Study supervision and funding were done by GZ. Traditional Chinese medicine Lianhua Qingwen treating corona - PLOS 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]. No meta-regression was performed for COVID-19 pneumonia due to the limited number of studies. Few reports of adverse reactions in the course of treating COVID-19 pneumonia with LHQW are available. 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. [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. Shi, M., Peng, B., Li, A., Li, Z., Song, P., Li, J., et al. Otherwise, the fixed-effects model was used (DerSimonian and Laird, 1986; Higgins et al., 2003). Both Lian-Hua-Qing-Wen Capsule (LHQWC) and Jin-Hua-Qing . This review provides comprehensive evidence of LHQW as a complementary strategy for treating COVID-19. ADVERSE REACTION Uncertainty. Vahl [Oleaceae; Forsythiae Fructus], Lonicera japonica Thunb. In recent years, LHQW has been registered to obtain marketing authorization in Canada, Brazil, Singapore, Thailand, the Philippines, Kuwait and other countries under the designation Chinese patent medicine, medicine, physical natural health products, food supplement, modern botanical medicine or natural medicine (Yiling Pharmaceutical, 2020). The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. The current meta-analysis was conducted to systematically evaluate the security of LHQW compared with conventional drug in clinical application. Dang Y., Xu J., Yang Y., Li C., Zhang Q., Zhou W., Zhang L., Ji G. Ling-gui-zhu-gan decoction alleviates hepatic steatosis through SOCS2 modification by N6-methyladenosine. No use, distribution or reproduction is permitted which does not comply with these terms. Covid-19: an Update on the Epidemiological, Clinical, Preventive and Therapeutic Evidence and Guidelines of Integrative Chinese-Western Medicine for the Management of 2019 Novel Coronavirus Disease. 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. Seven of the studies showed that adverse reactions improved or healed spontaneously without any treatment, five reported that adverse reactions healed spontaneously after discontinuation of medication, eight showed that adverse reactions improved or healed with medication after meals and ten showed that adverse reactions improved or recovered after symptomatic treatment, while in the remaining eight studies, adverse reactions were not disposed or treated. Moher, D., Liberati, A., Tetzlaff, J., and Altman, D. G.PRISMA Group (2009). Liu, X. Y. Methods: Comprehensive document retrieval was performed from both English and Chinese databases. Control. Subgroup, sensitivity and meta-regression analyses were conducted to determine the potential sources of heterogeneity. Jie Chen, Qin Chen and Hua-Qian Jin analyzed literatures. LHQW is recommended by the National Health Commission of the Peoples Republic of China as a traditional Chinese medicine appropriate for COVID-19 pneumonia (trial version from Fourth to the Eighth Edition). Five studies reported heart rate and arrhythmia as adverse events. FDA Advisory No.2021-0723 - Food and Drug Administration 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. Figure 1 provides a detailed flowchart of the screening process. There was no statistically significant difference in the incidence of adverse reactions during treatment of common pneumonia between the LHQW group and the conventional drug group (RR = 0.99, 95% CI = 0.791.24, p = 0.927). The basic clinical treatments for COVID-19 include anti-infectious, anti-proinflammatory cytokines, nonspecific antiviral as well as life support therapies [[6], [7], [8]]. Percentage of risk of bias for all qualified studies. Fujian J. In addition to western medicine, the potential adverse drug reactions (ADRs) can not be ignored. (2015). (2020). World Health Organization Adverse Drug Reaction Terminology (2009). 2019ZYC-A85), and the Scientific Research Projects of Hospital Pharmacy of Zhejiang Pharmaceutical Association (No. LHQW is one of the TCM formulations that have been officially approved to treat COVID-19 patients, which may be due to its antiviral, lung protection, and regulation of inflammation response as well as immune regulation actions (Fig. [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. Clinical efficacy and mechanism of Lianhua Qingwen Granule on COVID-19 based on network pharmacology research. Li J.Y., You Z., Wang Q., Zhou Z.J., Qiu Y., Luo R., Ge X.Y. Mechanism by which ma-xing-shi-gan-tang inhibits the entry of influenza virus. It may benefit the treatment of COVID-19 by the signaling pathways such as advanced glycation end products (AGE)-receptor of AGE (RAGE), TNF, sarcoma-associated herpesvirus infection, IL-17 and human cytomegalovirus infection [41]. The official monograph of LHQW states that the adverse effects are "unclear". (2020). (2015). doi:10.3969/j.issn.1672-2809.2020.13.020, Liu, C. Y., Li, X. Q., and Cai, S. Q. The current. [4][10], In March 2022, during the Shanghai COVID-19 outbreak, the medication was distributed en masse to residents. The outcome measures included the alleviation of fever and other symptoms including nasal congestion, sore throat, cough, aches and pains, fatigue, headache, chills or sweats in subjects with acute uncomplicated influenza. Warning 1. 