lianhua qingwen contraindication lianhua qingwen contraindication
Subgroup, sensitivity and meta-regression analyses were conducted to explore the possible sources of heterogeneity across eligible studies. Mo H.Y., Yang Z.F., Zheng J.P., Mo Z.Y., Li Y.M., Xiao Z.L. 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. Control. In the evaluation of security indexes, LHQW group has a reduced incidence of respiratory system damage, skin and its appendages injury, nervous system damage and gastrointestinal system damage, along with other adverse reactions. 2020, 3196375. doi:10.1155/2020/3196375, Yao, K. T., Liu, M. Y., Li, X., Huang, J. H., and Cai, H. B. doi:10.1016/j.jep.2013.12.022. Use Overdosage Contraindications Special Precautions Adverse Reactions Storage MIMS Class ATC . Res. Study design was done by CH and BH. Six studies were included on treatment of herpes zoster and reported the adverse reactions. TABLE 2. 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 Cochrane Collaboration risk of bias tool comprising seven items was applied to assess the risk of bias of each eligible study (Higgins et al., 2011). 2017ZYY07). 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]. J. Chin. 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). Chin. LQ15H280003), the Clinical Research Projects of Zhejiang Medical Association (No. The quantitative analysis of all eligible studies. Though the quality of the included literature was mixed, the lung protection effects of LHQW was demonstrated. 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 mechanisms were mainly involved the antiviral activity, and regulation of inflammation response as well as immune function. Data analysis were done by CH and DZ. The inconsistent use of conventional drugs in individual studies, along with individual differences in drug absorption, may be factors underlying high heterogeneity. Case reports, unrelated studies, those with duplicate data, reviews, commentaries and animal-based studies were excluded from the current meta-analysis. Potential publication bias was assessed using Funnel plot, Beggs and Eggers test. Royal Botanic Gardens, Kew (2021). 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. [11] The pro-establishment DAB alliance was found to have distributed unregistered doses of LHQW, in breach of health regulations. Traditional Chinese medicine treatment maintains homeostasis through interactions between the body and pathogens or establishing a balance between stimulating antiviral responses and suppressing overactive immune responses that leads to tissue damage (Shi et al., 2021). Front. Further evaluation revealed that LHQW significantly inhibited SARS-CoV-2 replication in Vero E6 cells, markedly reduced pro-inflammatory cytokines (TNF-, IL-6, CCL-2/MCP-1 and CXCL-10/IP-10) production and resulted in abnormal particle morphology of virion in cells [30]. Beggs test and Eggers test detected no visible publication bias for data from pooled studies and disease evaluation. For pooled studies, the incidence of adverse reactions was lower in the LHQW group than the conventional drug group (RR = 0.63, 95% CI = 0.580.69, p < 0.001). HHS Vulnerability Disclosure, Help 6 (26), 8485. Liu, X. Y. 04:26. 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]. There was no statistically significant difference in the incidence of adverse reactions during treatment of herpes zoster between the LHQW group and the conventional drug group (RR = 0.80, 95% CI = 0.521.23, p = 0.302). 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. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Advances in Pharmacology and Clinical Research of Lianhua Qingwen Capsules. No adverse treatment-related effects were reported in all the included publications (from 2009 to 2011). Wang X., Ding Y.Q. Lianhua Qingwen can be a complementary strategy for treating COVID-19. System-Organ Code Retrieval Involved. National Administration of Traditional Chinese Medicine: Traditional Chinese Medicine Is Involved in a Wide Range of Treatment and Early Intervention Has Good Effects. Am. Wang Z., Chen X., Lu Y., Chen F., Zhang W. Clinical characteristics and therapeutic procedure for four cases with 2019 novel coronavirus pneumonia receiving combined Chinese and western medicine treatment. BMJ. Chin. Contraindications . Future related studies will provide accumulated evidence to clarify it. Effect of Lianhua Qingwen capsule on immunity of mice infected with flu virus. COVID-19 has led to a great case fatality. Batlle D., Wysocki J., Satchell K. Soluble angiotensin-converting enzyme 2: a potential approach for coronavirus infection therapy? Wang L., Yang Z.H., Zhang H.R., Yu H.X., Yang K., Fu B.H., Yang H.T. 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). Clin. