For rheum, sample size could partially explain heterogeneity (p = 0.005), but not year of publication (p = 0.658) and treatment of the control group (p = 0.712). 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). Peng L.L., Li L., Shen L., Li X.L. Eval. 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. There was no statistically significant difference in the incidence of adverse reactions during treatment of chronic obstructive pulmonary disease between the LHQW group and the conventional drug group (RR = 1.27, 95% CI = 0.513.17, p = 0.608). The current meta-analysis was performed to evaluate the safety profile of LHQW in relation to conventional drugs (PROSPERO CRD-42020224180). Two studies reported psychiatric disorders as the adverse reaction. (2015). Lianhua Qingwen(Forsythiae fructus 225 mg, Lonicerae japonicae flos 225 mg, Ephedrae herba (processed w/ honey) 85 mg, Armeniacae semen amarum (stir-baked) . (2015). Rev. 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]. The site is secure. Warning 1. A multi-center, randomized, double-blind, and placebo-controlled phase II clinical study, sponsored by Yiling Pharmaceutical Inc., was conducted to investigate the safety and efficacy of two doses of LHQW capsule compared to placebo in subjects with acute uncomplicated influenza in the U.S.A (https://www.clinicaltrials.gov/ct2/show/study/{"type":"clinical-trial","attrs":{"text":"NCT02867358","term_id":"NCT02867358"}}NCT02867358). LHQW prescription (capsules type, or granules type) consists of 11 herbs, gypsum and menthol [18]. doi:10.1097/MD.0000000000026059, Gallelli, L., Ferreri, G., Colosimo, M., Pirritano, D., Guadagnino, L., Pelaia, G., et al. 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 . Efficacy of Huoxiang Zhengqi Dropping Pills and Lianhua Qingwen Granules in Treatment of Covid-19: a Randomized Controlled Trial. Liu-Cheng Li was responsible for drafting the manuscript. For drowsiness of nervous system damage, sample size (p = 0.500), year of publication (p = 0.157), and treatment of the control group (p = 0.599) were not linked with heterogeneity. 160, 105101. doi:10.1016/j.phrs.2020.105101, Xiao, M., Tian, J., Zhou, Y., Xu, X., Min, X., Lv, Y., et al. Analysis of Clinical Application and Adverse Reactions of Houttuynia Cordata Injection. Future related studies will provide accumulated evidence to clarify it. Subgroup analysis additionally revealed a reduced incidence of some adverse reactions in the LHQW group compared to the conventional drug group (Rash of skin and its appendage damage, dizziness or headache owing to nervous system damage, nausea or vomiting from gastrointestinal system damage and resurgence of disease from other adverse reactions). Study on treatment of "cytokine storm" by anti-2019-nCoV prescriptions based on arachidonic acid metabolic pathway. 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. Lianhua Qingwen (LHQW) is a classical Chinese medical preparation, while one of its prescription compositions Maxingshigan Decoction has a history of more than thousand years to treat plague, and exhibits antiviral and lung protection actions [15,16]. Previous studies reported that Lianhua Qingwen might have positive effects, including broad-spectrum antiviral, cough and expectorant, antipyretic and anti-inflammatory, immune-regulating, effective antibacterial and other systemic intervention functions (Liu et al., 2010; Liu 2015; Wang, et al., 2015). Otherwise, the fixed-effects model was used (DerSimonian and Laird, 1986; Higgins et al., 2003). 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]. 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). Res. Formulae. For pooled studies, there was a significantly reduced risk of adverse reactions with LHQW group compared to the conventional drug group (RR = 0.63, 95% CI = 0.580.69, p < 0.001). J. Chin. However, no consensus has been reached on the security of LHQW to date. Niu Q.Q., Chen Y., Liu Y., Mao S.Z., Wang H., Zheng W.K., Zhang J.H. Clin. 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. 