Moher, D., Liberati, A., Tetzlaff, J., and Altman, D. G.PRISMA Group (2009). 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. COVID-19 has led to a great case fatality. Five studies reported respiratory system damage as an adverse event. Pharmacopoeia of Peoples Republic of China. showed that the usual treatment in combination with LHQW capsules (4 capsules thrice daily for 14 days) had significantly higher recovery rate, and shorter median time to symptom recovery, as compared with control group [43]. Overall, 61 chemical compounds of LHQW (including iridoids, flavonoids, anthraquinones, phenylpropanoids, triterpenoids, and other types) have been unambiguously or tentatively identified via rapid ultra-performance liquid chromatography coupled with diode-array detector and quadrupole time-of-flight mass spectrometry (Jia et al., 2015). doi:10.1590/1806-9282.66.6.771, Khan, Z., Karata, Y., and Rahman, H. (2020). Measuring Inconsistency in Meta-Analyses. 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. Systematic Review Registration: https://clinicaltrials.gov/, CRD-42020224180. Study on treatment of "cytokine storm" by anti-2019-nCoV prescriptions based on arachidonic acid metabolic pathway. Wang X., Ding Y.Q. 48 (3), 737762. Effect of lianhuaqingwen capsules on airway inflammation in patients with acute exacerbation of chronic obstructive pulmonary disease. (japanese honeysuckle) flower 27.41 mg, gypsu . Moreover, LHQW capsule also remarkably decreased the infectivity of H3N2 in vitro [25]. China Med. The novel coronavirus disease 2019 (COVID-19) has become a matter of international concern as the disease is spreading exponentially. LHQW has been recommended by the China International Exchange and Promotive Association for Medical and Health Care and the Chinese Research Hospital Association as comprehensive treatment for moderate or chronic COVID-19 pneumonia in conjunction with routine therapy (Jin et al., 2020). During the study, no serious adverse events were reported. Keywords: Lianhua Qingwen, adverse reaction, COVID-19, influenza, traditional Chinese medicine, meta-analysis, Citation: Hu C, He B, Gong F, Liang M, Zhao D and Zhang G (2022) The Adverse Reactions of Lianhua Qingwen Capsule/Granule Compared With Conventional Drug in Clinical Application: A Meta-Analysis. 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. 56 (2), 455463. Evid. (2013). 2015, 731765. doi:10.1155/2015/731765, Jin, L., Xu, Y., and Yuan, H. (2020). Furthermore, we also found that LHQW group has a reduced incidence of respiratory system damage compared to the conventional drug group. 13 (08), 676681. 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. 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. Retrospective Clinical Analysis on Treatment of Novel Coronavirus-Infected Pneumonia with Traditional Chinese Medicine Lianhua Qingwen. HHS Vulnerability Disclosure, Help The results are expected to enhance its effectiveness against viruses. Lianhua Qingwen combined with conventional treatment obviously improved COVID-19. 1 The sensitivity results are shown in Table 2. On March 27, 2019, Yiling Pharmaceutical Co. Ltd. amended the LHQW drug manual to include adverse reactions related to its clinical application. 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]. Beijing: China Medical Science Press. Kunming: Kunming University of technology. 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: , , /.. Peng L.L., Li L., Shen L., Li X.L. Dr. Tan says that LianHua QingWen is not advisable for COVID patients who are experiencing a chilling sensation due to the infection. 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. Zhou X.P. Contraindications . Skin rashes, allergic dermatitis and other skin allergic reactions are also reported to be associated with LHQW treatment, and may be related to Houttuynia cordata Thunb. Fig. Res. The mechanisms were mainly involved the antiviral activity, and regulation of inflammation response as well as immune function. Guo H., Zhang Q.H., Yang J., Gong J.N., Zhao Y.S., Zhou X.P. Potential publication bias was assessed using Funnel plot, Beggs and Eggers test. Li L.C., Kan L.D. Ren Y., Yao M.C., Huo X.Q., Gu Y., Zhu W.X., Qiao Y.J., Zhang Y.L. Pharmacological Action, Clinical Application and Adverse Reactions of Houttuynia Cordata. LHQW is composed of 11 herbs including Forsythia suspensa (Thunb.) 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]. Use Overdosage Contraindications Special Precautions Adverse Reactions Storage MIMS Class ATC . Efficacy and safety of Lianhuaqingwen capsules, a repurposed Chinese herb, in patients with coronavirus disease 2019: a multicenter, prospective, randomized controlled trial. [5], Sources of its formulation reportedly consist of:[6], The medicine is both in capsule and granular form. Efficacy and Safety of Lianhua Qingwen Granule Combined with Oseltamivir in the Treatment of Influenza Virus Infection in Children. Rev. 