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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] [MESH Headings] [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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Xu J, Xu S, Luo J, Zhang S, Wu D, Yang Q, Fang R, Shi C, Liu Q, Zhao J. Epigallocatechin-3-gallate Alleviates Ethanol-Induced Endothelia Cells Injury Partly through Alteration of NF-κB Translocation and Activation of the Nrf2 Signaling Pathway. Biol Pharm Bull 2024; 47:1248-1254. [PMID: 38866477 DOI: 10.1248/bpb.b23-00773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
Ethanol (alcohol) is a risk factor that contributes to non-communicable diseases. Chronic abuse of ethanol is toxic to both the heart and overall health, and even results in death. Ethanol and its byproduct acetaldehyde can harm the cardiovascular system by impairing mitochondrial function, causing oxidative damage, and reducing contractile proteins. Endothelial cells are essential components of the cardiovascular system, are highly susceptible to ethanol, either through direct or indirect exposure. Thus, protection against endothelial injury is of great importance for persons who chronic abuse of ethanol. In this study, an in vitro model of endothelial injury was created using ethanol. The findings revealed that a concentration of 20.0 mM of ethanol reduced cell viability and Bcl-2 expression, while increasing cell apoptosis, intracellular reactive oxygen species (ROS) levels, mitochondrial depolarization, and the expression of Bax and cleaved-caspase-3 in endothelial cells. Further study showed that ethanol promoted nuclear translocation of nuclear factor kappa B (NF-κB), increased the secretion of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 in the culture medium, and inhibited nuclear factor-erythroid 2-related factor 2 (Nrf2) signaling pathway. The aforementioned findings suggest that ethanol has a harmful impact on endothelial cells. Nevertheless, the application of epigallocatechin-3-gallate (EGCG) to the cells can effectively mitigate the detrimental effects of ethanol on endothelial cells. In conclusion, EGCG alleviates ethanol-induced endothelial injury partly through alteration of NF-κB translocation and activation of the Nrf2 signaling pathway. Therefore, EGCG holds great potential in safeguarding individuals who chronically abuse ethanol from endothelial dysfunction.
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Affiliation(s)
- Jie Xu
- Department of Public Health, Shaanxi University of Chinese Medicine
- College of Life Sciences, Northwest University
| | - Shouzhu Xu
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Jiayin Luo
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Shihao Zhang
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Dongdong Wu
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Qifan Yang
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Rourou Fang
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Chuandao Shi
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Qiling Liu
- Department of Public Health, Shaanxi University of Chinese Medicine
| | - Jing Zhao
- Shaanxi Key Laboratory of Acupuncture & Medicine, Shaanxi University of Chinese Medicine
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Fang X, Jiang XF, Zhang YP, Zhou CL, Dong YJ, Li B, Lv GY, Chen SH. Exploring the Action Mechanism and Validation of the Key Pathways of Dendrobium officinale Throat-clearing Formula for the Treatment of Chronic Pharyngitis Based on Network Pharmacology. Comb Chem High Throughput Screen 2024; 27:479-496. [PMID: 37877149 PMCID: PMC10964081 DOI: 10.2174/0113862073261351231005111817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/27/2023] [Accepted: 09/08/2023] [Indexed: 10/26/2023]
Abstract
AIM This study investigated the molecular action mechanism of a compound herb, also known as the Dendrobium officinale throat-clearing formula (QYF), by using network pharmacology and animal experimental validation methods to treat chronic pharyngitis (CP). METHODS The active ingredients and disease targets of QYF were determined by searching the Batman-TCM and GeneCards databases. Subsequently, the drug-active ingredient-target and protein-protein interaction networks were constructed, and the core targets were obtained through network topology. The Metascape database was screened, and the core targets were enriched with Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes. RESULTS In total, 1403 and 241 potential targets for drugs and diseases, respectively, and 81 intersecting targets were yielded. The core targets included TNF, IL-6, and IL-1β, and the core pathways included PI3K-Akt. The QYF treatment group exhibited effectively improved general signs, enhanced anti-inflammatory ability in vitro, reduced serum and tissue expressions of TNF- α, IL-6, and IL-1β inflammatory factors, and decreased blood LPS levels and Myd88, TLR4, PI3K, Akt, and NF-κB p65 protein expression in the tissues. CONCLUSION QYF could inhibit LPS production, which regulated the expression of the TLR4/PI3K/Akt/NF-κB signaling pathway to suppress the expression of the related inflammatory factors (i.e., TNF-α, IL-6, and IL-1β), thereby alleviating the CP process.
