Guideline on treating community-acquired pneumonia with Chinese patent medicines.

Community-acquired pneumonia (CAP) is one of the most common infectious diseases, and its morbidity and mortality increase with age. Resistance and mutations development make the use of anti-infective therapy challenging. Chinese patent medicines (CPMs) are often used to treat CAP in China and well tolerable. However, currently there are no evidence-based guideline for the treatment of CAP with CPMs, and the misuse of CPMs is common. Therefore, we established a guideline panel to develop this guideline. We identified six clinical questions through two rounds of survey, and we then systematically searched relevant evidence and performed meta-analyses, evidence summaries and GRADE decision tables to draft recommendations, which were then voted on by a consensus panel using the Delphi method. Finally, we developed ten recommendations based on evidence synthesis and expert consensus. For the treatment of severe CAP in adults, we recommend Tanreqing injection, Reduning injection, Xuebijing injection, Shenfu injection, and Shenmai injection respectively. For the treatment of non-severe CAP in adults, we recommend Tanreqing injection, Reduning injection, Lianhua Qingwen capsule/granule, Qingfei Xiaoyan Pill and Shufeng Jiedu capsule respectively. CPMs have great potential to help in the fight against CAP worldwide, but more high-quality studies are still needed to strengthen the evidence.

Clinical practice guideline on treating influenza in adult patients with Chinese patent medicines.

Influenza is a major public health problem worldwide. Mutations and resistance development make the use of antiviral therapy challenging. Chinese patent medicines are often used to treat influenza in China and well tolerable. However, the misuse of Chinese patent medicines is common. We therefore aimed to develop an evidence-based guideline on treating influenza with Chinese patent medicines in adults to guide clinical practice. We formed a steering committee, a consensus panel, a consultants' group and an evidence synthesis team to guide the development of the guideline. We formulated the clinical questions through two rounds of survey, and finally selected five questions. We then systematically searched the related evidence and conducted meta-analyses, evidence summaries and GRADE decision tables to draft the recommendations, which the consensus panel then voted on using the Delphi method. Finally, we formulated six recommendations based on the evidence synthesis and experts' consensus. For treating mild influenza, we suggest either Lianhua Qingwen capsule, Jinhua Qinggan granule, Banlangen granule, Shufeng Jiedu capsule, or Jinfang Baidu pill, depending on the manifestations. For severe influenza, or mild influenza in patients at high risk of developing severe influenza, we suggest Lianhua Qingwen capsule in combination with antiviral medications and supportive therapy. The strength of all recommendations was weak. Traditional Chinese medicine has great potential to help in the fight against influenza worldwide, but more high-quality studies are still needed to strengthen the evidence.

Molecular pharmacology of inflammation: Medicinal plants as anti-inflammatory agents.

Except for an essential step for the pathology of multiple diseases including atherosclerosis and rheumatoid arthritis, inflammation is an imperative therapeutic target for developing novel approaches for pharmacological interventions. Thus, molecular understanding of inflammation not only revealed the mechanisms of drug action and their biological targets but also has spawned innovative maneuvers to influence multifaceted biological systems, providing new prospects for drug designing and suggesting important new implications for existing clinical medicine. Meanwhile, modulation of inflammation with the use of medicinal plants proposed an alternate to conventional therapeutic strategies for numerous ailments, particularly when suppression of inflammation is expected. In modern literature, several species of medicinal plants have been shown substantial antiinflammatory and immunomodulatory actions including inhibitory effects on suppression of cellular and humoral immunity, lymphocyte activation, and propagation of apoptosis. Herein, we reviewed the molecular pharmacology of inflammation, chemical components and biological activities of medicinal plants such as, curcumin from Curcuma longa, and epigallocatechin-3-gallate from Camellia sinensis as well as their mechanism of action during inflammation at molecular level. An extensive review of the literature and electronic databases was conducted, encompassing PubMed, GoogleScholar, ScienceDirect, medlineplus, www.clinicaltrial.gov, www.fda.gov, www.ema.europa.eu, www.drugbank.ca, TrialBulletin.com, www.theplantlist.org, and www.pharmacodia.com for assembling the information. Additionally, data was attained from books, ethnopharmacological literature, and relevant publications for essential elements of molecular mechanisms, signal transduction networks, transcription factors, complement system, reactive species, and clinical trials are selected for substantial understanding of biochemistry, pathophysiology as well as clinical importance of medicinal plants during inflammatory diseases.