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. 2022 Jul 1;28(7):650–660. doi: 10.1007/s11655-022-3578-8

Efficacy and Safety of Lianhua Qingwen for Patients with COVID-19: A Systematic Review and Meta-Analysis

Xiao-hu Sun 1,2, Shuo Zhang 3, Zhen Yang 4, Zhen-lin Chen 5, Shi-jun Yue 1, Sai Zhang 1, Yu-ping Tang 1,
PMCID: PMC9247911  PMID: 35776293

Abstract

Background

Corona virus disease 2019 (COVID-19) has spread around the world since its outbreak, and there is no ascertained effective drug up to now. Lianhua Qingwen (LHQW) has been widely used in China and overseas Chinese, which had some advantages in the treatment of COVID-19.

Objective

To evaluate the efficacy and safety of LHQW for COVID-19 by conducting a systematic review with meta-analysis.

Methods

A comprehensive literature search was conducted in 12 electronic databases from their establishment to October 30, 2021. Note Express 3.2.0 was used for screening of trials, and the data was independently extracted in duplicate by 2 researchers. The risk of bias of randomized controlled trials (RCTs) and retrospective studies were assessed by using the Cochrane collaboration tool and Newcastle Ottawa Scale, respectively, followed by data analysis using RevMan 5.3. The RCTs or retrospective studies to treat COVID-19 using LHQW were included. The intervention measures in the experimental group were LHQW alone or combined with chemical drugs (LCWC), and that in the control group were chemical drugs (CDs). Outcome measures included computed tomography (CT) recovery rate, disappearance rates of primary (fever, cough, fatigue), respiratory, gastrointestinal and other symptoms, exacerbation rate and adverse reaction. Subgroup analysis was conducted according to whether LHQW was combined with CDs and the different treatment methods in the control group.

Results

Nine trials with 1,152 participants with COVID-19 were included. The CT recovery rates of LHQW and LCWC were 1.36 and 1.32 times of CDs, respectively (P<0.05). Compared with CDs, LCWC remarkably increased the disappearance rates of fever, cough, fatigue, expectoration, shortness of breath, and muscle soreness (P<0.05). LHQW also obviously decreased the exacerbation rate, which was 0.45 times of CDs alone (P<0.05). There was no obvious difference between LCWC and CDs in adverse reaction (P>0.05).

Conclusions

LHQW was more suitable for treating COVID-19 patients with obvious expectoration, shortness of breath and muscle soreness. LHQW had advantages in treating COVID-19 with no obvious exacerbation. (PROSPERO No. CRD42021235937)

Electronic Supplementary Material

Supplementary material (Appendixes 1–5) is available in the online version of this article at 10.1007/s11655-022-3578-8.

Keywords: Lianhua Qingwen, COVID-19, 2019-nCoV, systematic review, meta-analysis, Chinese medicine

Electronic supplementary material

11655_2022_3578_MOESM1_ESM.pdf (93.5KB, pdf)

Appendix 1. PRISMA Flow Diagram of Literature Selection

11655_2022_3578_MOESM2_ESM.pdf (126.2KB, pdf)

Supplementary material, approximately 126 KB.

Author Contributions

Sun XH, Zhang Sh and Tang YP were responsible for the conception and design of the study; Sun XH, Zhang Sh, Yang Z, Chen ZL, Yue SJ and Zhang S conducted the statistical analysis, drew the tables and pictures, and drafted the manuscript; Sun XH, Zhang Sh and Chen ZL retrieved the database, screened the trials, extracted the data, evaluated the methodological quality. All authors critically revised the manuscript and approved the fi nal version.

Conflict of Interest

The authors have no potential conflicts of interest to declare.

