RECOMMENDED

Lianhua Qingwen Recommended by the National Health Commission for Treatment during Medical Observation Period

date:2020-02-15

The Standard Therapy for Novel Coronavirus Pneumonia (Version IV, Tentative) has been published by the National Health Commission and the National Administration of Traditional Chinese Medicine together in order to effectively control the current epidemic event and practically protect the health of the people. And Lianhua Qingwen Capsules/Granules have been listed as recommended products to be used during the medical observation period.  What is the population during the medical observation period? What roles can Lianhua Qingwen play in this population? How shall Lianhua Qingwen be used?

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The Standard Therapy for Novel Coronavirus Pneumonia (Version IV, Tentative) has been published by the National Health Commission and the National Administration of Traditional Chinese Medicine together in order to effectively control the current epidemic event and practically protect the health of the people. And Lianhua Qingwen Capsules/Granules have been listed as recommended products to be used during the medical observation period.  What is the population during the medical observation period? What roles can Lianhua Qingwen play in this population? How shall Lianhua Qingwen be used?

Correct Symptomatic Treatment of the Population by the Recipe of Lianhua Qingwen

Most of the patients included into the medical observation population have such manifestations as fever, red throat, mild coughing and anidrosis. This corresponds to the syndrome of wind-heat invading the defensive energy according to TCM. And there are also quite a number of patients who have high fever, coughing, sticky phlegm that cannot be expectorate smoothly and sore throat right after the onset of the disease. This corresponds to the syndrome of heat invading the lung according to TCM.

The recipe of Lianhua Qingwen integrates the famous recipes of three dynasties in the treatment of exogenous febrile diseases, such as the hemp apricot decoction of Zhang Zhongjing in the Han Dynasty, the use of rheum for the treatment of epidemic diseases by Wu Youke in the Ming Dynasty and the Forsythia Powder in the Qing Dynasty. Among them, ephedra herb and mint can effuse the wind-heat exogenous pathogenic factors of the syndrome of wind-heat invading the defensive energy. The honeysuckle flower, fructus forsythiae, isatis root and cyrtomium fortunei can cure the sore throat. The apricot kernel and houttuynia cordata can cure coughing and expectoration. The gypsum and rheum officinale can clear the lung heat and releasing the heat pathogenic factors of the syndrome of heat invading the lung through the stools. Especially that agastache rugosus is also used in the recipe for removing dampness by aromatics, which is very suitable for the heavy damp pathogenic factors of this epidemic disease.  The whole recipe can alleviate such symptoms as fever or high fever, coughing, sticky phlegm that cannot be expectorate smoothly and sore throat. So Lianhua Qingwen can be used for prevention and treatment for both patients definitely diagnosed as suffering from Novel Coronavirus Pneumonia and patients suffering from influenza or common cold.

国家卫健委推荐连花清瘟用于医学观察期

Anti-virus Efficacy based on Large Amount of Basic Studies

Severe Acute Respiratory Syndromes (SARS) hit China in March, 2003. And there were no effective therapeutic products against it at that time. The research and development team of Yiling Pharma developed the recipe of Lianhua Qingwen referencing the experience of famous doctors of all ages in the treatment of febrile diseases and epidemic diseases based on the famous recipes for epidemic diseases used in Han, Ming and Qing Dynasties using the herbal medicinal materials with reliable anti-virus and anti-inflammation effects identified in combination with the modern scientific researches.

国家卫健委推荐连花清瘟用于医学观察期

The Chinese Academy of Military Medical Sciences started the study on the treatment of the coronavirus SARS by Lianhua Qingwen. The results show that the median effective inhibition concentration (IC50) of Lianhua Qingwen Capsules against the SARS-CoV virus is 0.09mg/ml, the therapeutic index is 40.33, and it can satisfactorily inhibit the copy of the SARS virus. Lianhua Qingwen is also among the few TCM products that have been shown to have effects against SARS-CoV.  So this action is also clearly stated in the package insert of Lianhua Qingwen Granules.  In 2015, another kind of novel coronavirus caused the Middle East Respiratory Syndrome. And Lianhua Qingwen Capsules/Granules was recommended by the National Health Commission for the prevention and treatment of this disease.

During the recent years, such authoritative scientific research institutes as China Academy of Chinese Medical Science and the National Key Laboratory of Respiratory Diseases of Guangzhou Medical University have performed a large amount of studies on this product. The results show that Lianhua Qingwen Capsules has a broad spectrum of actions against viruses and has excellent inhibition and antagonistic actions against multiple kinds of influenza A viruses, influenza B virus and common cold viruses. And it can also inhibit many kinds of bacteria.

The mechanism of action of a TCM product is different from that of a western drug. A TCM product does not act on a single kind of virus. It acts on the group of syndromes such as fever, coughing and expectoration caused by multiple kinds of viruses. Lianhua Qingwen will also be effective if similar symptoms occur for a patient suffering from Novel Coronavirus Pneumonia.

