Efficacy of lianhuaqingwen granules in the management of chronic rhinosinusitis without nasal polyps
Authors: Guoqiang Ren
Zheng Chen
Jinjin Wei
Fei Dai
Lin Lin
Xinyue Tang
Journal: American Journal of Otolaryngology (2020)
Discipline: CLINICAL MEDICINE
Keywords: Chronic rhinosinusitis; Inflammation; Lianhuaqingwen; Placebo; Treatment.
Affiliations: Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital North of Fudan University, Shanghai, China. Electronic address: ., Department of Otorhinolaryngology-Head and Neck Surgery, Huashan Hospital North of Fudan University, Shanghai, China., Department of Pathology, Huashan Hospital North of Fudan University, Shanghai, China.

Abstract:  Objectives: Chronic rhinosinusitis (CRS) is a complicated disease with clinical symptoms that are impacted by the absence or presence of nasal polyps (CRSsNP or CRSwNP). Understanding of the different treatments of CRS is very significant in selecting appropriate therapies and preventing exacerbation relevant to this chronic inflammation. This study was aimed to evaluate the effect of Chinese traditional medicine lianhuaqingwen granules on CRSsNP. Materials and methods: CRSsNP patients were enrolled and randomized into placebo or lianhuaqingwen (LHQW) granules treatment group (placebo or LHQW group). Their clinical symptoms were scored using Visual Analog Scale (VAS) and Sino-Nasal Outcome Test (SNOT)-22. Nitric oxide (NO) from nasal cavity and sinus and nasal resistance were also examined. Then, nasal biopsy samples and nasal lavage fluid (NLF) were obtained from these patients, and histologic characteristics of nasal mucosa and T cell subpopulations patterns in the NLF were evaluated. Finally, inflammatory mediators in the NLF were assessed in both groups. Results: One hundred and forty patients with CRSsNP finished this one-month study. VAS and SNOT-22 scores and nasal resistance were all decreased distinctly after the treatment of LHQW, but not after placebo. However, the nasal NO concentration was increased in LHQW administration group in comparison with placebo group. There were significant differences in above parameters between these two treatments. Histologic changes in nasal mucosa were improved only in LHQW group. CD4+ and CD8+ T cells were all downregulated in the LHQW treatment group, but not in placebo group. Inflammatory mediators from the NLF were decreased in LHQW treatment group compared to placebo group. Furthermore, there were significant changes between these two groups in CD4+ and CD8+ T cell subpopulations and concentrations of inflammatory substances. Conclusion: These findings demonstrate that LHQW granules treatment may control the inflammation in nasal mucosa and result in the improvement of CRSsNP. This Chinese medicine might become a promising therapy in the management of this disease. 

Retracted: No

PubPeer comments:
 Figure 3. * Blue boxes: Panels A (Pre-treatment of Placebo) and B (Placebo treatment) appear to show an overlap. * Green boxes: Panels C (Pre-treatment of LHQW) and D (LHQW treatment) appear to show an overlap.  , 
 Dear Elisabeth M Bik, We are very glad to know you point out the mistake in the paper. You are very kind and respectable. The problem was that we made an mistake in organizing histochemical images in Figure 3 (A, B, C and D). Because of so many pictures, we got confused at that time. It was only an honest error. We didn t mean it. We are very sorry for that. In addition, we have suggested the editorial office can correct the mistake through a corrigendum. Thank you for your attention and consideration. , 
 Corrigendum, May 2020: https: www.sciencedirect.com science article pii S0196070920301927  *The authors regret u201cthat with regard to the clinical research article entitled u2018Efficacy of lianhuaqingwen granules in the management of chronic rhinosinusitis without nasal polypsu2019 authored by Lin L, Dai F, Ren G, Wei J, Chen Z, Tang X, published in American Journal of Otolaryngology, 2020 Jan - Feb;41(1):102311 , as a corresponding author, I would like to inform you that there is a corrigendum in Fig. 3 (A, B, C and D) in the online issue. It needs to be corrected. I hereby attach the correct figure and hope it will be presented in the online issue and also indicated in the corrigendum section.u201d* *The authors would like to apologise for any inconvenience caused.* , 
 Thank you for your attention and consideration. ,