Results of publication bias and sensitivity analysis. National Administration of Traditional Chinese Medicine: Traditional Chinese Medicine Is Involved in a Wide Range of Treatment and Early Intervention Has Good Effects. Bethesda, MD 20894, Web Policies BMJ. The sensitivity results are shown in Table 2. 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). Accordingly, other biases were defined as low risk of bias. The risk of bias data is presented as a percentage, as shown in Figure 2. Cheng D.Z., Li Y. Protection against COVID-19 injury by qingfei paidu decoction via anti-viral, anti-inflammatory activity and metabolic programming. 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]. Moher, D., Liberati, A., Tetzlaff, J., and Altman, D. G.PRISMA Group (2009). government site. Lianhua Qingwen combined with conventional treatment obviously improved COVID-19. 2019ZYC-A85), and the Scientific Research Projects of Hospital Pharmacy of Zhejiang Pharmaceutical Association (No. J. Med. [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. (2020). The documents were filtered and summarized for final evaluation. 38 studies reported dispose or outcomes of adverse reactions. (2021). 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). Liu, X. Y. 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. (2020). Efficacy and Safety of Lianhuaqingwen for Mild or Moderate Coronavirus Disease 2019. 100 (21), e26059. Salvi R., Patankar P. Emerging pharmacotherapies for COVID-19. Theoretical Study of the Anti-ncp Molecular Mechanism of Traditional Chinese Medicine Lianhua-Qingwen Formula (Lqf). (2020). Pract. Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease. 382 (21), e68. recently published a clinical study on the treatment of mild COVID-19 with LHQW granules (6g, tid) combined with abidor (0.2g, tid) [44]. [Fabaceae; Glycyrrhizae Radix et Rhizoma] (85g) (Rivera et al., 2014; Royal Botanic Gardens, Kew, 2021; Royal Botanic Gardens, Kew science, 2021; The Plant List, 2021; Yiling Pharmaceutical, 2021). Zhu N., Zhang D., Wang W., Li X., Yang B., Song J., Zhao X., Huang B., Shi W., Lu R., Niu P., Zhan F., Ma X., Wang D. A novel coronavirus from patients with pneumonia in China, 2019. Lianhua Qingwen Capsules/granules Product Details. The following terms were searched using the title, abstract or keywords in the English databases: Lianhuaqinwen granule, Lianhuaqinwen capsule, Lianhua Qingwen capsule/granule. For the Chinese databases, the search terms used were: , , /.. Chinese supplement Lianhua Qingwen: What you need to know Data were considered statistically significant at p values <0.05. Zhong Y., Zhou J., Liang N., Liu B., Lu R., He Y., Liang C., Wu J., Zhou Y., Hu M., Zhou J. 66 (6), 771777. Recent data also showed that LHQW played a vigorous role in COVID-19 treatment. Available at: http://www.plantsoftheworldonline.org (Accessed December 18, 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). Asia-Pacific Traditional Med. 20 studies documented other adverse reactions. In the evaluation of security indexes, our meta-analysis revealed that LHQW group having a lower level of adverse reactions compared to the conventional drug group, such as respiratory system damage, skin and its appendage damage, nervous system damage, gastrointestinal system damage and other adverse reactions. There are multiple drug trials going on, but there are no specific anti-SARS-CoV-2 drugs or vaccines till now. 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. doi:10.1136/bmj.d5928, Higgins, J. P., Thompson, S. G., Deeks, J. J., and Altman, D. G. (2003). Lianhua Qingwen prescription for Coronavirus disease 2019 (COVID-19 Chin. It is not registered as a COVID-19 medication, and a doctor's prescription is required for its use. Are there any known contraindications? 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). Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. DerSimonian, R., and Laird, N. (1986). Retrospective Clinical Analysis on Treatment of Novel Coronavirus-Infected Pneumonia with Traditional Chinese Medicine Lianhua Qingwen. Flow chart of the search and selection process. Efficacy of Lianhua Qingwen Compared with Conventional Drugs - Hindawi doi:10.11954/ytctyy.201608076, Chan, K. W., Wong, V. T., and Tang, S. C. W. (2020). Lianhua Qingwen(Forsythia suspensa (Thunb.) (Nat. 13:764774. doi: 10.3389/fphar.2022.764774. [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. Exploring material basis and mechanism of Lianhua Qingwen prescription against coronavirus based on network pharmacology. The term adverse reaction represents any undesired and unintended response that occurs with normal drug use (Gallelli et al., 2002). 