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. To protect the interests of patients, the risk-benefit ratio of the drug needs to be considered in clinical applications. 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. Evid. The main characteristics of the eligible studies are summarized in Supplementary Table S1, while the composition of LHQW and how LHQW were reported in the original studies presented in Supplementary Table S2. doi:10.1126/science.367.6485.1412, Lei, X. 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. Conclusion: The current study provides potential a reference for the security of LHQW. 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]. Objectives: Lianhua Qingwen capsule/granule (LHQW) is an innovative patented traditional Chinese medicine with potential curative effects on respiratory diseases. Before doi:10.1371/journal.pmed.100009710.1136/bmj.b2535, Peng, L. L., Li, L., Shen, L., and Li, X. X. This work was supported by the National Natural Science Foundation of China (No. 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). We examined 54 studies on treatment of influenza, 42 of which reported adverse reactions. Further long-term high-quality studies are essential to validate our conclusions. Pharmacol. Nevertheless, pressing researches should be conducted to illuminate the unconfirmed effects, regulatory mechanisms and adverse reactions of LHQW in treating COVID-19. 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. Yiling Pharmaceutical (2020). Chin. (2002). Vahl (Lianqiao); Lonicera japonica Thunb. The risk ratio (RR) and 95% confidence interval (CI) were calculated for categorical variables. Available at: http://m.news.cctv.com/2020/03/17/ARTIEYQ2aws8fPYWQxjnynzo200317.shtml?from=singlemessage (Accessed Apirl 29, 2021). 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]. Broad Anti-viral Capacities of Lian-Hua-Qing-Wen Capsule and Jin-Hua-Qing-gan Granule and Rational Use against Covid-19 Based on Literature Mining. Traditional Chin. government site. Asia-Pacific Traditional Med. doi:10.1007/s12325-020-01351-9, Kupferschmidt, K., and Cohen, J. Additionally, LHQW group also had shorter time to recovery of fever, fatigue and coughing, and higher improvement rate in chest computed tomographic manifestations and clinical cure [43]. (Jinyinhua), Ephedra sinica Stapf (Mahuang), Armeniacae Amarum Semen (Kuxingren), Gypsum Fibrosuum (Shigao), Isatis tinctoria L. (Banlangen), Dryopteridis Crassirhizomatis Rhizoma (Mianmaguanzhong), Houttuynia cordata Thunb. ). Among the eight included studies on rheum therapy, six reported adverse reactions. The documents were filtered and summarized for final evaluation. [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. Percentage of risk of bias for all qualified studies. The site is secure. While LHQW has recently been approved for marketing by CFDA, its safety is yet to be conclusively established. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. We would like to express our appreciation to all authors of eligible studies which were included in the current meta-analysis. The current. The epidemic of 2019-novel-coronavirus (2019-nCoV) pneumonia and insights for emerging infectious diseases in the future. An official website of the United States government. 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]. There was no statistically significant difference in the incidence of psychiatric disorders between the LHQW group and the conventional drug group (RR = 1.00, 95% CI = 0.253.97, p = 1.000). Lv R.B., Wang W.J., Li X. World Health Organization Adverse Drug Reaction Terminology (2009). doi:10.1142/S0192415X20500378. (1990). (2020). (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). [Fabaceae; Glycyrrhizae Radix et Rhizoma] (85g) (Rivera et al., 2014; Royal Botanic Gardens, Kew, 2021; Royal Botanic Gardens, Kew science, 2021; The Plant List, 2021; Yiling Pharmaceutical, 2021). 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]. Due to the low quality of the clinical research, the accuracy of this conclusion needs to be conducted to verify. With gradual improvement of the adverse drug reaction monitoring system of China, reports of adverse reactions or events have increased. