[4] Its formulation includes 13 herbs which are said to have been used for medical purposes as early as the Han dynasty. [13], A 2020 "randomized controlled trial" of LHQW involving Zhong was also found in April 2022 to have undisclosed funding from Yiling Pharmaceuticals, forcing an erratum. 2015, 731765. doi:10.1155/2015/731765, Jin, L., Xu, Y., and Yuan, H. (2020). Literature analysis of Chinese patent medicine treatment in the observation period of Clinical Management of Corona Virus Disease 2019 (trial 6th edition). Analysis of the molecular mechanism of Pudilan (PDL) treatment for COVID-19 by network pharmacology tools. Drug Related Hospital Admissions: the Role of Definitions and Intensity of Data Collection, and the Possibility of Prevention. 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). Therefore, further attention should be paid to the occurrence of adverse reaction with LHQW among different age groups in the future. Ni L., Zhou L., Zhou M., Zhao J., Wang D.W. The current. 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. Natural herbal medicine Lianhuaqingwen capsule anti-influenza A (H1N1) trial: a randomized, double blind, positive controlled clinical trial. 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. In response to the severe SARS-CoV-2 attack, TCM has gained high usage in recent several months especially in China [47]. (2021). 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. 2020, 5157089. doi:10.1155/2020/5157089, Huang, N. L., Huang, H. M., Zhang, B. Y., and Xie, J. 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 following aspects were assessed for each study: random sequence generation, allocation concealment, blinding, incomplete outcome data, selective outcome reporting, and other sources of bias. 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]]. [Systematic review of efficacy and safety of Lianhua Qingwen - PubMed recently published a clinical study on the treatment of mild COVID-19 with LHQW granules (6g, tid) combined with abidor (0.2g, tid) [44]. 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. The different incidence of these adverse reactions may be related to the metabolic level, which varies greatly among the different age groups. Statistics showed that infected patients in China who received combined treatment of Traditional Chinese Medicine and modern medicine exhibited lower fatality rate and relatively better clinical outcomes. 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. In addition, it can also interact with other compounds and herbs. 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). Pharmacol. doi:10.1371/journal.pmed.100009710.1136/bmj.b2535, Peng, L. L., Li, L., Shen, L., and Li, X. X. Frontiers | Broad Anti-Viral Capacities of Lian-Hua-Qing-Wen Capsule doi:10.13260/j.cnki.jfjtcm.012210, Jia, W., Wang, C., Wang, Y., Pan, G., Jiang, M., Li, Z., et al. The collected evidence demonstrated that LHQW exhibited benefits against COVID-19. Currently, the drug has been approved for marketing in 23 countries and regions, including Canada, Russia, Cambodia and Indonesia. [7] In the United States, the FDA is advising consumers not to purchase or use Lianhua Qingwen, stating that it has not been approved or authorized by FDA and is being misleadingly represented as safe and/or effective for the treatment or prevention of COVID-19. The inconsistent use of conventional drugs in individual studies, along with individual differences in drug absorption, may be factors underlying high heterogeneity. Use Overdosage Contraindications Special Precautions Adverse Reactions Storage MIMS Class ATC . A recent clinical trial including 36 common cold with wind-heat syndrome patients demonstrated that LHQW (three times daily for four days) treatment could significantly reduce TCM symptom score, with the median time to fever relief of (45) h and the median time to fever clearance of 36h [35]. Considerable research to date has focused on the clinical efficacy of LHQW, the safety of LHQW is additionally an important consideration for clinical application that should not be neglected. (2010). 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). CONTRAINDICATIONS Uncertainty. The current meta-analysis was performed to evaluate the safety profile of LHQW in relation to conventional drugs (PROSPERO CRD-42020224180). Nevertheless, imperious researches should be conducted to clarify the unconfirmed effects, regulatory mechanisms and adverse reactions of LHQW in treating COVID-19 by means of well designed randomized controlled trials. The novel coronavirus disease 2019 (COVID-19) has become a matter of international concern as the disease is spreading exponentially. 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]. Business China. The sensitivity results are shown in Table 2. Pregnancy & lactation. Batlle D., Wysocki J., Satchell K. Soluble angiotensin-converting enzyme 2: a potential approach for coronavirus infection therapy? 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. Lu Y., Yang J., Wang X., Ma Z., Li S., Liu Z., Fan X. Percentage of risk of bias for all qualified studies. 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). 12 (08), 140141. (2021). 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]. Received: 27 August 2021; Accepted: 06 January 2022;Published: 27 January 2022. Though no specific drug has been developed so far, emerging agents have been confirmed effective or potentially beneficial to restrain it. 