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ObjectiveTo analyze relevant literature on Lianhua Qingwen preparations and clarify the research advances and hot spots in this field， so as to provide references for clinical rational application and further research. MethodLiterature related to Lianhua Qingwen preparations in the recent 10 years was retrieved from six databases， including China National Knowledge Infrastructure（CNKI）， VIP， Wanfang Data， PubMed， and Web of Science， followed by management and analysis by NoteExpress and CiteSpace. ResultFinally， 344 and 76 Chinese and English research articles were included， and the number of publications increased in recent years. The research articles were published in 162 Chinese and 48 English journals. Shijiazhuang Yiling Pharmaceutical Co.， Ltd. and Guangzhou Medical University were institutions with the largest number of Chinese and English publications， respectively. LIU Minyan was the author who had published the most articles. Keywords with high frequency included clinical efficacy， Lianhua Qingwen， inflammatory factors， traditional Chinese medicine， and coronavirus disease-2019（COVID-19）. Nineteen clusters， including clinical efficacy， Chinese medicine， Lianhua Qingwen， COVID-19， and influenza A virus， and 47 emergent keywords， including herpes zoster， pneumonia， inflammatory factors， influenza， and gut microbiota， were generated. ConclusionCooperation and exchanges in this field are insufficient. Research focuses on the clinical efficacy of Lianhua Qingwen in the treatment of COVID-19 and other diseases， pharmacological action and mechanism of antiviral drugs， and micro-mechanism research focuses on related pathways and target proteins， as well as the combination of Chinese and western medicines.
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The COVID-19 pandemic has resulted in excess deaths worldwide. Conventional antiviral medicines have been used to relieve the symptoms, with limited therapeutic effect. In contrast, Lianhua Qingwen Capsule is reported to exert remarkable anti-COVID-19 effect. The current review aims to: 1) uncover the main pharmacological actions of Lianhua Qingwen Capsule for managing COVID-19; 2) verify the bioactive ingredients and pharmacological actions of Lianhua Qingwen Capsule by network analysis; 3) investigate the compatibility effect of major botanical drug pairs in Lianhua Qingwen Capsule; and 4) clarify the clinical evidence and safety of the combined therapy of Lianhua Qingwen Capsule and conventional drugs. Numerous bioactive ingredients in Lianhu Qingwen, such as quercetin, naringenin, β-sitosterol, luteolin, and stigmasterol, were identified to target host cytokines, and to regulate the immune defence in response to COVID-19. Genes including androgen receptor (AR), myeloperoxidase (MPO), epidermal growth factor receptor (EGFR), insulin (INS), and aryl hydrocarbon receptor (AHR) were found to be significantly involved in the pharmacological actions of Lianhua Qingwen Capsule against COVID-19. Four botanical drug pairs in Lianhua Qingwen Capsule were shown to have synergistic effect for the treatment of COVID-19. Clinical studies demonstrated the medicinal effect of the combined use of Lianhua Qingwen Capsule and conventional drugs against COVID-19. In conclusion, the four main pharmacological mechanisms of Lianhua Qingwen Capsule for managing COVID-19 are revealed. Therapeutic effect has been noted against COVID-19 in Lianhua Qingwen Capsule.
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Humans , COVID-19 , Pandemics , Drugs, Chinese Herbal/therapeutic use , Antiviral Agents/therapeutic use , COVID-19 Drug TreatmentABSTRACT
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with high pathogenicity and infectiousness has become a sudden and lethal pandemic worldwide. Currently, there is no accepted specific drug for COVID-19 treatment. Therefore, it is extremely urgent to clarify the pathogenic mechanism and develop effective therapies for patients with COVID-19. According to several reliable reports from China, traditional Chinese medicine (TCM), especially for three Chinese patent medicines and three Chinese medicine formulas, has been demonstrated to effectively alleviate the symptoms of COVID-19 either used alone or in combination with Western medicines. In this review, we systematically summarized and analyzed the pathogenesis of COVID-19, the detailed clinical practice, active ingredients investigation, network pharmacology prediction and underlying mechanism verification of three Chinese patent medicines and three Chinese medicine formulas in the COVID-19 combat. Additionally, we summarized some promising and high-frequency drugs of these prescriptions and discussed their regulatory mechanism, which provides guidance for the development of new drugs against COVID-19. Collectively, by addressing critical challenges, for example, unclear targets and complicated active ingredients of these medicines and formulas, we believe that TCM will represent promising and efficient strategies for curing COVID-19 and related pandemics.
