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TABLE 1. Five studies reported heart rate and arrhythmia as adverse events. The documents were filtered and summarized for final evaluation. Comprehensive analysis of influenza may provide a significant advantage in generalization of the conclusions. Besides, the effective rate of chest CT in the LHQW group was 69.39 %, which was higher than 62.84 % in abidor group [44]. 2015, 731765. doi:10.1155/2015/731765, Jin, L., Xu, Y., and Yuan, H. (2020). Clin. Wang S.H., Liu J.F., Zhang Y.L., Dong Z. Med. [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. Chinese Pharmacopoeia (2020). Federal government websites often end in .gov or .mil. LHQW prescription (capsules type, or granules type) consists of 11 herbs, gypsum and menthol [18]. 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. 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. Here, we performed a meta-analysis of 217 Chinese experimental studies to evaluate the safety of LHQW. In the evaluation of treating disease, the incidence of adverse reactions during treatment of influenza A (H1N1) and influenza were lower in the LHQW group compared to the conventional drug group. The discovery of potential effective drugs on the market becomes one of the principal means to develop antiviral drugs for COVID-19. Rev. To protect the interests of patients, the risk-benefit ratio of the drug needs to be considered in clinical applications. Clin. Hence, the researches on specific active components of LHQW are still important and the reduction of irrelevant ingredients may be related to less adverse reactions. (2015). LHQW has a reduced incidence of other adverse reactions compared to the conventional drug group (RR = 0.60, 95% CI = 0.430.84, p = 0.003). Zhi-Hui Zhang and Wen-Cheng Zhou collected literatures and made the illustration. 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). Figure 1 provides a detailed flowchart of the screening process. Lianhua Qingwen Capsules of Yiling Pharmaceutical Approved in mauritius. 14 (2), 6772. Mo H.Y., Yang Z.F., Zheng J.P., Mo Z.Y., Li Y.M., Xiao Z.L. 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 . Salvi R., Patankar P. Emerging pharmacotherapies for COVID-19. Pharmacol. J. Med. The current meta-analysis was performed to evaluate the safety profile of LHQW in relation to conventional drugs (PROSPERO CRD-42020224180). It warned that sellers who make claims that it can prevent, protect against or treat COVID-19 may face prosecution. The current. Methods: Comprehensive document retrieval was performed from both English and Chinese databases. 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. 1: An overview of approach to pharmacokinetics-based identification of potential therapeutic compounds from LianhuaQingwen, a Chinese herbal used as treatment for COVID-19. 46 (5), 395400. Guo H., Zhang Q.H., Yang J., Gong J.N., Zhao Y.S., Zhou X.P. Anal. Pharmacopoeia of Peoples Republic of China. There was no statistically significant difference in the incidence of adverse reactions during treatment of respiratory tract infection between the LHQW group and the conventional drug group (RR = 0.78, 95% CI = 0.581.03, p = 0.083). Flow chart of the search and selection process. Theoretical Study of the Anti-ncp Molecular Mechanism of Traditional Chinese Medicine Lianhua-Qingwen Formula (Lqf). [2] In the practice of TCM, LHQW is considered to have the effects of clearing excessive heat, removing toxins, improving lung ventilation, and discharging heat. 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. The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fphar.2022.764774/full#supplementary-material, Ahsan, W., Javed, S., Bratty, M. A., Alhazmi, H. A., and Najmi, A. Keywords: Liu, X. Y. Mechanism by which ma-xing-shi-gan-tang inhibits the entry of influenza virus. For hand-foot-mouth disease, sample size (p = 0.082), year of publication (p = 0.795), and treatment of the control group (p = 0.701) did not explain the issue of heterogeneity. 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]. [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". doi:10.1136/bmj.d5928, Higgins, J. P., Thompson, S. G., Deeks, J. J., and Altman, D. G. (2003). the contents by NLM or the National Institutes of Health. [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. Few reports of adverse reactions in the course of treating COVID-19 pneumonia with LHQW are available. Meta-analysis in Clinical Trials. Study on the network pharmacology and evidences of Lianhua Qingwen in the treatment of Novel Coronavirus (2019 nCoV) Pneumonia. 