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. Expert: Lianhua Qingwen capsule proven effective for COVID-19 - CGTN doi:10.1136/bmj.327.7414.557, Hu, C., Liang, M., Gong, F., He, B., Zhao, D., and Zhang, G. (2020). The risk ratio (RR) and 95% confidence interval (CI) were calculated for categorical variables. Subgroup analysis was performed based on adverse reactions and sensitivity analysis implemented to investigate the influence of each study on the overall evaluation by excluding studies in turn. We aim to assess the efficacy and safety of Lianhua Qingwen combined with Conventional antiviral Western Medicine in Clinical treatment of COVID-19 or asymptomatic infection. However, in evaluation of security index, Eggers test and funnel plot analyses disclosed the existence of publication bias with regard to hepatobiliary system damage, psychiatric disorders, gastrointestinal system damage and body as a whole-general disorders. Traditional Chinese medicine Lianhua Qingwen treating corona - PLOS 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. 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. Materia Med. LYY19H280006, No. (2021). Received 2020 Jul 3; Revised 2020 Aug 9; Accepted 2020 Aug 16. [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". TABLE 1. Clinical applications and pharmacological research progress of Lianhua 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. Anti-viral effects of Lianhua Qingwen capsule against influenza A virus. Meta-analysis and systematic review of efficacy and safety of Lianhua Qingwen in adjuvant treatment of adult pneumonia. (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). Efficacy and safety of Lianhua Qingwen combined with - PubMed FIGURE 1. Study on the network pharmacology and evidences of Lianhua Qingwen in the treatment of Novel Coronavirus (2019 nCoV) Pneumonia. Lianhua Qingwen Dosage & Drug Information | MIMS Thailand FDA Advisory No.2021-0723 - Food and Drug Administration Twenty-three studies on other diseases were included, with 12 reporting adverse reactions. (2015). Yang C.X., Qu J., Liu Y.T., Meng S.W., Wang B.L., Feng M.Q., Sun Y. Cheng D.Z., Wang W.J., Li Y., Wu X.D., Zhou B., Song Q.Y. Vahl. 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. 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. 25 (4), 727790728729. Five studies reported heart rate and arrhythmia as adverse events. doi:10.14009/j.issn.1672-2124.2013.08.001, Wang, Y. 367 (6485), 14121413. Med. Efficacy of Lianhua Qingwen Compared With Conventional Drugs in the Treatment of Common Pneumonia and Covid-19 Pneumonia: a Meta-Analysis. LHQW had been proven to accelerate the improvement of acute exacerbation of COPD (AECOPD) patients, especially for the high-risk subgroup, due to the decreased release of inflammatory mediators including IL-8, TNF- , IL-17, and IL-23 [38]. Experimental study on prevention and treatment of influenza virus FM1 infection in mice by Lianhua Qingwen capsule. 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. Keywords: Lianhua Qingwen capsule; Meta-analysis; influenza; systematic review. doi:10.1136/bmj.d5928, Higgins, J. P., Thompson, S. G., Deeks, J. J., and Altman, D. G. (2003). Yiling Pharmaceutical (2021). TABLE 2. Ther. Efficacy and Safety of Lianhua Qingwen Granule Combined with Oseltamivir in the Treatment of Influenza Virus Infection in Children. doi:10.1016/0197-2456(86)90046-2, Duval, S., and Tweedie, R. (2000). Avoid prolonged use. 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). The latest meta-analysis by Fan et al. The trim and fill method was employed in cases where publication bias existed (Duval and Tweedie, 2000). (2020). Medicinal Plant Names Services. Cui L.F., Xu H.R., Li F.Z., Wang C.X. Patients with severe cases will develop acute respiratory distress syndrome and septic shock, and eventually develop multi-organ failure and death [5]. Based Complement. Traditional Chin. 152 (3), 393402. Case reports, unrelated studies, those with duplicate data, reviews, commentaries and animal-based studies were excluded from the current meta-analysis. [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. 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. Res. (1990). Careers, Unable to load your collection due to an error. Jie Chen, Qin Chen and Hua-Qian Jin analyzed literatures. 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]. Therefore, it is essential to perform a systematic review and meta-analysis to assess the effect of Lianhua Qingwen combined with conventional antiviral Western Medicine in clinical treatment of COVID-19 or asymptomatic infection. 17 studies focused on the treatment of Influenza A (H1N1), 12 of which reported adverse reactions. COPD is characterized by a chronic inflammatory response and can be worsened by acute exacerbations. (2020) identified 38 randomized controlled trials (RCTs) comparing LHQW with antivirals or other Chinese medicines for treating influenza and reported a lower risk of adverse reactions in the LHQW group compared to oseltamivir (RR = 0.29, 95%CI = 0.110.80), and ribavirin groups (RR = 0.29, 95%CI = 0.110.80). Wang L., Yang Z.H., Zhang H.R., Yu H.X., Yang K., Fu B.H., Yang H.T. 17 (13), 6264. 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 .