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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).
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Humans , COVID-19/drug therapy , Cough/drug therapy , Drugs, Chinese Herbal/adverse effects , Dyspnea/drug therapy , Fatigue/drug therapy , Myalgia/drug therapyABSTRACT
BACKGROUND@#Coronavirus disease 2019 (COVID-19) has become a worldwide life-threatening pandemic. Lianhua Qingwen is believed to possess the ability to treat or significantly improve the symptoms of COVID-19. These claims make it important to systematically evaluate the effects of using Lianhua Qingwen with Western medicine to treat COVID-19.@*OBJECTIVE@#To evaluate the safety and efficacy of combination therapy, employing Lianhua Qingwen with Western medicine, to treat COVID-19, using a meta-analysis approach.@*SEARCH STRATEGY@#China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Embase, and Cochrane Library databases were searched for studies evaluating the effect of Lianhua Qingwen-Western medicine combination therapy in the treatment of COVID-19.@*INCLUSION CRITERIA@#(1) Research object: hospitalized patients meeting the diagnostic criteria of COVID-19 were included. (2) Intervention measures: patients in the treatment group received Lianhua Qingwen treatment combined with Western medicine, while the control group received either Western medicine or Chinese medicine treatment. (3) Research type: randomized controlled trials and retrospective study were included.@*DATA EXTRACTION AND ANALYSIS@#Two researchers extracted the first author, the proportion of males and females, age, body temperature, course of treatment, rate of disappearance of main symptoms, duration of fever, adverse reactions, and total effectiveness from the literature. Odds ratio (OR) and 95% confidence interval (CI) were used as the effect value for count data, and mean difference (MD) and 95% CI were used as the effect value for measurement data.@*RESULTS@#Six articles met the inclusion criteria, including a total of 856 COVID-19 patients. The meta-analysis showed that Lianhua Qingwen combination therapy achieved higher rates of fever reduction (OR = 3.43, 95% CI [1.78, 6.59], P = 0.0002), cough reduction (OR = 3.39, 95% CI [1.85, 6.23], P < 0.0001), recovery from shortness of breath (OR = 10.62, 95% CI [3.71, 30.40], P < 0.0001) and recovery from fatigue (OR = 2.82, 95% CI [1.44, 5.53], P = 0.003), higher total effectiveness rate (OR = 2.51, 95% CI [1.73, 3.64], P < 0.00001), and shorter time to recovery from fever (MD = -1.00, 95% CI [-1.04, 0.96], P < 0.00001), and did not increase the adverse reaction rate (OR = 0.65, 95% CI [0.42, 1.01], P = 0.06), compared to the single medication control.@*CONCLUSION@#The Lianhua Qingwen and Western medicine combination therapy is highly effective for COVID-19 patients and has good clinical safety. As only a small number of studies and patients were included in this review, more high-quality, multicenter, large-sample-size, randomized, double-blind, controlled trials are still needed for verification.
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Female , Humans , Male , COVID-19 , Drugs, Chinese Herbal , Multicenter Studies as Topic , Pandemics , Randomized Controlled Trials as Topic , Retrospective Studies , SARS-CoV-2ABSTRACT
The Lianhua Qingwen (LHQW) capsule is a popular traditional Chinese medicine for the treatment of viral respiratory diseases.In particular,it has been recently prescribed to treat infections caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).However,due to its complex composi-tion,little attention has been directed toward the analysis of chemical constituents present in the LHQW capsule.This study presents a reliable and comprehensive approach to characterizing the chemical constituents present in LHQW by high-performance liquid chromatography-Q Exactive-Orbitrap mass spectrometry (HPLC-Q Exactive-Orbitrap-MS) coupled with gas chromatography-mass spectrometry(GC-MS).An automated library alignment method with a high mass accuracy (within 5 ppm) was used for the rapid identification of compounds.A total of 104 compounds,consisting of alkaloids,flavonoids,phenols,phenolic acids,phenylpropanoids,quinones,terpenoids,and other phytochemicals,were suc-cessfully characterized.In addition,the fragmentation pathways and characteristic fragments of some representative compounds were elucidated.GC-MS analysis was conducted to characterize the volatile compounds present in LHQW.In total,17 compounds were putatively characterized by comparing the acquired data with that from the NIST library.The major constituent was menthol,and all the other compounds were terpenoids.This is the first comprehensive report on the identification of the major chemical constituents present in the LHQW capsule by HPLC-Q Exactive-Orbitrap-MS,coupled with GC-MS,and the results of this study can be used for the quality control and standardization of LHQW capsules.