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Affiliation(s)
- Xi Fang
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Gangshu District, Hangzhou, Zhejiang, 310014, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, No. 999 Changhong East Street, Huzhou City, Zhejiang, 310023, China
| | - Xiao-Feng Jiang
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Gangshu District, Hangzhou, Zhejiang, 310014, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, No. 999 Changhong East Street, Huzhou City, Zhejiang, 310023, China
| | - Yi-Piao Zhang
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Gangshu District, Hangzhou, Zhejiang, 310014, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, No. 999 Changhong East Street, Huzhou City, Zhejiang, 310023, China
| | - Cheng-Liang Zhou
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Gangshu District, Hangzhou, Zhejiang, 310014, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, No. 999 Changhong East Street, Huzhou City, Zhejiang, 310023, China
| | - Ying-Jie Dong
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Gangshu District, Hangzhou, Zhejiang, 310014, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, No. 999 Changhong East Street, Huzhou City, Zhejiang, 310023, China
| | - Bo- Li
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Gangshu District, Hangzhou, Zhejiang, 310014, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, No. 999 Changhong East Street, Huzhou City, Zhejiang, 310023, China
| | - Gui-Yuan Lv
- College of Pharmaceutical Science, No. 548, Binwen Road, Binjiang District, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China
| | - Su-Hong Chen
- Collaborative Innovation Center of Yangtze River Delta Region Green Pharmaceuticals, Zhejiang University of Technology, No. 18, Chaowang Road, Gangshu District, Hangzhou, Zhejiang, 310014, China
- Zhejiang Provincial Key Laboratory of TCM for Innovative R & D and Digital Intelligent Manufacturing of TCM Great Health Products, No. 999 Changhong East Street, Huzhou City, Zhejiang, 310023, China
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Lingxia Z, Hong W, Man G, Xinzhou W, Lili W, Zhimin W, Liping D, Erping X. Rabdosichuanin C inhibits productions of pro-inflammatory mediators regulated by NF-κB signaling in LPS-stimulated RAW264.7 cells. J Cell Biochem 2023; 124:1667-1684. [PMID: 37850620 DOI: 10.1002/jcb.30474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/14/2023] [Accepted: 08/26/2023] [Indexed: 10/19/2023]
Abstract
Chronic pharyngitis (CP) is an inflammatory disease of the pharyngeal mucosa and its lymphatic tissues that is difficult to treat clinically. However, research on the exact therapeutic agents and molecular mechanisms of CP is still unclear. In this study, we investigated Rabdosichuanin C (RC) to attenuate lipopolysaccharide (LPS)-induced inflammatory damage in RAW264.7 cells by a combination of targeted virtual screening and in vitro activity assay and further clarified its molecular mechanism of action centering on the IκB/nuclear factor kappa B (NF-κB) pathway. Molecular docking and pharmacophore simulation methods were used to screen compounds with IκB inhibitory effects. Expression of genes and proteins related to the IκB/NF-κB signaling pathway by RC in LPS-induced inflammatory injury model of RAW264.7 cells was detected by PCR, enzyme-linked immunosorbent assay, and Western blot. The docking of RC with IκB protein showed good binding energy, and pharmacophore simulations further confirmed the active effect of RC in inhibiting IκB protein. RC intervention in LPS-induced RAW264.7 cells significantly reduced the expression levels of inflammatory factors tumor necrosis factor-α, interleukins-6, iNOS, and CD-86 at the messenger RNA and protein levels, downregulated IκB, p65 protein phosphorylation levels, and significantly inhibited IκB/NF-κB signaling pathway activation. Virtual screening provided us with an effective method to rapidly identify compounds RC that target inhibit the action of IκB, and the activity results showed that RC inhibits NF-κB signaling pathway activation. It is suggested that RC may play a role in the treatment of CP by inhibiting the IκB/NF-κB signaling pathway.