25 (4), 727790728729. Systematic Review Registration: https://clinicaltrials.gov/, CRD-42020224180. Study design was done by CH and BH. Study on treatment of "cytokine storm" by anti-2019-nCoV prescriptions based on arachidonic acid metabolic pathway. (2015). 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. doi:10.19803/j.1672-8629.2015.12.011, Rivera, D., Allkin, R., Obn, C., Alcaraz, F., Verpoorte, R., and Heinrich, M. (2014). Mo H.Y., Ke C.W., Zheng J.P., Zhong N.S. The current. 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). However, the efficacy and safety of which shall be confirmed by more high-quality clinical trials. The most common adverse reactions in our analysis were gastrointestinal system damage, skin and its appendage damage. [Saururaceae; Houttuyniae Botanical drug], a composition of LHQW (Huang et al., 2021), that contains allergenic ingredients, such as chlorogenic acid, as well as the unstable nature of houttuyfonate, which can cause adverse reactions (Cao, 2016). (2021). 81703740), the Zhejiang Provincial Natural Science Foundation of China (No. Therefore, people have also observed that Lianhua Qingwen capsule (granule) inhibits the over-expression of human common coronavirus (HcV-229E), novel coronavirus (COVID-19) infected cells and. (1990). Further evaluation revealed that LHQW significantly inhibited SARS-CoV-2 replication in Vero E6 cells, markedly reduced pro-inflammatory cytokines (TNF-, IL-6, CCL-2/MCP-1 and CXCL-10/IP-10) production and resulted in abnormal particle morphology of virion in cells [30]. Pregnancy & lactation. Pulmonary Rale.Eighteen studies reported an effect on the duration of pulmonary rale. Available at: https://mpns.science.kew.org/mpns-portal/(Accessed December 19, 2021). Res. 367 (6485), 14121413. Lianhua Qingwen Prescription is approved for the treatment of fever, cough, and fatigue caused by light and common type of COVID-19 . There was no statistically significant difference in the incidence of adverse reactions during treatment of hand-foot-mouth disease between the LHQW group and the conventional drug group (RR = 0.53, 95% CI = 0.221.30, p = 0.165). 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. Available at: http://m.news.cctv.com/2020/03/17/ARTIEYQ2aws8fPYWQxjnynzo200317.shtml?from=singlemessage (Accessed Apirl 29, 2021). (2011). Experimental study on prevention and treatment of influenza virus FM1 infection in mice by Lianhua Qingwen capsule. Few reports of adverse reactions in the course of treating COVID-19 pneumonia with LHQW are available. The results remained statistically robust after different number supplement of potential studies (for hepatobiliary system damage: RR = 0.90, 95% CI = 0.60 to 1.34; for psychiatric disorders: RR = 1.00, 95% CI = 0.20 to 4.91; for gastrointestinal system damage: RR = 0.86, 95% CI = 0.76 to 0.98; for body as a whole-general disorders: RR = 0.73, 95% CI = 0.212.56). (2015). No adverse treatment-related effects were reported in all the included publications (from 2009 to 2011). Drug-Use Hospitals China. Wang X., Ding Y.Q. To clarify the in vivo effects of LHQW, Gao and colleagues recently showed that LHQW could treat influenza A virus infection in H1N1 mouse model by improving pathologic alterations and body weight loss, and reducing virus replication, lung lesions as well as inflammation [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. (2020). 327 (7414), 557560. On March 27, 2019, Yiling Pharmaceutical Co. Ltd. amended the LHQW drug manual to include adverse reactions related to its clinical application. The Plant List (2021). 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. Lianhua Qingwen, the traditional Chinese medicine recently approved for use in the Philippines by the country's Food and Drugs Administration (FDA), only treats symptoms of the coronavirus disease 2019 (COVID-19), and not the disease itself, a traditional Chinese medicine physician said Tuesday. 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. 2017ZYY07). 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. Clinical effectiveness and case analysis in 54 NCP patients treated with Lanhuaqingwen granules. 