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Objective To evaluate the efficacy and safety of Llianhua Qingwen capsule versus oseltamivir in the treatment of influenza. Methods Data from PubMed, Cochrane Library, Embase, VIP, CNKI and CBM, RCTs about Lianhua Qingwen capsule or Lianhua Qingwen capsule combined with other drugs (trial group) versus oseltamivir (control group) in the influenza were collected. The outcome indicators such as the effective rate of extraction, the time for viral nucleic acid to become negative, the time for fever and the time for symptom resolution, etc., were used for Meta analysis with RevMan 5.3 statistical software. Results Totally 14 studies were included, involving 1459 patients. The Meta analysis results showed that there was no significant difference in the therapeutic effect, the time of virus turning negative and defervescence, and fever reduction time in the experimental group compared with the control group. In terms of symptom relief, the effect of cough and headache resolution in the experimental group was better than that in the control group, and the difference was statistically significant. There was no significant difference in the time to subside of general muscle soreness and pharyngeal pain in the test group and the control group. In terms of safety, there was no statistically significant difference in the incidence of adverse reactions between the experimental group and the control group. Conclusion Lianhua Qingwen capsule is similar to oseltamivir phosphate in curative effect and adverse reaction rate in the treatment of influenza, and is superior to oseltamivir in relieving cough and headache symptoms.
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The innovation and patent layout of traditional Chinese medicine compounds reflects the innovation level of the traditio-nal Chinese medicine industry to a certain extent. Lianhua Qingwen Formula was taken as an example to analyze the innovation and patent layout of traditional Chinese medicine compounds. The study first proposed an innovative technology system for traditional Chinese medicine compounds, and then analyzed the advantages and disadvantages of Lianhua Qingwen Formula in innovation and patent layout based on 56 patents and other relevant patents. The analysis results showed that Lianhua Qingwen Formula had the following characte-ristics in terms of patent layout. In terms of innovation technical route, the patented technical route of Lianhua Qingwen Formula was mainly based on the composition and preparation of granules as the first choice, followed by corresponding process improvements, new uses, and detection methods as the main improvement routes. In terms of the corresponding patent layout, the basic patent protection scope of Lianhua Qingwen Formula completely covered marketed drugs, and then took new functions as the main layout strategy for subsequent patent applications. With the advancement of modern technical means, the preparation process and testing methods have been optimized continuously. At the same time, the international patent layout was given the priority in domestic patent application. Based on the above characteristics, the study gave suggestions for follow-up innovation and patent work for Lianhua Qingwen Formula, so as to provide enlightenment for other traditional Chinese medicine companies in exploring original innovation of traditional Chinese medicine compounds, improving innovative methods, and enhancing the ability of patent layout of innovative achievements.