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Affiliation(s)
- Zhang Lingxia
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wu Hong
- Laboratory of Cell Imaging, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Gong Man
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wang Xinzhou
- Laboratory of Cell Imaging, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wang Lili
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Wang Zhimin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dai Liping
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Xu Erping
- School of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, Henan, China
- Engineering Technology Research Center for Comprehensive Development and Utilization of Authentic Medicinal Materials in Henan Province, Henan University of Chinese Medicine, Zhengzhou, Henan, China
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Zhang H, Tong Y, Jin Y, Cai G, Li Z, Pan X. Elucidation of the mechanism of action of Runyan Mixture in the treatment of pharyngitis using a network pharmacological approach. Medicine (Baltimore) 2022; 101:e32437. [PMID: 36595833 PMCID: PMC9794313 DOI: 10.1097/md.0000000000032437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
This study aimed to elucidate the mechanism of action of Runyan Mixture in treating pharyngitis using a network pharmacological approach. The active components of the Runyan Mixture were obtained from the traditional chinese medicine systems pharmacology database and evaluated using Lipinski's rules. The SwissTargetPrediction database was used to predict the action targets of the Runyan Mixture, and a protein-protein interaction network was constructed using the STRING database. Moreover, the anti-inflammatory effect of Runyan Mixture was validated in vitro using the lipopolysaccharide induced inflammation in macrophages. The Runyan Mixture was the liquid preparation from 8 traditional Chinese medicine. A total of 89 types of active components, 53 core targets, and 98 signaling pathways (P < .001) were identified for the Runyan Mixture. The main action targets were EGFR, MAPK1, AKT1, PIK3CA, NFKB1, SRC, TNF, MAPK8, MET, and PTGS2. Among the identified signaling pathways, 20 were associated with microbial infection and 24 were related to the immune-inflammatory response. Experimental results in vitro showed that Runyan Mixture could significantly inhibit the expression of interleukin-1, interleukin-6, and tumor necrosis factor-α (P < .05) in macrophages by lipopolysaccharide stimulation. Based on the results of the protein-protein interaction network analysis and the anti-inflammatory effect in vitro, the efficiency of the Runyan Mixture in pharyngitis treatment could be attributed to the inhibition of the inflammatory response.
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Affiliation(s)
- Huihui Zhang
- Traditional Chinese medicine pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua, China
| | - Yingpeng Tong
- College of Pharmaceutical Sciences, Taizhou University, Taizhou, China
| | - Yinzhi Jin
- Traditional Chinese medicine pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua, China
| | - Guoyun Cai
- Traditional Chinese medicine pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua, China
| | - Zhenxin Li
- Traditional Chinese medicine pharmacy, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua, China
| | - Xinling Pan
- Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, Jinhua, China
- * Correspondence: Xinling Pan, Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital of Wenzhou Medical University, No. 60 Wuningxi Road, Dongyang, Zhejiang, China (e-mail: )
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Gerlitz M, Voitl P, Voitl JJM, Diesner-Treiber SC. Non-prescription treatments for childhood infections: an Austrian, monocentric, cross-sectional questionnaire study. BMC Pediatr 2022; 22:154. [PMID: 35331197 PMCID: PMC8943939 DOI: 10.1186/s12887-022-03220-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 03/16/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Infectious diseases like the common cold, otitis media, or gastroenteritis frequently occur in childhood. In addition to prescription drugs, parents often use supplementary over-the-counter (OTC) products recommended by pharmacists and other non-medical professionals to relieve their children's symptoms. However, the