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Lin L, Xiao J, Wu L, Fan F, Feng W, Wei J, Wang G, Liu G, Zhang W, Lu Y, Li Y, Lu L, Li H, Sun S, Gou J, Dang Y, Sun X, Jiang B, Qin J, Zhen H, Fang Y, Ding J, Huang M, Zhao W, Cai Y, Huang K, Tong X, Chen Y, Zhang H, Lin L. Efficacy and safety of Kegan Liyan oral liquid for patients with acute pharyngitis: A randomized, double-blinded, placebo-controlled, multi-center trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 134:155960. [PMID: 39217655 DOI: 10.1016/j.phymed.2024.155960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/30/2024] [Accepted: 08/14/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Alleviating the sore throat caused by acute pharyngitis is a primary patient concern. However, antibiotics are not commonly recommended drugs, and abuse can lead to serious consequences such as drug resistance. Therefore, seeking alternative treatments is necessary. PURPOSE To investigate the efficacy and safety of Kegan Liyan (KGLY) oral liquid for patients with acute pharyngitis. STUDY DESIGN Randomized, double-blinded, placebo-controlled, multi-center study. METHODS Participants from 17 hospitals were randomly assigned 1:1 to receive KGLY oral liquid or placebo for five days. Assessments occurred at baseline, day 3, and day 6. The primary outcome was the recovery rate. Secondary outcomes included sore throat and cough visual analogue scale (VAS), the area under the curve (AUC) of sore throat VAS, time to sore throat relief and recovery, proportion of participants with sore throat relief and recovery, traditional Chinese medicine (TCM) syndrome score, single TCM manifestation score and use of acetaminophen. RESULTS Involving 239 participants (120 in KGLY and 119 in placebo group), the study found a significantly higher recovery rate on day 6 in the KGLY group (between-group difference, 27.20 % [15.00 % to 39.40 %], p < 0.001). On day 3 and 6, the KGLY group showed significantly larger reductions in sore throat (-3.02 vs -2.37, p = 0.001; -4.66 vs -3.64, p < 0.001) and cough VAS scores (-1.55 vs -1.05, p = 0.004; -2.28 vs -1.56, p < 0.001) from baseline. KGLY oral liquid lowered the AUC of sore throat VAS score (-2.33 [-4.10 to -0.56], p = 0.011), shortened time to sore throat recovery (hazard ratio, 0.42 [0.30 to 0.59], p < 0.001), increased sore throat recovery rate at day 6 (75.00 % vs 42.86 %, p < 0.001), decreased the TCM syndrome score (-2.03 [-2.69 to -1.37], p < 0.001), and improved individual TCM symptoms compared to placebo. No significant differences between the groups in acetaminophen usage. KGLY oral liquid was safe and tolerated. CONCLUSION KGLY oral liquid may be a beneficial and safe alternative treatment for acute pharyngitis, which can alleviate symptoms such as sore throat, swollen throat, cough, and phlegm production.