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]. The quantitative analysis of all eligible studies. doi:10.1016/0197-2456(86)90046-2, Duval, S., and Tweedie, R. (2000). An outbreak of Coronavirus Disease 2019 (COVID-19) which was infected by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is still spreading and has led to unprecedented health emergency over the world. Drug Discov. Drugs and Clinic. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). COPD is characterized by a chronic inflammatory response and can be worsened by acute exacerbations. We would like to express our appreciation to all authors of eligible studies which were included in the current meta-analysis. (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). doi:10.1056/NEJMc2008043, Cao, L. J. official website and that any information you provide is encrypted Drafting of the manuscript was done by CH and BH. 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. Ren Y., Yao M.C., Huo X.Q., Gu Y., Zhu W.X., Qiao Y.J., Zhang Y.L. In addition, LHQW treatment efficiently impaired the nuclear export of the viral RNPl [24]. 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]. Language links are at the top of the page across from the title. Most patients infected with the coronavirus are showing mild symptoms, taking Lianhua Qingwen Capsule as early as possible, the effect will be obvious, It [sic] can recover 91.5% of mild cases and . 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]. Although the data were far from adequate, the latest advances had shown the benefits of LHQW in COVID-19, especially in combination with other antiviral drugs. The latest meta-analysis by Fan et al. 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. 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. Hsieh C.F., Lo C.W., Liu C.H., Lin S., Yen H.R., Lin T.Y., Horng J.T. The literature materials were collected from the scientific databases including the Pubmed, CNKI and Web of Science (up to August 8, 2020), on ethnobotany and ethno medicines. Clin. 12 (08), 140141. Homogeneity of baseline data was reported in most studies. Batlle D., Wysocki J., Satchell K. Soluble angiotensin-converting enzyme 2: a potential approach for coronavirus infection therapy? Wu et al. Available at: https://mpns.science.kew.org/mpns-portal/(Accessed December 19, 2021). Plants of the World Online. Drug Related Hospital Admissions: the Role of Definitions and Intensity of Data Collection, and the Possibility of Prevention. Trials. Future related studies will provide accumulated evidence to clarify it. Avoid prolonged use. 17 (13), 6264. 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. f. & Thoms.) Control. 66 (6), 771777. Copyright 2022 Hu, He, Gong, Liang, Zhao and Zhang. As Chinese Pharmacopoeia records, LHQW consists of 13 ingredients: Forsythia suspensa (Thunb.) Advances in Pharmacology and Clinical Research of Lianhua Qingwen Capsules. Traditional Chinese medicine Lianhua Qingwen capsule has been proven effective for the treatment of COVID-19, China's top respiratory expert Zhong Nanshan said in a webinar with overseas Chinese students on Monday. Accessibility Results: In total, 217 experimental studies were included. Sci.). Medicine (Baltimore). (Guanghuoxiang), Rheum palmatum L. (Dahuang), Rhodiola rosea Linn. Qualitative and Quantitative Analysis of the Major Constituents in Chinese Medical Preparation Lianhua-Qingwen Capsule by UPLC-DAD-QTOF-MS. ScientificWorldJournal. Available at: http://www.theplantlist.org/(Accessed December 18, 2021). Lianhua Qingwen (LHQW) is a commonly used Chinese medical preparation to treat viral influenza, including in the fight against SARS in 20022003 in China. Asia-Pacific Traditional Med. The complex components of LHQW stand for multiple targets and pleiotropic effects, but may also lead to more ADRs. 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. (2020). Bras (1992). (2015). Seven studies reported the adverse reactions of hepatobiliary system damage. 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. 2020, 5157089. doi:10.1155/2020/5157089, Huang, N. L., Huang, H. M., Zhang, B. Y., and Xie, J. 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. Li Q., Yin J., Ran Q.S., Yang Q., Liu L., Zhao Z., Li Y.J., Chen Y., Sun L.D., Wang Y.J., Weng X.G., Cai W.Y., Zhu X.X. Publication bias data are shown in Table 2 and the Funnel plot of pooled studies presented in Figure 3. Pharmacol. Besides, in view of the definite effects of LHQW in preventing severe viral infections such as SARS and COVID-19 [17,44,45,49,52,53], LHQW may represent a considerable and effective strategy against unknown viral epidemics. 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.

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