There is an indisputable truth in the medical world: it is the three poisons of medicine.
When you decide to take the medicine, you enjoy the benefits of the drug for the body, but also suffer from the side effects of the drug.
It's just that people who are sick must take medicine, because rational medication means that the benefits of drugs to patients outweigh the side effects.
As the saying goes, no medicine is a hundred benefits and no harm, nothing more than a trade-off.
Therefore, Lotus Qing plague also has side effects, today we will talk about the side effects of Lotus Qing plague.
1. What exactly is the Lotus Flower Plague?
According to the Chinese Pharmacopoeia, Lotus Qing plague is composed of 13 ingredients: forsythia, honeysuckle, hot ephedra, cotton horse guanzhong, plate blue root, plaster, menthol, patchouli, rhodiola rosea, houttuynia, rhubarb, fried bitter almonds, licorice and so on.
These raw materials are decocted, distilled, filtered, refrigerated, mixed with powdered sugar, dextrin or starch, and dried to make lotus flowers [1].
Second, what are the side effects of Lotus Qing Plague?
In 2015, the Drug Evaluation Center of the State Food and Drug Administration released the "Literature Analysis of Adverse Drug Reactions/Events Caused by Lotus Qing Plague Capsules in 175 Cases", which selected january 2005 to December 2014 and analyzed the research on the side effects of Lotus Qing plague in the past 10 years [2].
In the end, 38 eligible literature were included, with a total of 2185 cases and 175 adverse reaction reports.
Side effects of Lotus Qing Plague Capsules:
Among them, the gastrointestinal tract has the most reactions, accounting for 73.9%, including nausea, vomiting, bloating, diarrhea, etc.;
Skin and adnexal injuries are the second, accounting for 9.6%, such as rashes, urticaria and so on
Nervous system injuries, such as dizziness and headaches.
In addition to the above 2 kinds of side effects with obvious symptoms, there are also 2 kinds of problems that are not listed, but many traditional Chinese medicines/proprietary Chinese medicines cannot avoid, that is, kidney toxicity and liver toxicity.
First of all, nephrotoxicity.
The kidneys are the centers for the concentration and excretion of drugs and toxic substances, and the kidneys are extremely sensitive to the toxic effects of drugs. Abnormal exposure of the kidneys to high levels of drugs or their metabolites can cause cell damage due to the kidneys' own high blood flow and metabolism of heterologous organisms, and the incidence of acute kidney injury related to Chinese herbal medicines has been reported to be as high as 60%.
The following is derived from a paper published in 2018, Nephrotoxicity and Chinese Herbal Medicine, which records the possible kidney damage of various Traditional Chinese medicines/proprietary Chinese medicines, and the ingredients often added to many cold proprietary Chinese medicines such as rhubarb and licorice are also among them.
However, it does not mean that all people who have used these drugs will develop acute kidney failure or chronic kidney disease, only that the patient is pushed in this direction.
These factors influence the eventual nephrotoxicity response.
The lack of basic research on certain Chinese medicine pharmacodynamic substances and the lack of perfect records of clinical evidence have led to insufficient understanding of the toxic ingredients contained in them;
In the process of clinical use, there are improper compatibility, confusion or misuse of the source of medicinal materials, improper preparation or unconditioning, etc.;
Third, in real application, problems such as excessive dosage, prolonged medication, and improper combination of Chinese and Western medicines have caused kidney damage to different degrees [3].
In addition to hepatotoxicity, liver damage caused by traditional Chinese medicine has become one of the important causes of clinically drug-induced liver injury.
Similarly, there are three factors that affect the extent to which drugs damage the liver [4]:
Pharmaceutical factors, such as hepatotoxicity of the ingredients contained in it, unqualified APIs of proprietary Chinese medicines, and difficulty in regulating the processing process;
The figure below shows some of the API ingredients that may cause hepatotoxicity in Chinese medicines/proprietary Chinese medicines.
Patients with physical factors
Clinical drug factors, if you mistakenly think that traditional Chinese medicine is safe, there is a treatment course of too long, the dose is too large, too many drugs are used, the prescription evidence does not correspond, etc., which will increase the risk of liver damage.
Seeing this, we know that in addition to the side effects of the drug itself, the irrational use of drugs in practice is also a very dangerous thing.
Third, lotus plague: super indications of medication, over-dose medication, and even contraindicated population medication is very common
In the above-mentioned paper released by the Drug Evaluation Center of the State Food and Drug Administration, it was found that lotus qing plague existed in the use of: super-indication drugs, over-dose drugs, and even contraindicated population drugs.
That is: many people who should not use it use it, use it too much, and people who can't use it also use it.
From the clinical application and research of 2185 cases in the literature, the patient's original disease fully met the 797 cases described in the instructions for Lotus Qing plague capsules, accounting for 36.5%, that is, only one-third of the cases were applied within the indications covered by the lotus qing plague instructions.
More than two-thirds of the applications are supra-indications, including viral colds (external cold), hand-foot-and-mouth disease, shingles and elderly community-acquired pneumonia with fever, etc. The approved indications for Lotus Qing plague do not indicate that there is a therapeutic effect on these diseases.
There are also cases of overdose medication and even contraindications to medication in the clinic.
