Expert consensus on Antiviral Oral Liquid in treatment of influenza in clinical practice / 中国中药杂志

Antiviral Oral Liquid is modified on the basis of Baihu Decoction in Treatise on Febrility Diseases by ZHANG Zhongjing and Qingwen Baidu Yin in Qing Dynasty, with effects in clearing toxic heat, repelling dampness and cooling blood. It is widely used in clinical treatment of common colds, influenza and upper respiratory tract infection, mumps, viral conjunctivitis and hand-foot-mouth disease, with a good clinical efficacy and safety. Based on a questionnaire survey of clinicians and a systematic review of study literatures on Antiviral Oral Liquid, the international clinical practice guidelines development method was adopted to analyze the optimal available evidences and expert experiences in the "evidence-based, consensus-based and experience-based" principles. The consensus was jointly reached by more than 30 multidisciplinary experts nationwide, including clinical experts of traditional Chinese and Western medicine in the field of respiratory diseases and infectious diseases, and methodological experts. In the study, literatures were retrieved based on clinical problems in the clinical survey as well as PICO clinical problems. The GRADE system was used for the classification and evaluation of evidence, and fully combined with clinical expert experience, so as to reach expert consensus by the nominal grouping method. This expert consensus recommended or suggested indications, usage and dosage, course of treatment, intervention time for treatment, and the safety and precautions of Antiviral Oral Liquid for treatment of influenza, and can provide reference for the rational use of this drug in clinical practice.

Analysis of pathogenesis clauses and prescriptions of “Treatise on differentiation and treatment of epidemic febrile disease” related to clinical symptoms of COVID-19 / 中草药

Objective: To collect the clinical symptoms of novel coronavirus pneumonia, explore and analyze the clauses and prescriptions related to the clinical symptoms of 2019 novel coronavirus pneumonia in “Treatise on differentiation and treatment of epidemic febrile disease”, in order to provide a reference for clinical treatments of the disease. Methods: Searching literature from the databases CNKI and PubMed by entering “novel coronavirus” (in Chinese) and “2019 Novel Coronavirus” as key words, classifying typical symptoms depending on their reported frequencies of occurrence, comparing with related pathogenesis in “Treatise on differentiation and treatment of epidemic febrile disease”, and analyzing clauses and prescriptions combined with the sixth version of “New coronavirus pneumonia diagnosis and treatment scheme”. Results: We optimized 20 literatures published in Chinese or English for the review, in which, a total of 647 clinical cases were reported. Based on that, 28 typical symptoms were summarized, including respiratory symptoms, such as fever and cough; Gastrointestinal symptoms, such as poor appetite, nausea, vomiting, diarrhea; Other symptoms, such as myalgia, fatigue, and so forth. Among them, fever (558 cases), cough (395 cases), and fatigue (257 cases) were the top three clinical symptoms. By analysis, we optimized 15 clauses, 18 prescriptions, and 46 traditional Chinese medicines from “Treatise on differentiation and treatment of epidemic febrile disease”, including two clauses in the upper energizer, nine in the middle energizer, and four in the lower energizer; A total of seven prescriptions for treating dampness-heat, five for cold-dampness, and six for warm-heat diseases; as well as Chinese medicines Pinellia ternata (mentioned for six times), Cinnamomi Ramulus (five times), Tetrapanacis Medulla (five times), Poria cocos (four times), Talcum (four times), Coptis chinensis (four times) and Coicis Semen (four times), etc. P. ternata, Cinnamomi Ramulus, C. chinensis, Scutellaria baicalensis, and Zingiberis Rhizoma were selected to treat dampness-heat diseases, in order to “pungency opening and bitter discharging”; P. cocos, Tetrapanacis Medulla, Talcum, and Coicis Semen were selected for “eliminating dampness with bland medicinal”; Almond, Amomum kravanh, and Magnolia officinalis were used to “regulating qi movement”; Anemarrhenae Rhizoma, Gypsum Fibrosum, and Forsythiae Fructus were used to treat warm-hot diseases for “purging fire and removing toxin”. The formula of Sanren Decoction, Yiyizhuye Powder can be used for people in the stage of medical observation period; Sanren Decoction, Yiyizhuye Powder, Xingrenyiyi Decoction, Wuling Powder, Baihujiaguizhi Decoction, and Lingjiangzhugui Decoction for treating mild cases; Huangqin Huashi Tang, Xingren Huashi Decoction, and Fulingpi Decoction for severe cases; Jiaomei Decoction, Jianweiwumei Pill, Sini Decoction, and Taohua Porridge for critical patients, and Maidong Maren Decoction, Wuzhi Yin, and Niuru Yin for convalescents. Conclusion: The prescriptions of “Treatise on differentiation and treatment of epidemic febrile disease” can provide reference for the clinical treatments of 2019 novel coronavirus pneumonia.

Clinical study on Qinghouyan lozenge in treatment of acute pharyngitis / 中国中药杂志

To evaluate the clinical efficacy and safety of Qinghouyan lozenge in the treatment of acute pharyngitis due to Lung-heat and Yin-deficiency, and compare with Qinghouyan oral Liquid. Totally 144 subjects were enrolled and randomly divided into two groups (72 in the test group and 72 in the control group). The participants in the test group were given Qinghouyan lozenge for 5 days, and those in the control group were given Qinghouyan oral Liquid for 5 days. The effectiveness evaluation indexes were pharyngalgia/odynophagia disappearance rate, overall efficacy of TCM syndromes, TCM syndrome scores, and single syndrome and sign disappearance rate. During the test, the safety was evaluated by vital sign, lab examination indexes and adverse events. The results for the full analysis set showed that the couth disappearance rate, the incidence rate of TCM syndromes, and the throat/uvula congestion disappearance rate of the test group were higher than that of the control group (P < 0.05), with significant differences in the changes in syndrome scores between the two groups (P < 0.05). Altogether 3 adverse events were observed in the test group while 6 adverse events in the control group, without significant differences in the adverse event rate between the two groups (P < 0.05), serious abnormal laboratory examinations and vital signs. In conclusion, Qinghouyan lozenge has better efficacy in treatment of acute pharyngitis due to Lung-heat and Yin-deficiency than Qinghouyan oral liquid, with good safety.