Footnotes

Supported by the Key Research and Development Program of Shaanxi (No. 2019ZDLSF04-05), Subject Innovation Team of Shaanxi University of Chinese Medicine (No. 2019-YL10)

References

  • 1.Chakraborty C, Sharma AR, Sharma G, Bhattacharya M, Lee SS. SARS-CoV-2 causing pneumonia-associated respiratory disorder (COVID-19): diagnostic and proposed therapeutic options. Eur Rev Med Pharmacol Sci. 2020;24:4016–4026. doi: 10.26355/eurrev_202004_20871. [DOI] [PubMed] [Google Scholar]
  • 2.Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020;109:102433. doi: 10.1016/j.jaut.2020.102433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3.NationalProvincial Health Commissions . Real time big data report on the epidemic situation of COVID-19 pneumonia. 2022. [Google Scholar]
  • 4.Wissem H, Nadia BL. COVID-19: main therapeutic options. Tunis Med. 2020;98:299–303. [PubMed] [Google Scholar]
  • 5.Duan ZP, Jia ZH, Zhang J, Liu S, Chen Y, Liang LC, et al. Natural herbal medicine Lianhuaqingwen Capsule anti-influenza A (H1N1) trial: a randomized, double blind, positive controlled clinical trial. Chin Med J. 2011;124:2925–2933. [PubMed] [Google Scholar]
  • 6.Yuan B. Chinese medicine, which targets body’s response state, is an effective way to treat epidemic infectious diseases. Chin J Integr Med. 2022;28:168–175. doi: 10.1007/s11655-020-3324-z. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Ji XY, Ma Y, Shi S, Liu SH, Tong L, Lu C, et al. Chin J Integr Med. 2022. Medication rule analysis of the diagnosis and treatment programs of Chinese medicine for the prevention and treatment of COVID-19 in China. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Ren JL, Zhang AH, Wang XJ. Traditional Chinese medicine for COVID-19 treatment. Pharmacol Res. 2020;155:104743. doi: 10.1016/j.phrs.2020.104743. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Liu M, Gao Y, Yuan Y, Yang KL, Shi SZ, Zhang JH, et al. Efficacy and safety of integrated traditional Chinese and Western medicine for corona virus disease 2019 (COVID-19): a systematic review and meta-analysis. Pharmacol Res. 2020;158:104896. doi: 10.1016/j.phrs.2020.104896. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 10.Zheng SC, Baak JP, Li S, Xiao WK, Ren H, Yang H, et al. Network pharmacology analysis of the therapeutic mechanisms of the traditional Chinese herbal formula Lian Hua Qing Wen in corona virus disease 2019 (COVID-19), gives fundamental support to the clinical use of LHQW. Phytomedicine. 2020;79:153336. doi: 10.1016/j.phymed.2020.153336. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.National Health Commission of the People’s . Republic of China. Guidelines for the diagnosis and treatment of COVID-19 pneumonia. 2020. [Google Scholar]
  • 12.Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097. doi: 10.1371/journal.pmed.1000097. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 13.Luchini C, Stubbs B, Solmi M, Veronese N. Assessing the quality of studies in meta-analyses: advantages and limitations of the Newcastle Ottawa Scale. World J Meta Anal. 2017;5:80–84. doi: 10.13105/wjma.v5.i4.80. [DOI] [Google Scholar]
  • 14.Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;97:557–560. doi: 10.1136/bmj.327.7414.557. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Sedgwick P, Marston L. How to read a funnel plot in a meta-analysis. BMJ. 2015;351:h4718. doi: 10.1136/bmj.h4718. [DOI] [PubMed] [Google Scholar]
  • 16.Chen JJ, Zhou YL, Chen FG, Liu X, Chen YL, Wang S. Clinical study on treatment of COVID-19 in convalescent period treated with Lianhua Qingwen Capsule combined with interferon α-2b. Adv Clin Med (Chin) 2020;10:1144–1149. doi: 10.12677/ACM.2020.106174. [DOI] [Google Scholar]
  • 17.Cheng DZ, Wang WJ, Li Y, Wu XD, Zhou B, Song QY. Analysis of curative effect of 51 patients with novel coronavirus pneumonia treated with Chinese medicine Lianhua Qingwen: a multicentre retrospective study. Tianjin J Tradit Chin Med (Chin) 2020;37:509–516. [Google Scholar]