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. In addition to western medicine, the potential adverse drug reactions (ADRs) can not be ignored. [18], In Singapore, the Health Sciences Authority has issued an advisory to clarify that although it has been approved for sale as a Chinese proprietary medicine for the relief of cold and flu symptoms, Lianhua Qingwen is not approved to treat or alleviate symptoms of COVID-19. 2015, 731765. doi:10.1155/2015/731765, Jin, L., Xu, Y., and Yuan, H. (2020). Current evidence shows that Lianhua Qingwen capsule is more effective and safer than Oseltamivir, Ribavirin and Ankahuangmin capsules. The search keywords for screening the literature information were virus, COVID-19, or SARS-CoV-2, and Lianhua Qingwen. Ther. Six studies reported the adverse reactions of abnormal white blood cells and reticuloendothelial system. [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. It blocked the early stages (02h) of virus infection, and reduced virus-induced nuclear factor-kappa B (NF-B) activation and the gene expression of interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-, interferon-inducible protein (IP)-10, and monocyte chemoattractant protein (MCP)-1 [24]. Prof. Zhenhua Jia formulates the prescription of Lianhua Qingwen based on the theory of collateral disease, and participates in the research projects of Lianhua Qingwen against H 1 N 1 and COVID-19. 48 (3), 737762. The following information was collected from each qualifying study: first authors name, year, treating disease, sample size, number of male and female, age, adverse reactions, dispose or outcome of adverse reactions. A number of advantages of our study should additionally be mentioned. 46 (5), 395400. [4][10], In March 2022, during the Shanghai COVID-19 outbreak, the medication was distributed en masse to residents. Accessibility [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". The Chinese herbal medicine that can help treat COVID, according to 11 (31), 52605355. 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. (2015). [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 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]. 343, d5928. Clin. Lianhuaqingwencaps.com - 608667 - 07/06/2020 | FDA However, while the potential clinical efficacy of LHQW has been demonstrated in several studies (Hu et al., 2020; Wu et al., 2020; Xiao et al., 2020; Wang et al., 2021), no consensus has been reached regarding the adverse reactions associated with LHQW therapy to date. (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). CONTRAINDICATIONS Uncertainty. Pharmacokinetics-based identification of pseudoaldosterogenic compounds Avoid alcohol and tobacco and spicy,cold, greasy food during taking this product. Despite the ban, Lianhua Qingwen has been sold illegally in Australia as a COVID-19 treatment.[21]. 43 studies on treatment of respiratory tract infection were examined, with 29 reporting adverse reactions. 12 (12), 753759754755. Effect of Maxing Shigan Tang on H1N1 influenza A virus-associated acute lung injury in mice. 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"}}. Traditional Chinese medicine formulation used for the treatment of influenza, Uses and controversies of Lianhua Qingwen in relation to COVID-19, by region, "How traditional Chinese medicine TCM is used to treat Covid-19", "The mechanisms and clinical application of Traditional Chinese Medicine Lianhua-Qingwen capsule", "Clinical applications and pharmacological research progress of Lianhua Qingwen capsules/granules", "Traditional Chinese cures battle for acceptance in COVID-19 fight", "Chinese traditional medicine for Covid-19 becomes money tree", "Efficacy of Lianhua Qingwen Compared with Conventional Drugs in the Treatment of Common Pneumonia and COVID-19 Pneumonia: A Meta-Analysis", "Doctors warn against claims that Beijing-touted health supplement distributed in Canada treats COVID-19", "The Adverse Reactions of Lianhua Qingwen Capsule/Granule Compared With Conventional Drug in Clinical Application: A Meta-Analysis", "Beijing pushes traditional Chinese medicine as coronavirus treatment", "China Covid-19 tsar pushed treatments without revealing business ties", "Efficacy and Safety of Lianhuaqingwen Capsules, a repurposed Chinese Herb, in Patients with Coronavirus disease 2019: A multicenter, prospective, randomized controlled trial", "Prominent Chinese scientist failed to disclose company ties in COVID-19 clinical trial paper", "DOH and FDA Clarify Claims on the Approval of Potential COVID-19 Treatments and Calls for Resignation of the SoH", "Lianhua Qingwen, the FDA-approved traditional