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Drugs, Chinese Herbal , Medicine, Chinese Traditional , Research Design , TechnologyABSTRACT
To systematically evaluate the clinical efficacy and safety of Lianhua Qingwen in the treatment of adult pneumonia. The randomized controlled trial of Lianhua Qingwen combined with conventional Western medicine in the treatment of pneumonia were retrieved from PubMed, EMbase, Wanfang database, VIP database, and CNKI from the establishment of database to March 2020. Two researchers independently conducted literature screening and data extraction, and the third researcher was in charge of arbitration in case of any disagreement. Outcome indicators included total clinical effective rate, symptom improvement time, and incidence of adverse events. R 3.6.1 was used for Meta-analysis, and RevMan 5.3 was used for quality evaluation. Twenty-two studies were included, with a total of 2 007 patients, including 1 017 patients in the experimental group and 990 patients in the control group. The results showed that the total clinical effective rate of the experimental group was higher than that of the control group(RR=1.11, 95%CI[1.08, 1.15], P<0.001), and the antifebrile time(MD=-1.81, 95%CI[-2.42,-1.21], P<0.001), cough duration(MD=-2.32, 95%CI[-2.89,-1.76], P<0.001), rale duration(MD=-2.19, 95%CI[-2.74,-1.63], P<0.001), imaging recovery time(MD=-2.17, 95%CI[-2.76,-1.58], P<0.001) and post-treatment CRP(MD=-4.07, 95%CI[-6.39,-1.75], P<0.001] were all significantly lower than those of the control group. However, it did not proved that the experimental group was safer than the control group(RR=0.84, 95%CI[0.57, 1.24], P=0.382). The results confirmed that Lianhua Qingwen combined with conventional Western medicine in the treatment of pneumonia could improve the clinical treatment efficiency, shorten the time of fever, cough, rale disappearance and imaging recovery, improve CRP index and accelerate the recovery of pneumonia patients. However, the literatures included in this study had a low quality, and the conclusions still need to be further confirmed by more high-quality, multi-center, rigorously designed randomized controlled trial.
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Adult , Humans , Cough , Drugs, Chinese Herbal/adverse effects , Pneumonia/drug therapy , Treatment OutcomeABSTRACT
Objective:To explore the clinical diagnosis and treatment characteristics as well as the optimal schemes of Lianhua Qingwen Capsule in the treatment of upper respiratory tract infection （URTI） in the real world. Method:The information of 454 patients receiving Lianhua Qingwen Capsule for URTI was collected from the electronic medical data warehouse constructed by the Institute of Basic Research in Clinical Medicine， China Academy of Chinese Medical Sciences， which covered 16 large-scale tertiary Class A hospital information systems （HISs）. The harvested information was subjected to descriptive analysis， Apriori algorithm-based analysis and Louvain （BGLL） algorithm-based complex network analysis to explore the clinical medication schemes. Result:The commonly adopted medication schemes were heat-clearing and detoxicating Chinese medicinal injections combined with expectorants， analgesic-antipyretic drugs， or antibacterial agents in western medicine. Besides， the combination with heat-clearing and phlegm-resolving Chinese medicinals， vitamins， or hypotensive， lipid-lowering， hypoglycemic， coronary circulation-improving， or antiplatelet aggregation drugs targeting the underlying diseases was also detectable. Conclusion:The complex network analysis based on BGLL clustering method can be used to find out the medication rules of Lianhua Qingwen Capsule for URTI. The traditional Chinese medicine has been widely employed for resolving phlegm and relieving cough due to its good efficacy. The combination with antibiotics follows the guidelines for the use of antimicrobial agents. Drug safety is one of the most concerned aspects in clinical drug combination. The uncovering of these rules has provided a direction for exploring the optimal treatments.
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The outbreak of COVID-19 posed a huge threat to human health and social stability. With the rapid spread of the virus around the world, the drug development and related research of novel coronavirus (SARS-CoV-2) have become an urgent issue in the medical field. COVID-19 fails into the category of epidemics in the theory of TCM. LHQW capsule has repeatedly played an important role in many major epidemics. Previous studies have shown that LHQW capsule can inhibit the biological activity of varied viruses including MERS-CoV and SARS-CoV. The paper summarizes the relevant research data and achievements of LHQW capsule in the past few years, reviews the chemical constituents, clinical efficacy and pharmacological effects of LHQW capsule, and provides scientific basis for the anti-virus mechanism of LHQW capsule and clinical treatment of COVID-19.
