., Jiang, M., Li, Z., et al. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. The Trim and Fill method was further applied to assess the impact of publication bias. Jia and colleagues established a rapid ultraperformance liquid chromatography coupled with diode-array detector and quadrupole time-of-flight mass spectrometry (UPLC-DAD-QTOF-MS) to analyze the major constituents of LHQW capsule, and the results demonstrated that 12 representative compounds were quantified as chemical marker, including salidroside, chlorogenic acid, forsythoside E, cryptochlorogenic acid, amygdalin, sweroside, hyperin, rutin, forsythoside A, phillyrin, rhein, and glycyrrhizic acid [17]. 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. Based on analysis of 40 cases of RCT, the clinical safety of LHQW was comprehensively examined, 163 adverse reactions were reported from 24 studies (Wang et al., 2013). (Gancao) with a herbal ratio of 170 g: 170 g: 57g: 57g: 170 g: 170 g: 170 g: 170 g: 57g: 34 g: 57g: 5 g: 57g, which is recorded in Chinese Pharmacopeia (2015 Edition). Traditional Med. Multiple clinical observations of Lianhua Qingwen combined with conventional treatment can increase the disappearance rate of major symptoms of NCP (fever, cough, fatigue) and other symptoms (chest tightness, dyspnea, and loss of appetite), and reduce the proportion of severe symptoms. Mo H.Y., Yang Z.F., Zheng J.P., Mo Z.Y., Li Y.M., Xiao Z.L. (10), 100. (japanese honeysuckle) flower 27.41 mg, gypsu . Zhong Y., Zhou J., Liang N., Liu B., Lu R., He Y., Liang C., Wu J., Zhou Y., Hu M., Zhou J. [14] Retraction Watch also notes that author Jia Zheng-hua is the son-in-law of Wu Yi-ling, the founder of the company in question. Med. 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. Dr. Tan says that LianHua QingWen is not advisable for COVID patients who are experiencing a chilling sensation due to the infection. There was no statistically significant difference in the incidence of adverse reactions during treatment of chronic obstructive pulmonary disease between the LHQW group and the conventional drug group (RR = 1.27, 95% CI = 0.513.17, p = 0.608). (2021). Potential publication bias was assessed using Funnel plot, Beggs and Eggers test. Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19. Traditional Chinese medicine has accumulated substantial clinical experience over thousands of years. These results were different from our findings, which may be attributed to the limited number of adverse reactions reported in the previous study. Am. LYY19H280006, No. Based Complement. Homogeneity of baseline data was reported in most studies. The .gov means its official. COVID-19 has led to a great case fatality. SuperHealthGuard and Loyal Great International Ltd. - 608633 - 06/26 37 studies reported adverse reactions of skin and its appendage damage. [4][10], In March 2022, during the Shanghai COVID-19 outbreak, the medication was distributed en masse to residents. Drug Discov. [Systematic review of efficacy and safety of Lianhua Qingwen - PubMed Lianhua Qingwen capsule/granule (LHQW) is obtained by combining Ma Xing Shigan Decoction with Yinqiao Powder and widely used in the clinical treatment of respiratory disorders (Liu et al., 2010). The current. Drug Related Hospital Admissions: the Role of Definitions and Intensity of Data Collection, and the Possibility of Prevention. From SARS to COVID-19: pathogens, receptor, pathogenesis and principles of the treatment. 3.2.2. 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. Anal. DerSimonian, R., and Laird, N. (1986). (1990). 2019ZYC-A85), and the Scientific Research Projects of Hospital Pharmacy of Zhejiang Pharmaceutical Association (No. No meta-regression was performed for COVID-19 pneumonia due to the limited number of studies. Currently, the drug has been approved for marketing in 23 countries and regions, including Canada, Russia, Cambodia and Indonesia. (Bohe), Glycyrrhiza uralensis Fisch. Frontiers | The Adverse Reactions of Lianhua Qingwen Capsule/Granule doi:10.26434/chemrxiv.12016236.v1. Since the adverse reactions of LHQW are relatively minor, these functional changes can be recovered. Expert: Lianhua Qingwen capsule proven effective for COVID-19 - CGTN (2021). Four studies reported body as a whole-general disorders as an adverse event. Preliminary Study on the Inhibitory Effect of Lianhua Qingwen Capsule on virusMaster Degree. [3], Lianhua Qingwen was developed by Shijiazhuang Yiling Pharmaceutical in 2003 as a treatment for severe acute respiratory syndrome (SARS) following the outbreak of the disease in 2002 and was listed by the National Health Commission of China in 2004 as a treatment for influenza and other respiratory disease. Here, we performed a meta-analysis of 217 Chinese experimental studies to evaluate the safety of LHQW. Flow chart of the search and selection process. 37 (6), 25752579. [8], Lianhua Qingwen has also been promoted and distributed by the government in Hong Kong (HK). Theoretical Study of the Anti-ncp Molecular Mechanism of Traditional Chinese Medicine Lianhua-Qingwen Formula (Lqf). Lianhua Qingwen, the FDA-approved traditional Chinese med, only treats doi:10.1111/j.0006-341x.2000.00455.x, Fan, Z., Guo, G., Che, X., Yang, Y., Liu, Y., Li, L., et al. Before Chin. Heterogeneity was evaluated using I2 statistic. FIGURE 2. There was a reduced risk of skin and its appendage damage in the LHQW group compared to the conventional drug group (RR = 0.63, 95% CI = 0.440.92, p = 0.015). Cheng D.Z., Li Y. Ma Y., Zhang Z., Wei L., He S., Deng X., Ji A., Zhou B., Jiang D., Li M., Wang Y. Efficacy and safety of Reduqing granules in the treatment of common cold with wind-heat syndrome: a randomized, double-blind, double-dummy, positive-controlled trial. Exploring material basis and mechanism of Lianhua Qingwen prescription against coronavirus based on network pharmacology. (Lianqiao), Lonicera japonica Thunb. 38 studies reported dispose or outcomes of adverse reactions. Res. Peng L.L., Li L., Shen L., Li X.L. sharing sensitive information, make sure youre on a federal Experiments on animals using a combination of LHQW and oseltamivir to treat influenza B virus infections showed a potential inhibitory effect on overexpression of TNF-, MIP-1, RANTES, IFN-, IL-6, IL-8, IP-10, and MCP-1 at the mRNA level, and consequent prevented of the development of severe inflammatory reactions (Yang et al., 2020).