The instructions for Lianhua Qingpeng capsules [precautions] clearly stipulate that it is not applicable to those with cold and wind [5].
However, a case was reported in Qufu, Shandong Province, where a 44-year-old male patient took Lotus Qing plague capsules on his own after a cold, and a rash and itching appeared a day later.
There are also children's medications.
Children are not shrinking adults. Children's bodies are not yet mature, and the metabolic capacity and adverse reaction tolerance of children's liver and kidneys for drugs are obviously different from those of adults, and drugs that may be safe for adults are poisons for children.
There have been many literature reports of lotus plague used for hand, foot and mouth disease in children, but the drug instructions do not say that it has the effect of treating hand, foot and mouth disease.
Fourth, what are the benefits and risks of different people eating lotus flowers?
In summary, we have to consider the benefits and risks when taking a drug. What are the benefits and risks of different people eating lotus flowers?
If you take lotus flower plague to prevent the new crown, it is an over-the-instruction medication.
Hyper-indication medication is a serious problem in medicine. Since the use of drugs in the over-label has not been approved by the drug supervision and management department, the risk of patient use is higher than that of the drugs in the instructions (digression: In the mainland, even if it is a drug within the medical insurance, only the drugs within the scope of the indications can be reimbursed by medical insurance, and the cost of over-the-instruction drugs is still mainly borne by the patient. ）
Indeed, there are some diseases in the clinic that inevitably need to be used beyond the instructions, such as some tumor patients, who have previously resisted tumor drugs, and the update of the new anti-tumor drug instructions is lagging behind, and there have been experiments to prove that the drug has an effect on patients.
Over-label medication should follow six principles: no substitution, evidence, non-trial, approval, informed, and monitorable. The Declaration of Helsinki states that when a patient is treated without existing effective methods of prevention, diagnosis and treatment, if a doctor feels the hope of saving lives, restoring health or alleviating suffering, the doctor should have unrestricted access to unproven or new preventive, diagnostic and therapeutic measures with the patient's informed consent.
On the issue of the new crown...
Most people still get vaccinated, wear masks, and do prevention.
Secondly, if you are an indication group...
This is the "indications" and "precautions" published in the instructions of lotus qing plague capsules.
At present, the approved indications of Lotus Qing plague capsules are influenza (heat poisoning lung certificate) and mild and ordinary new crown pneumonia.
Taking the flu as an example, like other drugs, Lotus Qing Plague Capsules are mainly to relieve symptoms, your muscle soreness may slowly dissolve the point, the tongue is yellow and greasy, and the tongue is slightly moist, which is to make you feel better. It does not have the ability to directly kill the virus, and what really kills the virus is human immunity.
According to the theory of Chinese medicine, lotus flower qing plague medicinal bitter cold, if the righteous qi is insufficient, eating harmful and useless; and in the prevention of no effect, may even be because of the damage to the positive qi to play a counterproductive effect. It is used correctly to determine that the new crown virus is positive, during the absence of symptoms, or manifested as physical fatigue, headache, nasal congestion, dry throat, itchy throat, dry cough, fever, red tongue, moss yellow, pulse float, etc.
In the [Precautions], it is written that the people who are forbidden and cautious are written, that is, these people may be more dangerous to eat, and it is best not to use or use under the guidance of a doctor.
Third, it is the three poisons of medicine, and Chinese medicine and proprietary Chinese medicine need to remember this sentence.
Many people still have a very dangerous idea: they think that Chinese medicine is convenient, safe, and has no toxic side effects, and can even "cure diseases and fitness without diseases"... Eat casually, eat for a long time, but there is no illness to eat sick.
in a word
No medicine is beneficial and harmless, and every time you take medicine, you have to weigh the pros and cons;
There is no medicine that is not for people with indications (if you come across such a miracle drug, don't buy it!). It's a liar! The drug is eaten right to cure the disease, and not eating it is really harmful.
And the latter is often very common, I hope it is not you who read this article.
bibliography
[1]https://www.frontiersin.org/articles/10.3389/fphar.2022.764774/full#h4
[2] Literature Analysis of Adverse Drug Reactions/Events Caused by Lotus Qing Plague Capsules in 175 Cases
Guo Xiao, Wang Meng, Zhu Yan, Liu Yang, Hao Yu. Research status and evaluation methods of nephrotoxicity mechanism of traditional Chinese medicine[J]. Chinese Herbal Medicine, 2015, 46(23): 3581-3591
[4] Li Zhiqi, Fan Qiqi, Chen Meilin, Li Chaofeng, Wang Zhaoyi, Feng Dan, Zhong Xinyue, Guo Simin, Zhao Chongjun, Lin Ruichao. Research progress on the material basis and mechanism of action of hepatotoxicity in traditional Chinese medicine[J].Chinese Herbal Medicine,2021,52(13):4082-4095
Kong Yuanyuan. A case of rash caused by oral Lianhua Qingpeng capsules[J].New Medicine,2010,41(07):420+433.
Qian Suyun, Yang Mei. Status quo and principle of over-label medication [J] . Chinese Journal of Pediatric Emergency Medicine,2018,25(1): 1-3. DOI: 10.3760/cma.j.issn.1673-4912.2018.01.001