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OBJECTIVE: To discuss the effects of Lianhua Qingwen granules plus arbidol on treatment of mild corona virus disease-19 (COVID-19). METHODS: A total of 295 COVID-19 patients (2020.2.17-2020.3.6) in Wuhan Third Hospital were chosen and randomly assigned to control group (n=148) and observation group (n=147). The control group orally took arbidol and the observation group took Lianhua Qingwen granules and arbidol. TCM symptom scores, white blood count (WBC), lymphocyte count (LYM), C-reactive protein (CRP), procalcitonin (PCT) and chest CT review conditions were compared. RESULTS: Total effective rate in the observation group was significantly higher than control group ((80.95% vs. 64.86%); severe transfer rate in the observation group was lower than control group (14.29% vs. 23.65%) (P0.05); after 7 d of treatment, TCM syndromes like fever, weakness, cough, throat dryness and sore and chest discomfort, CRP and PCT levels in the observation group were significantly lower than control group (P0.05); WBC and LYM levels in the observation group were significantly higher than control group (P0.05); based on CT review, effective cure rate in the observation group (69.39%) and control group (62.84%) was not significantly different (P0.05). Both of groups had no serious adverse reactions. CONCLUSION: Lianhua Qingwen granules combined with arbidol can relieve the clinical symptoms, adjust the inflammatory factors, increase the curative effects and reduce the severe transfer rate.
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Objective: To systematically evaluate the efficacy of Lianhua Qingwen (LQC) on COVID-19, and provide evidence for the formulation and optimization of clinical therapy on COVID-19. Methods: Six databases (PubMed, Cochrane Library, Wanfang, Weipu, CBM and CNKI) were searched up to May 27, 2020. The Cochrane collaborative bias risk tool was used for risk evaluation and quality assessment; Meta-analysis was carried out by Stata 15 software. Begg's test was used for publication bias. Results: Seven clinical trials were included with 665 COVID-19 patients. Compared with Western medicine alone, integrated Lianhua Qingwen significantly improved the effective rate of clinical symptoms [RR = 1.24, 95% CI (1.12, 1.38), P < 0.05] of COVID-19, increased CT improvement [RR = 1.14, 95% CI (1.02, 1.28), P < 0.05] and reduced the proportion of progressing into sever clinical level [RR = 0.48, 95% CI (0.31, 0.72), P < 0.05]; In addition, integrated Lianhua Qingwen could effectively shorten the duration of fever [SMD = -0.87, 95% CI (-1.22,-0.52), P < 0.05], time of clinical symptoms disappearance [SMD = -1.19, 95% CI (-1.56, -0.82), P < 0.05] and hospital stay [SMD = -0.61, 95% CI (-0.91, -0.30), P < 0.05]. Conclusion: Lianhua Qingwen could be used as adaptive and complementary medicine to improve clinical symptoms and CT for COVID-19.
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Objective:To analyze the clinical effect of traditional Chinese medicine Lianhua Qingwen in the treatment of coronavirus disease 2019 (COVID-19) and provide the basis for medication guides through a retrospective study in a cohort of COVID-19 confirmed patients. Method:A retrospective analysis of clinical records was conducted in COVID-19 confirmed patients at The Ninth Hospital of Wuhan and CR&WISCO General Hospital including the treatment group (21 patients, basic treatment in combination with Lianhua Qingwen granules, 1 packet/time, 3 times/day) and the control group (21 patients, basic treatment). Comparison between the two groups was made in terms of the disappearance rates of cardinal symptoms (fever, cough and weakness), duration of fever, and disappearance rates of other symptoms (muscle pain, expectoration, nasal obstruction, running nose, dry throat, pharyngalgia, shortness of breath, chest distress, dyspnea, dizziness, headache, nausea, vomiting, loss of appetite and diarrhea). Result:The baseline data were similar between the two groups. When compared with the control group, patients in the treatment group had the higher clinical effect, including the disappearance rate of fever (85.7% vs 57.1%, χ2=4.200, P=0.040), the disappearance rate of cough (46.7% vs 5.6%, P=0.012), the disappearance rate expectoration (64.3% vs 9.1%, P=0.012), the disappearance rate of shortness of breath (77.8% vs 0, P=0.021), and the duration of fever [(4.6±3.2) d vs (6.1±3.1) d, P=0.218]. Conclusion:Lianhua Qingwen can significantly relieve cardinal symptoms in COVID-19 confirmed patients by inhibiting fever and cough, reducing their duration, as well as improving individual symptoms. All these results provide preliminary clinical evidence for Lianhua Qingwen granules in the COVID-19 treatment.
