Lianhua Qingwen, the FDA-approved traditional Chinese med, only treats 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. [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. Clinical effectiveness and case analysis in 54 NCP patients treated with Lanhuaqingwen granules. 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). 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]. Meta-analysis in Clinical Trials. ex DC. 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). Li H.R., Chang L.P., Wei C., Jia Z.H. Advances in Pharmacology and Clinical Research of Lianhua Qingwen Capsules. 2020, 5157089. doi:10.1155/2020/5157089, Huang, N. L., Huang, H. M., Zhang, B. Y., and Xie, J. (2021) investigated the efficacy and security of LHQW in the treatment of mild or moderate COVID-2019 pneumonia, reported no statistical difference in the incidence of adverse reactions between LHQW and conventional treatment groups from two studies (RR = 0.43, 95%CI = 0.121.54, p = 0.19). The novel coronavirus disease 2019 (COVID-19) has become a matter of international concern as the disease is spreading exponentially. Traditional Chinese medicine Lianhua Qingwen treating corona - PLOS CONTRAINDICATIONS Uncertainty. 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]. 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. Kong Q., Wu Y., Gu Y., Lv Q., Qi F., Gong S., Chen X. However, no statistical difference was detected with regard to rash (RR = 0.60, 95% CI = 0.211.67) and dizziness (RR = 1.79, 95% CI = 0.339.74). (2021). Yu P., Li Y.Z., Wan S.B., Wang Y. Efficacy of Lianhua Qingwen granules combined with abidor in the treatment of mild COVID-19. LHQW also decreased the influenza viral titers in the lungs of mice, with decreased inflammatory cytokine levels in the early stages of infection [24]. 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. Jia W., Wang C., Wang Y., Pan G., Jiang M., Li Z., Zhu Y. Qualitative and quantitative analysis of the major constituents in Chinese medical preparation Lianhua-Qingwen capsule by UPLC-DAD-QTOF-MS. Wang C.H., Zhong Y., Zhang Y., Liu J.P., Wang Y.F., Jia W.N., Wang G.C., Li Z., Zhu Y., Gao X.M. It was demonstrated that the use of LHQW also brought the incidence of gastrointestinal reactions, as well as skin and its accessories injuries, including diarrhea, abdominal distension, gastrointestinal discomfort, rash, and itching, despite the low quality of the included documents [50,51]. This review has introduced the advances of LHQW in anti-viral treatment, intending to provide ideas for the timely treatment of COVID-19 patients. [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. Keywords: Lianhua Qingwen capsule; Meta-analysis; influenza; systematic review. Percentage of risk of bias for all qualified studies. This study provides a basis for establishing the clinical safety profile of LHQW. Pharmacol. Retrospective Clinical Analysis on Treatment of Novel Coronavirus-Infected Pneumonia with Traditional Chinese Medicine Lianhua Qingwen. Z., Wang, H. T., Han, X., Liu, C., Sun, Y. N., Liu, B., et al. Liu, X. Y. Despite the ban, Lianhua Qingwen has been sold illegally in Australia as a COVID-19 treatment.[21]. Lianhua Qingwen (LHQW) is a commonly used Chinese medical preparation to treat viral influenza, including in the fight against SARS in 20022003 in China. 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. 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. National Administration of Traditional Chinese Medicine: Traditional Chinese Medicine Is Involved in a Wide Range of Treatment and Early Intervention Has Good Effects. Though no specific drug has been developed so far, emerging agents have been confirmed effective or potentially beneficial to restrain it. LHQW has a reduced incidence of other adverse reactions compared to the conventional drug group (RR = 0.60, 95% CI = 0.430.84, p = 0.003). The literature materials were collected from the scientific databases including the Pubmed, CNKI and Web of Science (up to August 8, 2020), on ethnobotany and ethno medicines. As a library, NLM provides access to scientific literature. Both Lian-Hua-Qing-Wen Capsule (LHQWC) and Jin-Hua-Qing . doi:10.1016/s1043661802002104, Hallas, J., Harvald, B., Gram, L. F., Grodum, E., Brsen, K., Haghfelt, T., et al. Front. Among the 13 included studies on treatment of hand-foot-mouth disease, eight reported adverse reactions. LHQW capsules not only had hemagglutination inhibition activity against B/Guangzhou/0215/2012 of influenza B virus, but also inhibited the over-expression of RANTES, IL-6, IL-8, IP-10, TNF-, MCP-1, macrophage inflammatory protein (MIP)-1, and interferon (IFN)- at the mRNA level and prevented a severe inflammatory response [26]. FIGURE 2. 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. Lianhua Qingwen prescription for Coronavirus disease 2019 (COVID-19 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. These in vitro studies indicate that LHQW shows a wide range of antiviral activities including its anti-SARS-CoV-2 role. 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]. An article on telemedicine and medical news platform Dr. Lilac pointed out that there was no scientific evidence available to indicate that LHQW was effective as prophylaxis to prevent infection, nor did there exist any official government recommendation for such usage; instead, taking the drug unnecessarily carried a risk of side effects. The current meta-analysis was performed to evaluate the safety profile of LHQW in relation to conventional drugs (PROSPERO CRD-42020224180). Introduction As the global epidemic continues to spread, countries have tapped effective drugs to treat new coronavirus pneumonia. Chin. [9], During the COVID-19 pandemic, the government of the People's Republic of China (PRC) approved the use of Lianhua Qingwen for mild to moderate COVID-19 cases in January 2020, and promotes the use of the medicine abroad. 