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. The post-marketing monitoring data incorporated information on the following gastrointestinal adverse reactions: nausea, diarrhea, vomiting, abdominal pain, abdominal distension, dry mouth; as well as skin rash, itching, dizziness (Yiling Pharmaceutical, 2021). It is urgent to develop effective drugs to contain and treat COVID-19. Clinical efficacy and mechanism of Lianhua Qingwen Granule on COVID-19 based on network pharmacology research. The results are expected to enhance its effectiveness against viruses. (2020). (2021). Moher, D., Liberati, A., Tetzlaff, J., and Altman, D. G.PRISMA Group (2009). (1990). Homogeneity of baseline data was reported in most studies. Clinical effectiveness and case analysis in 54 NCP patients treated with Lanhuaqingwen granules. Medicine (Baltimore). sharing sensitive information, make sure youre on a federal 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. Multiple clinical observations of Lianhua Qingwen combined with conventional treatment can increase the disappearance rate of major symptoms of NCP (fever, cough, fatigue) and other symptoms (chest tightness, dyspnea, and loss of appetite), and reduce the proportion of severe symptoms. Based on analysis of 40 cases of RCT, the clinical safety of LHQW was comprehensively examined, 163 adverse reactions were reported from 24 studies (Wang et al., 2013). [20], In Australia, the Therapeutic Goods Administration has not given approval to Lianhua Qingwen, as it contains ephedra, a key ingredient used to make the drug methamphetamine. 161, 105126. doi:10.1016/j.phrs.2020.105126, Yang, C., Wang, Y., He, J., Yan, W., Jiang, H., Chen, Q., et al. Fujian J. Med. 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 COVID-19 pneumonia epidemic has spread across the globe poses a significant challenge to public health worldwide. 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). 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]. While LHQW has recently been approved for marketing by CFDA, its safety is yet to be conclusively established. Lianhua Qingwen capsule and Lianhua Qingwen granules were approved to add "functional indications" to the originally approved indications: "In the conventional treatment of novel. Methods: Comprehensive document retrieval was performed from both English and Chinese databases. [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. In addition, it can also interact with other compounds and herbs. Subgroup analysis revealed that LHQW group has a reduced incidence of rash than the conventional drug group (RR = 0.58, 95% CI = 0.390.86, p = 0.007), no statistical difference was detected for itchy skin. Protection against COVID-19 injury by qingfei paidu decoction via anti-viral, anti-inflammatory activity and metabolic programming. COPD is characterized by a chronic inflammatory response and can be worsened by acute exacerbations. It warned that sellers who make claims that it can prevent, protect against or treat COVID-19 may face prosecution. With gradual improvement of the adverse drug reaction monitoring system of China, reports of adverse reactions or events have increased. Clinical Drug Safety of Lianhuaqingwen Preparation: a Systematic Evaluation. These data indicate that LHQW prescription protects against the virus attack, and it has been recommended in the treatment of COVID-19 in China [47]. Some notable dangerous reactions include heart attacks, strokes, seizures, and sudden deaths. No use, distribution or reproduction is permitted which does not comply with these terms. Combined with western medicine conventional therapy in the treatment of 63 suspected cases of Coronavirus Disease 2019. 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. Yang C.X., Qu J., Liu Y.T., Meng S.W., Wang B.L., Feng M.Q., Sun Y. [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". 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). Available at: http://www.plantsoftheworldonline.org (Accessed December 18, 2021). aDepartment of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, PR China, bShanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200082, PR China, cShanghai TCM-Integrated Institute of Vascular Anomalies, Shanghai, 200082, PR China, dDepartment of Pharmacy, The First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, 310018, PR China, eDepartment of Pharmacy, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, 310018, PR China, fState Key Laboratory of Pharmaceutical Biotechnology, Department of Biotechnology and Pharmaceutical Sciences, School of Life Science, Nanjing University, Nanjing, 210023, PR China. Several limitations of our meta-analysis should be taken into consideration. These in vivo data further demonstrate the antiviral effects of LHQW as well as its lung protection role. China Med. Pregnancy & lactation. (2021). Chin. An official website of the United States government. conducted another single center clinical trial which was showed that seven days after treatment with LHQW granules (6g, tid) in conjunction with conventional treatment for COVID-19 patients had a total effective rate of 92.73 % accompanied by significantly reduced major symptoms including fever, cough, fatigue and chest tightness [41]. 