efficacy of such alternative treatments lacks conclusive evidence. The objective of this study was to investigate the use of OTC products and related active ingredients in children, and the motivations behind this choice. METHODS The present study included 215 children aged between 1 and 14 years with an acute respiratory tract infection, e.g., common cold, bronchitis, otitis media, tonsillitis, or gastroenteritis. During their visit to the pediatric practice, parents filled in a self-administered questionnaire about their child's diagnosis, additional treatment options, and motivations to integrate supplementary medicinal products after their first visit for acute infection or follow-up examination. Children with chronic illnesses and patients visiting for a routine maternal and child health program check-up were excluded. RESULTS The study included 111 (51.6%) males and 104 (48.4%) females. Median age was 3.00 (IQR 2.0 - 5.0) years. The most common reason for a visit was a respiratory tract infection (78.6%). Out of 215 parents, 182 (84.7%) resorted to non-prescription remedies to alleviate their child's symptoms. Teas (45.1%), and home remedies (43.3%) were the most popular. At total 133 (74.3%) followed recommendations from friends and family regarding additional medications usage. Parents with previous experience with complementary medicine tended to prefer this approach to treat their children (p.adjust = 0.08). CONCLUSION The use of non-prescription medicine is increasing as well as the range of related information sources. Evidence-based recommendations in this field might improve pediatric care.
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Affiliation(s)
- Matthias Gerlitz
- First Vienna Pediatric Medical Center, Donau-City-Strasse 1, 1220 Vienna, Austria
| | - Peter Voitl
- First Vienna Pediatric Medical Center, Donau-City-Strasse 1, 1220 Vienna, Austria
- Sigmund Freud University Vienna, Donau-City Strasse 1, 1220 Vienna, Austria
| | - Julian J. M. Voitl
- First Vienna Pediatric Medical Center, Donau-City-Strasse 1, 1220 Vienna, Austria
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Ji S, Xu F, Zhu R, Wang C, Guo D, Jiang Y. Mechanism of Yinqin Oral Liquid in the Treatment of Chronic Pharyngitis Based on Network Pharmacology. DRUG DESIGN DEVELOPMENT AND THERAPY 2021; 15:4413-4421. [PMID: 34707348 PMCID: PMC8542895 DOI: 10.2147/dddt.s324139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/04/2021] [Indexed: 11/23/2022]
Abstract
Background Yinqin oral liquid (YOL) has curative effect for upper respiratory tract infections, especially for chronic pharyngitis (CP). Since the traditional Chinese herbal formulae are complicated, the pharmacological mechanism of YOL remains unclear. The aim of this work was to explore the active ingredients and mechanisms of YOL against CP. Methods First, the profile of putative target of YOL was predicted based on structural and functional similarities of all available YOL components, which were obtained from the Drug Bank database, to the known drugs using TCMSP. The chemical constituents and targets of honeysuckle, scutellaria, bupleurum and cicada were searched by TCMSP, CTD, GeneCards and other databases were used to query the CP-related genes, which were searched by UniProt database. Thereafter, the interactions network between compounds and overlapping genes was constructed, visualized, and analyzed by Cytoscape software. Finally, pathway enrichment analysis of overlapping genes was carried out on Database for Annotation, Visualization, and Integrated Discovery (DAVID) platform. Results The pathway enrichment analysis showed 55 compounds and 113 corresponding targets in the compound-target network, and the key targets involved PTGS1, ESR2, GSK3β, NCOA2, ESR1. The PPI core network contained 30 proteins, including VEGFA, IL6, ESR1, RELA and HIF1A. A total of 148 GO items were obtained (p<0.05), 102 entries on biological process (BP), 34 entries on biological process (BP) and 12 entries on cell composition (CC) were included. A total of 46 signaling pathways were obtained by KEGG pathway enrichment screening (p<0.05), involving cancer, PI3K-AKT, hepatitis, proteoglycans, p53, HIF-1 signaling pathways. Conclusion These results collectively indicate YOL (including the main ingredients luteolin and baicalein) as a highly effective therapeutic agent for anti-inflammation, through the NF-kB pathway.