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Affiliation(s)
- Luoqi Lin
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China
| | - Jingmin Xiao
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Lei Wu
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Feiting Fan
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Wenjie Feng
- Qinhuangdao Hospital of Traditional Chinese Medicine, Hebei, PR China
| | - Jun Wei
- Tianyou Hospital Affiliated to Wuhan University of Science and Technology, Hubei, PR China
| | - Guangen Wang
- Handan Hospital of Traditional Chinese Medicine, Hebei, PR China
| | - Gang Liu
- The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Anhui, PR China
| | - Wei Zhang
- Shandong Provincial Hospital of Traditional Chinese Medicine, Shandong, PR China
| | - Yun Lu
- Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan, PR China
| | - Yunhui Li
- The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, PR China
| | - Lijun Lu
- Wuhan Hospital of Traditional Chinese Medicine, Hubei, PR China
| | - Huimin Li
- Search North China Medical and Health Group Fengfeng General Hospital, Hebei, PR China
| | | | - Jian Gou
- The First People's Hospital of Xianyang City, Shanxi, PR China
| | - Yuqi Dang
- Yinchuan Hospital of Traditional Chinese Medicine, Ningxia, PR China
| | - Xuwu Sun
- Mudanjiang Hospital of Traditional Chinese Medicine, Heilongjiang, PR China
| | - Baihua Jiang
- Heilongjiang Provincial Hospital of Traditional Chinese Medicine, Heilongjiang, PR China
| | - Jiangbo Qin
- Changzhi People's Hospital, Shanxi, PR China
| | - Hui Zhen
- Respiratory Disease Research Committee of China Association of Traditional Chinese Medicine, Beijing, PR China
| | - Yun Fang
- Beijing Yaohai Ningkang Pharmaceutical Technology Co., LTD, Beijing, PR China
| | - Junping Ding
- Harbin Kangsaisi Medical Technology Development Co., LTD, Heilongjiang, PR China
| | - Minling Huang
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Wenhan Zhao
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Yan Cai
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Kaifeng Huang
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Xiaoping Tong
- Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China
| | - Yuanbin Chen
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China.
| | | | - Lin Lin
- State Key Laboratory of Traditional Chinese Medicine Syndrome/The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, PR China; State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, PR China; Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, PR China.
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Zhang X, Sun CY, Zhang YB, Guo HZ, Feng XX, Peng SZ, Yuan J, Zheng RB, Chen WP, Su ZR, Huang XD. Kegan Liyan oral liquid ameliorates lipopolysaccharide-induced acute lung injury through inhibition of TLR4-mediated NF-κB signaling pathway and MMP-9 expression. JOURNAL OF ETHNOPHARMACOLOGY 2016; 186:91-102. [PMID: 27036629 DOI: 10.1016/j.jep.2016.03.057] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 03/28/2016] [Accepted: 03/28/2016] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Kegan Liyan oral liquid (KGLY), a Chinese prescription modified from classic formulas Yin-Qiao-San (from TCM classic Wenbing Tiaobian) and Shen-Jie-San (first mentioned in Shanghan Wenyi Tiaobian), has been reported to exert heat-clearing and detoxifying effects and used extensively for the treatment of severe pulmonary diseases in clinics including influenza, cough and pneumonia. AIM OF THIS STUDY The purpose of this study was to investigate the protective effect of KGLY on lipopolysaccharide (LPS) induced acute lung injury (ALI) in mice and to illuminate the underlying mechanisms. MATERIALS AND METHODS Mice were orally administrated with KGLY (50, 100 and 150mg/kg) before intratracheal instillation of LPS. 24h post LPS challenge, lung tissues and the bronchoalveolar lavage fluid (BALF) were collected for lung wet/dry (W/D) weight ratio, histopathological examinations and biochemical analyses. The cell counts, protein concentration, interleukin-1β (IL-1β), interleukin-6 (IL-6), necrosis factor-α (TNF-α), macrophage inflammatory protein-2 (MIP-2) in BALF, superoxide dismutase (SOD), glutathione (GSH), myeloperoxidase (MPO) and malondialdehyde (MDA) levels were detected. Meanwhile, the activation of toll-like receptor 4 (TLR4), nuclear factor kappa B (NF-κB), as well as matrix metalloproteinases 9 (MMP-9) were determined by western blot assay. RESULTS KGLY significantly prolonged mice survival time and ameliorated LPS-induced edema, thickening of alveolar septa and inflammatory cell infiltration in a dose-dependent manner. Additionally, KGLY markedly attenuated LPS-induced acute pulmonary inflammation via decreasing the expressions of cytokines and chemokines (IL-1β, IL-6, TNF-α, and MIP-2), enhanced the activities of anti-oxidative indicators (SOD and GSH), suppressed the levels of MPO and MDA, and down-regulated the expressions of TLR4, NF-κB and MMP9. CONCLUSIONS The results suggested that the relieving effect of KGLY against LPS-induced ALI might be partially due to suppression of oxidative stress and inflammatory response, inhibition of TLR4-mediated NF-κB activation, and down-regulation of MMP9 expression, indicating it may be a potential therapeutic agent for ALI.