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. 2019ZYC-A85), and the Scientific Research Projects of Hospital Pharmacy of Zhejiang Pharmaceutical Association (No. Analysis of curative effects of 51 patients with COVID-19 treated with Chinese medicine Lianhua Qingwen: a multicentre retrospective study. A network analysis of the Chinese medicine Lianhua-Qingwen formula to identify its main effective components. Alternat Med. 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. Case reports, unrelated studies, those with duplicate data, reviews, commentaries and animal-based studies were excluded from the current meta-analysis. Front. Traditional Chinese medicine has accumulated substantial clinical experience over thousands of years. 228 (2), 8390. Recently, Yu et al. 11 (31), 52605355. The documents were filtered and summarized for final evaluation. 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. Res. 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. Trials. doi:10.1136/bmj.d5928, Higgins, J. P., Thompson, S. G., Deeks, J. J., and Altman, D. G. (2003). Cheng D.Z., Li Y. Flow chart of the search and selection process. (2015). Wang C., Horby P.W., Hayden F.G., Gao G.F. A novel coronavirus outbreak of global health concern. In vitro, LHQW capsules could inhibit the proliferation of influenza viruses of various strain with the 50 % inhibitory concentration ranging from 0.35 to 2mg/mL [24]. In treating fine particulates PM2.5 (7.5mg/kg)-exposed model rats, LHQW significantly relieved the pathological changes of thickened alveolar septum, congestion of capillary, interstitial edema and infiltration of lymphocyte and neutrophil surrounding bronchiole [34]. Cheng D.Z., Wang W.J., Li Y., Wu X.D., Zhou B., Song Q.Y. J. Exp. 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]. The clinical application experience of LHQW has improved over the years, the clinical considers the patients condition, physical quality, and age, controls the amount of LHQW prescribed accordingly and thereby, reduced the likelihood of adverse reactions. What Is in a Name? (2002). Wang L., Yang Z.H., Zhang H.R., Yu H.X., Yang K., Fu B.H., Yang H.T. 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. 46 (5), 395400. 17 studies focused on the treatment of Influenza A (H1N1), 12 of which reported adverse reactions. Available at: https://chemrxiv.org/engage/chemrxiv/article-details/60c74908ee301c485bc799cf (Accessed July 23, 2021). Treatment of SARS-Cov-2: How Far Have We Reached? Vahl. Subgroup, sensitivity and meta-regression analyses were conducted to determine the potential sources of heterogeneity. Accessibility Further investigation confirmed that the combination treatment of LHQW capsules (200mg/kg/day) with oseltamivir (2mg/kg/day) markedly reduced IBV infection over the individual administration of either alone in vivo, proving that LHQW capsules could be used as an assistant drug to enhance the effect of oseltamivir against IBV infection [26]. It was found that the total effective rate of LHQW granules combined with abidor treatment (LHQW group) was significantly higher than that of abidor group (80.95 % vs 64.86 %), while the rate of severe illness was markedly lower (14.29 % vs 23.65 %) [44]. [Caprifoliaceae; Lonicerae Japonicae Flos], Gypsum Fibrosum, Isatis indigotica Fort. As adverse reactions in COVID-19 pneumonia and chronic obstructive pulmonary disease treatment were only reported for a limited number of studies, no sensitivity analysis for these diseases was conducted. Beggs test and Eggers test detected no visible publication bias for data from pooled studies and disease evaluation. Cytokine storm is an excessive immune response of the body to external stimuli such as viruses, which will stimulate the secretion of a large number of inflammatory factors and lead to cytokine cascade reaction [4,6].

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