Efficacy of Lianhua Qingwen in Treatment of Influenza Proved through Evidence Based Medicine Studies

The evidence based medicine is the most objective and scientific way of assessing the efficacy of a product featuring large scopes, multiple sample and double blind studies.  In 2009, the evidence based medicine study of Treatment of Influenza A H1N1 Infections by Lianhua Qingwen Capsules was initiated as led by Beijing You'an Hospital Affiliated to Capital Medical University. The study was performed together with 9 hospitals around the country who are designated as hospitals for Influenza A H1N1 Infections such as Henan Provincial Hospital of Infectious Diseases, Hunan Provincial Center for Disease Prevention and Control, and the hospital for infectious diseases in Shenyang, Chengdu and Jinan. A large number of subjects were included around the country in the study. The subjects cover all the major age groups and patients with Influenza A H1N1 Infections with various kinds of symptoms.  These influenza patients were assigned to the study group and the control group respectively. The patients in the study group used Lianhua Qingwen Capsules according to dosages specified in the standard therapy and the patients in the other group used the control product Oseltamivir Capsules.

The evidence based medicine study results show that there is no difference between Lianhua Qingwen Capsules and Oseltamivir Capsules in the anti-virus actions. And Lianhua Qingwen is better than Oseltamivir Capsules in alleviating the symptoms of influenza, especially in alleviating such symptoms as fever, coughing, headache, sore muscles and weakness. After the assessment all the experts believe that Lianhua Qingwen is a kind of TCM patent drug with definite therapeutic effects proved through evidence based medicine studies.

In January of 2019, the Random, Double Blind, Placebo Control and Multi-center Clinical Study on Lianhua Qingwen Granules in Treatment of Viral Pneumonia led by Academician Wang Chen was un-blinded formally in the 13 Tier Three Class A hospitals all around the country such as Beijing Hospital of the Ministry of Health, Chaoyang Hospital of Capital Medical University, Xuanwu Hospital of Capital Medical University and Traditional Chinese Medicine Hospital of Guangdong Province.  The study results show that Lianhua Qingwen has excellent therapeutic effects in alleviating such clinical symptoms as fever and coughing of patients suffering from viral pneumonia.

The scientific research team led by the expert in respiratory diseases Academician Zhong Nanshan has performed multiple studies on Lianhua Qingwen. He pointed out that Lianhua Qingwen showed significant therapeutic effects in alleviating the symptoms of patients suffering from influenza in double blind evidence based medicine studies that are considered as the strictest studies by all the clinicians and its therapeutic effects are especially good when it is used at the early stage after the onset of the disease in patients with high fever.

Scientific Evidences Required for Preventive Effects

The therapeutic effects of Lianhua Qingwen have been proved through large amounts of experiments and clinical studies. Does it have any preventive effects?

In 2009, a sudden outbreak of Influenza A broke the peaceful lives of the people. In September of that year, the expert team of Hebei province for the prevention and control of Influenza A H1N1 Infections and the Third People's Hospital of Langfang of Hebei province reported a cluster outbreak of Influenza A H1N1 Infections in the University City of Langfang. The expert team of prevention and control rapidly isolated those who were in close contact with the confirmed cases and the surrounding healthy individuals, altogether more than 20,000 persons. Among the 20,553 persons isolated, 6,367 of them selected Lianhua Qingwen for the prevention of this disease, 1,177 of them selected other products for the prevention of this disease and 13,009 of them did not take any medicine for the prevention of this disease.  The results showed that the infection rate is 8.8% in those who did not take any medicine for prevent, 6.8% in those who selected other products and only 1.2% in those who selected Lianhua Qingwen, indicating that Lianhua Qingwen is effective in preventing Influenza A H1N1 Infections.

How shall Lianhua Qingwen be used in children?  Children have lower immunity and this population is a vulnerable population.  Usually the fever symptom will last for 3 to 5 days in children and it is often accompanied by such symptoms as headache, sore throat, and joint and muscle pains. And such complications as pneumonia, myocarditis and encephalitis can occur in severe cases of children.


国家卫健委推荐连花清瘟用于医学观察期

In the Guideline for Clinical Application of TCM Patent Products · Treatment of Pediatric Diseases, Lianhua Qingwen is clearly specified as a recommended product for the treatment of influenza corresponds to the syndrome of heat invading the lung in children.  The famous TCM pediatrician Professor Ma Rong, the former president of the No. 1 Affiliated Hospital of Tianjin University of Traditional Chinese Medicine says that Lianhua Qingwen is mainly composed of two recipes, one is the hemp apricot decoction for the treatment of syndromes caused by exterior pathogenic factors and the other is the Forsythia Powder that has been used for more than two hundred years for the treatment of upper respiratory infection in children. After these two recipes are combined, it is very effective in the treatment of influenza against both fever and coughing.  The agastache rugosus in Lianhua Qingwen has the function of removing dampness by means of aromatics and can stop vomiting and diarrhea. It is also very effective in lowering the temperature. Rheum officinale can help the children in bowel relaxing, and then both the fever and the coughing can be effectively alleviated. Rhodiola rosea can play a very important role against hypoxia.  The administration of Lianhua Qingwen Granules is very easy for children who have been included into the clinical observation population. It is only that the dosage needs to be adjusted according to the age and the body weight for the children.