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Affiliation(s)
- Shiliang Ji
- Laboratory of Clinical Pharmacy, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, People's Republic of China
| | - Fei Xu
- College of Pharmacy, Nanjing Medical University, Nanjing, People's Republic of China
| | - Ruifang Zhu
- Laboratory of Clinical Pharmacy, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, People's Republic of China
| | - Cheng Wang
- College of Pharmacy, Nanjing Medical University, Nanjing, People's Republic of China.,The Health Supervision Institute of Suzhou High-Tech Zone, Suzhou, People's Republic of China
| | - Dongkai Guo
- Laboratory of Clinical Pharmacy, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, People's Republic of China
| | - Yiguo Jiang
- Laboratory of Clinical Pharmacy, The Affiliated Suzhou Science and Technology Town Hospital of Nanjing Medical University, Suzhou, People's Republic of China
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Ran F, Han X, Deng X, Wu Z, Huang H, Qiu M, Song J, Wei X, Zhang D, Wang Y, Fan S, Lin J, Han L. High or low temperature extraction, which is more conducive to Triphala against chronic pharyngitis? Biomed Pharmacother 2021; 140:111787. [PMID: 34091181 DOI: 10.1016/j.biopha.2021.111787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/27/2021] [Accepted: 05/25/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Explore the effects of high-temperature reflux extraction and low-temperature decompressing inner ebullition on Triphala's chemical composition and anti-chronic pharyngitis activity. METHODS The network pharmacology was used to analyze the material basis, targets and pathways of Triphala for chronic pharyngitis. HPLC were used to compare the fingerprint profile and content of components between the two extracts. The antioxidant and anti-chronic pharyngitis activities of the two extracts were compared by DPPH assay and ammonia induced chronic pharyngitis model in rats. RESULTS The network pharmacology results showed that the active ingredients of Triphala for chronic pharyngitis are epigallocatechin-3-gallate, (+)-catechin, epicatechin, epicatechin gallate, (+)-gallocatechin, quercetin, luteolin, leucodelphinidin and other flavonoids; phenolic acids such as gallic acid and ellagic acid; alkaloids such as ellipticine, cheilanthifoline; hydrolyzed tannins such as corilagin and chebulic acid. The high-temperature reflux extract and the low-temperature decompressing inner ebullition extract have extremely significant differences in the fingerprint profile. Among them, the content of gallic acid, ellagic acid, chebulic acid, catechin, epicatechin, corilagin, quercetin, and epicatechin gallate in the reflux extract is 1.1-5.3 times as much as decompressing inner ebullition extract. The free radical scavenging ability of reflux extract is significantly stronger than that of decompression extract (p < 0.01), and it has a repairing effect on pharyngeal mucosal damage (reducing keratinization or hyperplasia of mucosal epithelium, reducing inflammatory cell infiltration and bleeding), and reducing IL-1β (P<0.05), IL-6 (p<0.05), TNF-α overexpression ability is stronger than the decompressing inner ebullition extract. CONCLUSIONS gallic acid, ellagic acid, chebulic acid, catechin, epicatechin, corilagin and epicatechin gallate are the basic aglycones or oligomers of tannin. High temperature reflux extraction can significantly promote the occurrence of the hydrolysis of tannins and significantly increases the content of these components.Therefore, its anti-chronic pharyngitis activity is enhanced. It is suggested that high temperature reflux extraction should be used in the treatment of chronic pharyngitis.