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Related records about discipline of diagnosis and treatment of exogenous febrile diseases by traditional Chinese medicine (TCM) were reviewed to summarize TCM knowledge about etiology, pathogenesis, progress and treatment of infectious epidemic diseases among exogenous febrile diseases. In consideration of onset time and major clinical manifestations of novel coronavirus pneumonia (NCP), this disease is considered as within the scope of pestilence in TCM, it is located in the lung, with etiology being poison of winter-warm syndrome, the viruses enter body via mouth and nose, and invade pulmonary collaterals. Based on the syndrome characteristics proposed in diagnosis and treatment schemes of various regions as well as the researches on medication rules, the present study points out the core pathogenesis of NCP is epidemic toxin invading the lung, pathogenic heat obstructing the lung and toxic heat blocking the lung. It also analyzes theoretical formula features of TCM Lianhua Qingwen and related clinical and experimental research results, in order to prove the clinical value of this drug in the outbreak of NCP.
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This paper uses the Luobing theory to guide the diagnosis and treatment of coronavirus disease-2019 (COVID-19), and states that lung collateral includes Qi collateral and blood collateral, and is the basis for playing the function of lung of dominating Qi, controlling breathing and connecting all vessels. The concept of Qi channel is different from that of Qi collateral, but its function is closely related to lung collateral. COVID-19 belongs to "pestilence" in traditional Chinese medicine. The epidemic pathogenic factor enters from mouth and nose and then causes the disease. The early characteristics of this disease include the invasion of the lung by the epidemic pathogenic factor, the obstruction of Qi channels, the prevailing of the evil and the retreat of the good, and the deficiency and stagnation of Qi collateral. Generation of toxic heat from inside, obstruction of Qi channels and dysfunction of "breathing and blood transfer" are the key links to the development and aggravation of this disease. Qi disease involves blood, blood wound intrudes into collateral, and blood consumption and hemorrhage are the late outcome of this disease. Based on the experience of doctors of all dynasties in the treatment and medication of pestilence, the treatment principle of active intervention in the early and middle stage is proposed, including focusing on pathogenesis and expelling of toxin, drug use before syndrome onset and active intervention, and the whole regulation and multi-target treatment. Lianhua Qingwen developed under the guidance of Luobing theory can inhibit the activity of novel coronavirus in vitro, relieve clinical symptoms (such as fever, cough, weakness, shortness of breath and so on) and reduce the rate of disease progression to severity. Lianhua Qingke can diffuse the lung, clear the lung heat, relieve cough and reduce sputum. It can be used to relieve the symptoms of cough and sputum in patients with COVID-19, which proves the important scientific value of Luobing theory and collateral-dredging drugs in epidemic prevention and control.
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Lianhua Qingwen preparation （LHQW） is a Chinese traditional patent medicine approved by China Food and Drug Administration （CFDA）， and divided into two dosage forms， namely capsules and granules. Based on TCM theory， its therapeutic functions are contagion-clearing， detoxification， antipyretic， and lung-ventilating regulation， with influenza as its indication. In this paper， its pharmacological activities were reviewed. LHQW had a significant anti-virus effect characterized by a broad-spectrum pattern. It was reported that it not only possessed definitely suppressive effect on a series of influenza viruses， respiratory syncytial virus， coxsackie， enterovirus， herpes simplex virus，but also displayed a significant inhibitory effect on both the new corona pneumonia virus （SARS-CoV-2） and SARS coronavirus （SARS-CoV）. Studies showed that LHQW has obvious anti-inflammatory effects on a variety of inflammation models. It can significantly increase the delayed hypersensitivity of immunocompromised mice （caused by hydrocortisone） against 2， 4-dinitrofluorobenzene， and improve their cellular immune function. It can improve the phagocytosis function of peritoneal macrophages， the serum hemolysin antibody level and the humoral immune function of mice with a low immune function， with a immunomodulatory effect. In addition， LHQW has therapeutic effects on the symptoms induced by respiratory tract infections， such as fever， cough and phlegm， so as to block the vicious circle of multiple pathological links of the disease， and bring the advantages of multi-target， multi-link and multi-approach overall treatment of TCM into play.