Chinese med, only treats symptoms, not COVID", "HSA Advisory on Lianhua Qingwen Products for Prevention or Treatment of COVID-19", "Fraudulent Coronavirus Disease 2019 (COVID-19) Products", "Chinese medicine Lianhua Qingwen makes its way into community for COVID-19 treatment despite Australian ban", https://en.wikipedia.org/w/index.php?title=Lianhua_Qingwen&oldid=1143380058, Short description is different from Wikidata, Articles needing expert attention from January 2023, Medicine articles needing expert attention, Articles containing simplified Chinese-language text, Articles containing traditional Chinese-language text, Articles with unsourced statements from August 2022, Creative Commons Attribution-ShareAlike License 3.0, Treatment against various respiratory diseases including, This page was last edited on 7 March 2023, at 11:01. Lianhua Qingwen has antiviral, anti-inflammatory and immunoregulatory activities. Subgroup, sensitivity and meta-regression analyses were conducted to determine the potential sources of heterogeneity. LHQW, an innovative proprietary traditional Chinese medicine used to treat influenza, was approved by the Food and Drug Administration of the United States for Phase II of clinical trial in 2015 (Ye et al., 2020). [Caprifoliaceae; Lonicerae Japonicae Flos], Gypsum Fibrosum, Isatis indigotica Fort. Lianhua Qingwen prescription for Coronavirus disease 2019 (COVID-19 Study supervision and funding were done by GZ. The recent network pharmacology studies showed that the effects of LHQW prescription was related to virus infection, inflammation and immunity, moreover, its main active ingredients were verified by molecular docking with angiotensin-converting enzyme 2 (ACE2), one receptor of SARS-CoV-2, so as to have a therapeutic effect on COVID-19 [[27], [28], [29]]. 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]. Results were reported as risk ratio (RR) with 95% confidence interval (CI). 52 (3), 5860. Combined with western medicine conventional therapy in the treatment of 63 suspected cases of Coronavirus Disease 2019. Besides, the collected clinical trials involving TCM in the treatment of COVID-19 were mainly from China and published in Chinese, and thus further well-designed multicenter RCTs from different countries will be more attractive before a definitive conclusion can be drawn. (Jinyinhua), Ephedra sinica Stapf (Mahuang), Armeniacae Amarum Semen (Kuxingren), Gypsum Fibrosuum (Shigao), Isatis tinctoria L. (Banlangen), Dryopteridis Crassirhizomatis Rhizoma (Mianmaguanzhong), Houttuynia cordata Thunb. Upon full text filtering of the remaining 715 citations, 498 were excluded due to a number of reasons (shown in Figure 1). During the study, no serious adverse events were reported. Based Complement. doi:10.1142/S0192415X20500378. Treatment of SARS-Cov-2: How Far Have We Reached? Comprehensive analysis of influenza may provide a significant advantage in generalization of the conclusions. Pharmacol. In addition, LHQW had antagonist effects on the pulmonary oxidative lesions that induced by fine particulates PM2.5 in rats [34]. Percentage of risk of bias for all qualified studies. doi:10.1097/MD.0000000000026059, Gallelli, L., Ferreri, G., Colosimo, M., Pirritano, D., Guadagnino, L., Pelaia, G., et al. The participants, interventions, comparison, outcome and study design (PICOS) criteria were used to identify articles: 1) participants: patients treated with LHQW, 2) interventions: LHQW or LHQW combined with conventional drug (LHQW capsule: Shijiazhuang Yiling Pharmaceutical Co., Ltd., National medicine approval Z20040063; LHQW granule: Shijiazhuang Yiling Pharmaceutical Co., Ltd., National medicine approval Z20100040), 3) comparison: conventional drugs, including antiviral drugs, conventional antibiotics or symptomatic treatment, 4) outcome: relevant data on adverse reactions, and 5) study design: experimental study. A Trial of Lopinavir-Ritonavir in Covid-19. J. Exp. HHS Vulnerability Disclosure, Help 2020, 5157089. doi:10.1155/2020/5157089, Huang, N. L., Huang, H. M., Zhang, B. Y., and Xie, J. Chen J., Wang Y.K., Gao Y., Hu L.S., Yang J.W., Wang J.R., Sun W.J., Liang Z.Q., Cao Y.M., Cao Y.B. 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. In response to the severe SARS-CoV-2 attack, TCM has gained high usage in recent several months especially in China [47]. In addition, LHQW treatment efficiently impaired the nuclear export of the viral RNPl [24].

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