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. Theoretical research basis and clinical efficacy of Lianhua Qingwen in treating Novel Coronavious pneumonica. [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. Vahl (Lianqiao); Lonicera japonica Thunb. 52 (3), 5860. 81703740), the Zhejiang Provincial Natural Science Foundation of China (No. The incidence of adverse reactions during treatment of influenza A (H1N1) was lower in the LHQW group compared to the conventional drug group (RR = 0.21, 95% CI = 0.130.36, p < 0.001). An official website of the United States government. A Trial of Lopinavir-Ritonavir in Covid-19. (2020). To protect the interests of patients, the risk-benefit ratio of the drug needs to be considered in clinical applications. 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. Received 2020 Jul 3; Revised 2020 Aug 9; Accepted 2020 Aug 16. 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. 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). doi:10.13422/j.cnki.syfjx.20201099, Ye, C., Gao, M., Lin, W., Yu, K., Li, P., and Chen, G. (2020). doi:10.14009/j.issn.1672-2124.2013.08.001, Wang, Y. 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]]. Chinese Pharmacopoeia (2020). Jiao Qu revised the manuscript. ). 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. Based Complement. FIGURE 1. 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. 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. 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. Nevertheless, pressing researches should be conducted to illuminate the unconfirmed effects, regulatory mechanisms and adverse reactions of LHQW in treating COVID-19. 152 (3), 393402. Med. 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.) No adverse treatment-related effects were reported in all the included publications (from 2009 to 2011). [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. Sensitivity analysis was performed by assessing the stability of the results after removal of individual studies. Are there any known contraindications? 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. The discovery of potential effective drugs on the market becomes one of the principal means to develop antiviral drugs for COVID-19. Identification of a pharmacological biomarker for the bioassay-based quality control of a thirteen-component TCM formula (Lianhua Qingwen) used in treating influenza A virus (H1N1) infection. Besides, on April 14, 2020, the National Medical Products Administration of China approved modifying the specification of LHQW (Yiling Pharmaceutical Inc.) by adding a new indication for COVID-19 treatment in mild and normal cases. [Cruciferae; Isatudus Radix], Dryopteris crassirhizoma Nakai [Polypodiaceae; Dryopteris Crassirhizomatis Rhizoma], Houttuynia cordata Thunb. Kong Q., Wu Y., Gu Y., Lv Q., Qi F., Gong S., Chen X. 2019ZYC-A85), and the Scientific Research Projects of Hospital Pharmacy of Zhejiang Pharmaceutical Association (No. Bras (1992). 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]. The therapeutic effect of the traditional Chinese medicine Lianhua Qingwen in this new coronary pneumonia epidemic has attracted attention from all walks of life, and relevant research reports continue to appear. Lu Z.J., Wu L.Y., Mou Y.Y., Duan H.M., Chen R.C., Xiao Y., Zheng W.J. 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). Reply. Finally, our data showed that LHQW reduces the incidence of a number of adverse reactions compared with conventional drugs. As a library, NLM provides access to scientific literature. Business China. Royal Botanic Gardens, Kew (2021). 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). Combination of western medicine and Chinese traditional patent medicine in treating a family case of COVID-19. Chin. Four studies reported body as a whole-general disorders as an adverse event. Current evidence shows that Lianhua Qingwen capsule is more effective and safer than Oseltamivir, Ribavirin and Ankahuangmin capsules. Although the results obtained for influenza were consistent with our findings, the control group in this earlier study was treated with a single drug while our control groups were treated with antiviral drugs, conventional antibiotics or symptomatic therapy. 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]. Clinical Drug Safety of Lianhuaqingwen Preparation: a Systematic Evaluation.

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