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Objective: To study the chemical constituents of Lianhua Qingwen Capsule and illuminate its substance foundation. Methods: The compounds were isolated and purified by LPLC and preparative HPLC from the 30% ethanol fraction of Lianhua Qingwen Capsule macroporous resin column chromatography. Their chemical structures were elucidated by the spectral analyses. Results: 18 compounds were isolated and identified as forsythoside A (1), forsythoside I (2), forsythoside H (3), lugrandoside (4), isolugrandoside (5), ferruginoside A (6), lianqiaoxinoside C (7), calceolarioside C (8), forsythoside E (9), ferruginoside B (10), D-amygdaloside (11), L-amygdaloside (12), sambunigrin (13), cornoside (14), 4-hydroxy-4-methylenecarbomethoxy-cyclohexa- 2,5-dienone (15), liriodendrin (16), liquiritigenin-7-O-β-D-glucopyranoside (17), and 3,4-dihydroxy benzaldehyde (18). Conclusion: Compounds 2-8, 10, and 13-18 are isolated from Lianhua Qingwen Capsule for the first time, and compounds 4-6, 10, 15, and 16 are isolated from single herb in Lianhua Qingwen Capsule compound for the first time. The spectral data in DMSO-d6 solution of compound 8 are reported firstly with 2D NMR spectral data. The above results show the high polar chemical constitutions of Lianhua Qingwen Capsule, which provides more chemical information of Lianhua Qingwen Capsule.
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This paper was mainly to discuss the potential role and mechanism of Lianhua Qingwen Capsules(LHQW) in inhibiting pathological inflammation in the model of acute lung injury caused by bacterial infection. For in vitro study, the mRNA expression of MCP-1 in RAW264.7 cells and THP-1 cells, the content of MCP-1 in cell supernatant, as well as the effect of LHQW on chemotaxis of macrophages were detected. For in vivo study, mice were randomly divided into 7 groups, including normal group, model group(LPS 5 mg·kg~(-1)), LHQW 300, 600 and 1 200 mg·kg~(-1)(low, middle and high dose) groups, dexamethasone 5 mg·kg~(-1) group and penicillin-streptomycin group. Then, the anal temperature was detected two hours later. Dry weight and wet weight of lung tissues in mice were determined; TNF-α and MCP-1 levels in alveolar lavage fluid and MCP-1 in serum were detected. In addition, the infiltration of alveolar macrophages was also observed and the infiltration count of alveolar macrophages was measured by CCK-8 method. HE staining was also used to observe the inflammatory infiltration of lung tissues in mice. Both of the in vitro and in vivo data consistently have confirmed that: by down-regulating the expression of MCP-1, LHWQ could efficiently decrease the chemotaxis of monocytes toward the pulmonary infection foci, thus blocking the disease development in ALI animal model.
Subject(s)
Animals , Humans , Mice , Acute Lung Injury , Microbiology , Bacterial Infections , Drug Therapy , Bronchoalveolar Lavage Fluid , Capsules , Chemokine CCL2 , Metabolism , Chemotaxis , Drugs, Chinese Herbal , Pharmacology , Lipopolysaccharides , Lung , Macrophages , Random Allocation , THP-1 Cells , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
To evaluate the efficacy and safety of Lianhua Qingwen Capsules in the treatment of viral influenza in order to guide clinical medication. Randomized controlled trials(RCTs) regarding Lianhua Qingwen Capsules for treatment of viral influenza were searched in the CNKI, WanFang, VIP, SinoMed and PubMed. The quality of papers selected based on the inclusion criteria were assessed according to the Cochrane collaboration method and Meta-analysis was performed by using RevMan 5.3 software. A total of 8 articles were included, with a total sample size of 955 cases, including 478 cases in the treatment group, and 477 cases in the control group. In terms of the therapeutic effect, Lianhua Qingwen Capsules group was superior to the control group, with a total effective rate RR=1.20, 95%CI [1.09,1.32], P=0.70; recovery rate of body temperature RR=1.13, 95%CI [1.02,1.24], P=0.001; rate of symptom improvement RR=1.18, 95%CI [1.12,1.24], P=0.16. In terms of adverse reactions, the control group was superior to Lianhua Qingwen Capsules, with the incidence of adverse reactions RR=1.54, 95%CI [0.73,3.24], P=0.93. 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. 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.