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. A systematic review on the efficacy of Traditional Chinese Medicine on influenza. 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]. 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]. There was no statistically significant difference in the incidence of adverse reactions during treatment of herpes zoster between the LHQW group and the conventional drug group (RR = 0.80, 95% CI = 0.521.23, p = 0.302). (2020). 367 (6485), 14121413. doi:10.26434/chemrxiv.12016236.v1. Clinical efficacy and mechanism of Lianhua Qingwen Granule on COVID-19 based on network pharmacology research. Individuals w/ cold deficiencies in spleen & stomach or w/ qi. (Guanghuoxiang), Rheum palmatum L. (Dahuang), Rhodiola rosea Linn. Similar results were obtained in subgroup analysis of hepatic function abnormal and transaminase increased. Available at: https://chemrxiv.org/engage/chemrxiv/article-details/60c74908ee301c485bc799cf (Accessed July 23, 2021). Meta-Analysis of Efficacy of Oseltamivir and Substitution Therapy for Anti- H1n1 Infection. LHQW: Lianhua Qingwen. Now, there are no study results posted on ClinicalTrials.gov for this study yet. Therefore, studies with blinded participants and personnel and blinded outcome assessments were classified as low risk of bias. In terms of incomplete outcome data and selective reporting, the majority of studies reported complete data on all symptom indicators with a low risk of attrition and reporting bias. doi:10.1111/j.1365-2796.1990.tb00199.x, Higgins, J. P., Altman, D. G., Gtzsche, P. C., Jni, P., Moher, D., Oxman, A. D., et al. The search keywords for screening the literature information were virus, COVID-19, or SARS-CoV-2, and Lianhua Qingwen. (Nat. Further clinical trial showed that LHQW was superior to oseltamivir in improving the symptoms of influenza A virus infection by a meta-analysis of randomized, controlled trials [37]. Furthermore, we also found that LHQW group has a reduced incidence of respiratory system damage compared to the conventional drug group. Retrospective clinical analysis on treatment of coronavirus disease 2019 with traditional Chinese medicine Lianhua Qingwen. Comprehensive analysis of influenza may provide a significant advantage in generalization of the conclusions. 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]]. Clin. (2002). The quantitative analysis of all eligible studies. Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19. It is urgent to develop effective drugs to contain and treat COVID-19. 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. The trim and fill method was employed in cases where publication bias existed (Duval and Tweedie, 2000). Impressively, LHQW in conjunction with conventional treatment could significantly improve COVID-19 patients as a synergetic strategy. Homogeneity of baseline data was reported in most studies. Anti-viral effects of Lianhua Qingwen capsule against influenza A virus. Lian-Di Kan, Ye-Cheng Jin and Hong-Mei Fang were responsible for the conception and design of the review. The serious attack of Coronavirus Disease 2019 (COVID-19), infected by Severe Acute Respiratory Syndrome (SARS) Coronavirus 2 (SARS-CoV-2), has quickly spread around the globe [[1], [2], [3]]. [5], Sources of its formulation reportedly consist of:[6], The medicine is both in capsule and granular form. 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. 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]. doi:10.1016/0197-2456(86)90046-2, Duval, S., and Tweedie, R. (2000). To explore the material basis and mechanism of Lianhua Qingwen 38 studies reported dispose or outcomes of adverse reactions. Electronic retrieval was performed using following databases, which were searched from outset to February 18, 2021: Embase, PubMed, the Cochrane Library, CNKI (a Chinese database), VIP (a Chinese database), and Wanfang (a Chinese database). and transmitted securely. sharing sensitive information, make sure youre on a federal Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. Eleven studies reported the treatment of viral influenza and adverse reactions. LHQW is composed of 11 herbs including Forsythia suspensa (Thunb.) 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 different incidence of these adverse reactions may be related to the metabolic level, which varies greatly among the different age groups. Chin. Trim and Fill: a Simple Funnel-Plot-Based Method of Testing and Adjusting for Publication Bias in Meta-Analysis. No meta-regression was performed for COVID-19 pneumonia due to the limited number of studies. aimed to assess the efficacy and safety of LH combined with usual treatment vs usual treatment alone in treating mild or moderate COVID-19 by a meta-analysis of randomized controlled trials (RCTs). Keywords: Management of adverse reactions was clearly documented in 38 studies, which reported improvement or resolution through discontinuation of medication, changes to post-meal administration, symptomatic or no treatment. Chinese drug Lianhua Qingwen not to be taken without doctor's OK Traditional Chinese medicine treatment maintains homeostasis through interactions between the body and pathogens or establishing a balance between stimulating antiviral responses and suppressing overactive immune responses that leads to tissue damage (Shi et al., 2021).
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