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Affiliation(s)
- Xie Zhang
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China; Guangdong Provincial Key Laboratory of New Chinese Medicinal Development and Research, Guangzhou 510006, PR China.
| | - Chao-Yue Sun
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China; Guangdong Provincial Key Laboratory of New Chinese Medicinal Development and Research, Guangzhou 510006, PR China.
| | - Yong-Bin Zhang
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China.
| | - Hui-Zhen Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong 510060, PR China.
| | - Xue-Xuan Feng
- Guangdong Medical Laboratory Animal Center, Foshan 528248, PR China.
| | - Shao-Zhong Peng
- Guangzhou Wanglaoji Pharmaceutical Company Limited, Guangzhou 510450, PR China.
| | - Jie Yuan
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China; Guangdong Provincial Key Laboratory of New Chinese Medicinal Development and Research, Guangzhou 510006, PR China.
| | - Rong-Bo Zheng
- Guangzhou Wanglaoji Pharmaceutical Company Limited, Guangzhou 510450, PR China.
| | - Wei-Ping Chen
- Guangzhou Wanglaoji Pharmaceutical Company Limited, Guangzhou 510450, PR China.
| | - Zi-Ren Su
- School of Chinese Materia Medica, Guangzhou University of Chinese Medicine, Guangzhou 510006, PR China; Guangdong Provincial Key Laboratory of New Chinese Medicinal Development and Research, Guangzhou 510006, PR China.
| | - Xiao-Dan Huang
- Guangzhou Wanglaoji Pharmaceutical Company Limited, Guangzhou 510450, PR China.
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Chang TC, Uen YH, Chou CH, Sheu JR, Chou DS. The role of cyclooxygenase-derived oxidative stress in surgically induced lymphedema in a mouse tail model. PHARMACEUTICAL BIOLOGY 2013; 51:573-580. [PMID: 23373707 DOI: 10.3109/13880209.2012.749923] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
CONTEXT Oxidative stress may contribute to lymphedema and subsequent tissue damage. However, the causal role of oxidative stress in lymphedema remains unclear. OBJECTIVE We attempted to detect and identify the free radicals formed in lymphedema fluid and assessed the protective mechanisms and effects of specific enzyme inhibitors and natural antioxidants. MATERIALS AND METHODS To study the level of postsurgical oxidative stress with lymphedema in a mouse tail model, we used an electron spin resonance (ESR) method and an ascorbyl radical's ESR spectrum as an oxidative stress biomarker. The drug-treatment group received an i.p. injection with indomethacin (2 mg/kg), baicalein (15 mg/kg), MK-886 (3 mg/kg), zileuton (6.25 mg/kg), diphenyleneiodonium (DPI; 1 mg/kg), sulforaphane (30 mg/kg), oryzanol (30 mg/kg) or sesamol (30 mg/kg) once daily for 14 d from the day of operation. All animals were sacrificed on day 14. RESULTS Administration of indomethacin, sulforaphane, oryzanol and sesamol significantly suppressed both the tail volume (56.9%, 77.8%, 72.2% and 38.1% inhibition, respectively, p < 0.01) and ascorbyl radical signals (31.4%, 54.5%, 79.3% and 57.1% inhibition, respectively, p < 0.01), compared with the control mice. No significant differences were found between any of the baicalein, MK-886, or zileuton groups compared with the control. DPI suppressed the tail volume (25.9% inhibition, p < 0.01) but not the ascorbyl radical signals. CONCLUSION This study showed that COX-derived oxidative stress plays a major role in the pathological mechanisms of surgically induced lymphedema. Indomethacin, sulforaphane, oryzanol and sesamol exhibit potent protective properties against surgically induced lymphedema.
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Affiliation(s)
- Ting-Chen Chang
- Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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