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. For thousands of years, traditional Chinese medicine (TCM) plays an important role in treating human diseases [[9], [10], [11], [12], [13], [14]]. Clin. There was no statistically significant difference in the incidence of adverse reactions during treatment of rheum between the LHQW group and the conventional drug group (RR = 0.46, 95% CI = 0.121.83, p = 0.270). Literature analysis of Chinese patent medicine treatment in the observation period of Clinical Management of Corona Virus Disease 2019 (trial 6th edition). Clinical effectiveness and case analysis in 54 NCP patients treated with Lanhuaqingwen granules. Li H.R., Chang L.P., Wei C., Jia Z.H. It is not registered as a COVID-19 medication, and a doctor's prescription is required for its use. No statistical difference was detected for sleepy. Anti-viral effects of Lianhua Qingwen capsule against influenza A virus. Recently, Yu et al. COPD is characterized by a chronic inflammatory response and can be worsened by acute exacerbations. Few reports of adverse reactions in the course of treating COVID-19 pneumonia with LHQW are available. 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. Nevertheless, none of the in vivo studies are directly focused on Corona virus or COVID-19. Otherwise, the fixed-effects model was used (DerSimonian and Laird, 1986; Higgins et al., 2003). No use, distribution or reproduction is permitted which does not comply with these terms. 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]. 367 (6485), 14121413. doi:10.3969/j.issn.1672-2809.2020.13.020, Liu, C. Y., Li, X. Q., and Cai, S. Q. As a library, NLM provides access to scientific literature. ADVERSE REACTION Uncertainty. Flow chart of the search and selection process. 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. "This medicine has a cooling effect so if you take this, lalo kang magchi -chill," he cautions. Pharmacol. 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. TABLE 1. The China National Medical Products Administration agency has officially approved LHQW for the treatment of mild or ordinary COVID-19 pneumonia (Ahsan et al., 2020; Cao et al., 2020; Chan et al., 2020; Khan et al., 2020; Kupferschmidt and Cohen, 2020). Eleven studies reported the treatment of viral influenza and adverse reactions. 2019ZYC-A85), and the Scientific Research Projects of Hospital Pharmacy of Zhejiang Pharmaceutical Association (No. Inclusion in an NLM database does not imply endorsement of, or agreement with, LHQW prescription (capsules type, or granules type) consists of 11 herbs, gypsum and menthol [18]. Yao K.T., Liu M.Y., Li X., Huang J.H., Cai H.B. Eval. However, the efficacy and safety of which shall be confirmed by more high-quality clinical trials. Protection against COVID-19 injury by qingfei paidu decoction via anti-viral, anti-inflammatory activity and metabolic programming. Finally, our data showed that LHQW reduces the incidence of a number of adverse reactions compared with conventional drugs. Traditional Chinese medicine, such as Lianhua Qingwen, has achieved some curative effect in many countries, but its effect is not clear. 13 (08), 676681. Systematic Review Registration: https://clinicaltrials.gov/, CRD-42020224180. During the study, no serious adverse events were reported. Federal government websites often end in .gov or .mil. (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). (10), 100. Niu Q.Q., Chen Y., Liu Y., Mao S.Z., Wang H., Zheng W.K., Zhang J.H. 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. Here, we performed a meta-analysis of 217 Chinese experimental studies to evaluate the safety of LHQW. The https:// ensures that you are connecting to the *Correspondence: Guoliang Zhang, zhangguoliang61@sina.com, These authors have contributed equally to this work, https://doi.org/10.3389/fphar.2022.764774, World Health Organization Adverse Drug Reaction Terminology (2009), https://www.frontiersin.org/articles/10.3389/fphar.2022.764774/full#supplementary-material, http://m.news.cctv.com/2020/03/17/ARTIEYQ2aws8fPYWQxjnynzo200317.shtml?from=singlemessage, https://mpns.science.kew.org/mpns-portal/, https://chemrxiv.org/engage/chemrxiv/article-details/60c74908ee301c485bc799cf, http://www.yiling.cn/contents/75/132.html. [5], Sources of its formulation reportedly consist of:[6], The medicine is both in capsule and granular form. 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). From SARS to COVID-19: pathogens, receptor, pathogenesis and principles of the treatment. Salvi R., Patankar P. Emerging pharmacotherapies for COVID-19. 28 (1), 1332. 12 (08), 140141. The term adverse reaction represents any undesired and unintended response that occurs with normal drug use (Gallelli et al., 2002). Study on treatment of "cytokine storm" by anti-2019-nCoV prescriptions based on arachidonic acid metabolic pathway. Pharmacol. 343, d5928. 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]. Ther. (2015). Experiments on animals using a combination of LHQW and oseltamivir to treat influenza B virus infections showed a potential inhibitory effect on overexpression of TNF-, MIP-1, RANTES, IFN-, IL-6, IL-8, IP-10, and MCP-1 at the mRNA level, and consequent prevented of the development of severe inflammatory reactions (Yang et al., 2020).
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