  • 18.Fang F, Yang L, Qin SC, Jiao R. Lianhua Qingwen Granule in the treatment of 42 children suspected cases of COVID-19. Chin New Drugs (Chin) 2020;29:2809–2812. [Google Scholar]
  • 19.Hu K, Guan WJ, Bi Y, Zhang W, Li LJ, Zhang BL, et al. Efficacy and safety of Lianhuaqingwen Capsules, a repurposed Chinese herb, in patients with coronavirus disease 2019: a multicenter, prospective, randomized controlled trial. Phytomedicine. 2020;85:153242. doi: 10.1016/j.phymed.2020.153242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 20.Lv RB, Wang WJ, Li X. Clinical observation on Lianhua Qingwen Granules combined with Western medicine conventional therapy in the treatment of 63 suspected cases of coronavirus disease 2019. J Tradit Chin Med (Chin) 2020;61:655–659. [Google Scholar]
  • 21.Xu XH, Dong H, Tu SH, Zhang MM, Liu D, Zhang HQ, et al. Retrospective analysis of Jinye Budu Granule and Lianhua Qinwen Capsule in the treatment of common type COVID-19. Res Integr Tradit Chin West Med (Chin) 2020;12:383–386. [Google Scholar]
  • 22.Yao KT, Liu MY, Li X, Huang JH, Cai HB. Retrospective clinical analysis on treatment of coronavirus disease 2019 with traditional Chinese medicine Lianhua Qingwen. Chin Exp Tradit Med Form (Chin) 2020;26:8–12. [Google Scholar]
  • 23.Yu P, Li YZ, Wan SB, Wang Y. Effects of Lianhua Qingwen Granules plus arbidol on treatment of mild corona virus disease-19. Chin Pharm J (Chin) 2020;55:1042–1045. [Google Scholar]
  • 24.Yu HY, Ren XH, Qi XX, Zuo Q, Liu D. Efficacy study of arbidol, Qingfei Paidu Decoction, Lianhua Qingwen Capsule and Jinye Baidu Granules in the treatment of mild/moderate COVID-19 in a Fangcang Shelter Hospital. Chin Assoc Chin Med (Chin) 2020;36:2–6. [Google Scholar]
  • 25.Hu CY, Liang MM, Gong FF, He B, Zhao DD, Zhang GL. Efficacy of Lianhua Qingwen compared with conventional drugs in the treatment of common pneumonia and COVID-19 pneumonia: a meta-analysis. Evid Based Complement Alternat Med. 2020;2020:5157089. doi: 10.1155/2020/5157089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26.Liu M, Gao Y, Yuan Y, Yang KL, Shi SZ, Tian JH, et al. Efficacy and safety of herbal medicine (Lianhuaqingwen) for treating COVID-19: a systematic review and meta-analysis. Integr Med Res. 2021;10:100644. doi: 10.1016/j.imr.2020.100644. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Zeng MJ, Li LJ, Wu ZQ. Traditional Chinese medicine Lianhua Qingwen treating corona virus disease 2019 (COVID-19): meta-analysis of randomized controlled trials. PLoS One. 2020;15:e0238828. doi: 10.1371/journal.pone.0238828. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 28.Li GD, Clercq ED. Therapeutic options for the 2019 novel coronavirus (2019nCoV) Nat Rev Drug Discov. 2020;19:149–150. doi: 10.1038/d41573-020-00016-0. [DOI] [PubMed] [Google Scholar]
  • 29.Pan WQ, Li RF, Hou YL, Huang JC, Ma QH, Shi YX, et al. Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARSCoV2) Pharmacol Res. 2020;156:104761. doi: 10.1016/j.phrs.2020.104761. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 30.Wang SH, Liu JF, Zhang YL, Dong Z. Systematic review of efficacy and safety of Lianhua Qingwen Capsules in treatment of viral influenza. Chin J Chin Mater Med (Chin) 2019;44:1503–1508. doi: 10.19540/j.cnki.cjcmm.20190102.001. [DOI] [PubMed] [Google Scholar]
  • 31.Ding Y, Zeng L, Li R, Chen QY, Zhou BX, Chen OL, et al. The Chinese prescription Lianhuaqingwen Capsule exerts anti-influenza activity through the inhibition of viral propagation and impacts immune function. BMC Complement Alternat Med. 2017;17:130. doi: 10.1186/s12906-017-1585-7. [DOI] [PMC free article] [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

11655_2022_3578_MOESM1_ESM.pdf (93.5KB, pdf)

Appendix 1. PRISMA Flow Diagram of Literature Selection

11655_2022_3578_MOESM2_ESM.pdf (126.2KB, pdf)

Supplementary material, approximately 126 KB.


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