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). In another prospective multicenter randomized controlled trial in confirmed COVID-19 cases, Hu et al. Pharmacokinetics-based identification of pseudoaldosterogenic compounds Efficacy and Safety of Lianhua Qingwen Granule Combined with Oseltamivir in the Treatment of Influenza Virus Infection in Children. (2015). 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). Royal Botanic Gardens, Kew (2021). 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. The control and improvement of the present COVID-19 situation in China could not be separated from the extensive participation of TCM, which has been proven effective by the clinical studies in COVID-19 patients [41,44,48,49]. Lianhua Qingwen Dosage & Drug Information | MIMS Thailand 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. Subgroup analysis further showed the incidence of disease recurrence was lower in the LHQW group than the conventional drug group (RR = 0.33, 95% CI = 0.170.65, p = 0.001), no statistical difference was detected for secondary infection. Among the eight included studies on rheum therapy, six reported adverse reactions. Eleven studies reported the treatment of viral influenza and adverse reactions. Currently, the drug has been approved for marketing in 23 countries and regions, including Canada, Russia, Cambodia and Indonesia. HHS Vulnerability Disclosure, Help doi:10.11954/ytctyy.201608076, Chan, K. W., Wong, V. T., and Tang, S. C. W. (2020). (1990). National Administration of Traditional Chinese Medicine: Traditional Chinese Medicine Is Involved in a Wide Range of Treatment and Early Intervention Has Good Effects. Inhibitorv Effect of Lianhua Oingwen Water Extract on Methicillin-Resistant staphylococcus Aureus Biofilm In Vitro. From SARS to COVID-19: pathogens, receptor, pathogenesis and principles of the treatment. The complex components of LHQW stand for multiple targets and pleiotropic effects, but may also lead to more ADRs. Eval. The search keywords for screening the literature information were virus, COVID-19, or SARS-CoV-2, and Lianhua Qingwen. Till August 8, 2020, over 19,000,000 people have been confirmed infected and more than 700,000 people have died during this severe viral prevalence. 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). In the Philippines, its Food and Drug Administration approved Lianhua Qingwen on 7 August 2020 as a traditional herbal product that helps remove "heat-toxin invasion of the lungs, including symptoms such as fever, aversion to cold, muscle soreness, stuffy and runny nose". 20 studies documented other adverse reactions. Evid. LHQW is composed of 11 herbs including Forsythia suspensa (Thunb.) Traditional Chin. Yiling Pharmaceutical (2021). Drugs and Clinic. These in vivo data further demonstrate the antiviral effects of LHQW as well as its lung protection role. 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]. Future related studies will provide accumulated evidence to clarify it. Qualitative and Quantitative Analysis of the Major Constituents in Chinese Medical Preparation Lianhua-Qingwen Capsule by UPLC-DAD-QTOF-MS. ScientificWorldJournal. 26 (11), 812. doi:10.19803/j.1672-8629.2015.12.011, Rivera, D., Allkin, R., Obn, C., Alcaraz, F., Verpoorte, R., and Heinrich, M. (2014). 3.2.2. Traditional Chinese medicine, such as Lianhua Qingwen, has achieved some curative effect in many countries, but its effect is not clear. Two studies reported psychiatric disorders as the adverse reaction. 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. Res. In recent years, LHQW has played a significant role in the prevention and control of viral public health events (Yao et al., 2020), and is widely accepted as a representative antiviral Chinese medicine in China. 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]. Several limitations of our meta-analysis should be taken into consideration.

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