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Affiliation(s)
- Fei Ran
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Xue Han
- School of Pharmacy, Chengdu Medical College, Chengdu 610500, China.
| | - Xuan Deng
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Zhenfeng Wu
- State key Laboratory of Innovation Medicine and High Efficiency and Energy Saving Pharmaceutical Equipment, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, China.
| | - Haozhou Huang
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Ming Qiu
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Jiao Song
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Xichuan Wei
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Dingkung Zhang
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
| | - Yu Wang
- Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu 610041, China.
| | - Sanhu Fan
- Sanajon Pharmaceutical Group, Chengdu 610000, China.
| | - Junzhi Lin
- Central Laboratory, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610072, China.
| | - Li Han
- State Key Laboratory of Southwest Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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Jun JH, Choi TY, Lee HW, Ang L, Lee MS. Herbal Medicine for Behçet's Disease: A Systematic Review and Meta-Analysis. Nutrients 2020; 13:E46. [PMID: 33375705 PMCID: PMC7824385 DOI: 10.3390/nu13010046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/14/2020] [Accepted: 12/20/2020] [Indexed: 02/07/2023] Open
Abstract
Patients with Behçet's disease often use complementary and alternative medicine for treating their symptoms, and herbal medicine is one of the options. This systematic review provides updated clinical evidence of the effectiveness of herbal medicine for the treatment of Behçet's disease (BD). We searched eleven electronic databases from inception to March 2020. All randomized controlled trials (RCTs) or quasi-RCTs of BD treatment with herbal medicine decoctions were included. We used the Cochrane Handbook for Systematic Reviews of Interventions to assess the risk of bias and the grading of recommendations assessment, development and evaluation (GRADE) approach to assess the certainty of evidence (CoE). Albatross plot was also used to present the direction of effect observed. Eight studies were included. The risk of bias was unclear or low. The methodological quality was low or very low. Seven RCTs showed significant effects of herbal medicine on the total response rate (Risk ratio, RR 1.26, 95% CI 1.09 to 1.45, seven studies, very low CoE). Four RCTs showed favorable effects of herbal medicine on the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level compared with drug therapy. Herbal medicine favorably affected the ESR (MD -5.56, 95% CI -9.99 to -1.12, p = 0.01, I2 = 96%, five studies, very low CoE). However, herbal medicine did not have a superior effect on CRP. Two RCTs reported that herbal medicine significantly decreased the recurrence rate after three months of follow-up (RR 0.23, 95% CI 0.09 to 0.63, two studies, low CoE). Our findings suggest that herbal medicine is effective in treating BD. However, the included studies had a poor methodological quality and some limitations. Well-designed clinical trials with large sample sizes are needed.
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Affiliation(s)
- Ji Hee Jun
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea; (J.H.J.); (T.Y.C.); (L.A.)
| | - Tae Young Choi
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea; (J.H.J.); (T.Y.C.); (L.A.)
| | - Hye Won Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Korea;
| | - Lin Ang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea; (J.H.J.); (T.Y.C.); (L.A.)
- Korean Convergence Medicine, University of Science and Technology, Daejeon 34113, Korea
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon 34054, Korea; (J.H.J.); (T.Y.C.); (L.A.)
- Korean Convergence Medicine, University of Science and Technology, Daejeon 34113, Korea
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10
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Network Pharmacology Identifies the Mechanisms of Sang-Xing-Zhi-Ke-Fang against Pharyngitis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2421916. [PMID: 33101439 PMCID: PMC7576344 DOI: 10.1155/2020/2421916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/01/2020] [Accepted: 09/09/2020] [Indexed: 12/26/2022]
Abstract
Background Sang-Xing-Zhi-Ke-Fang (SXZKF) demonstrates good therapeutic effect against pharyngitis. Nevertheless, the pharmacological mechanism underlying its effectiveness is still unclear. Objective To investigate the underlying mechanisms of SXZKF against pharyngitis using network pharmacology method. Methods Bioactive ingredients of SXZKF were collected and screened using published literature and two public databases. Using four public databases, the overlapping genes between these bioactive compound-related and pharyngitis-related genes were identified by Venn diagram. Protein-protein interaction (PPI) was obtained using “Search Tool for the Retrieval of Interacting Genes (STRING)” database. “Database for Annotation, Visualization, and Integrated Discovery ver. 6.8 (DAVID 6.8)” was used to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis to explore the molecular mechanisms of SXZKF against pharyngitis. Finally, Cytoscape 3.7.2 software was used to construct and visualize the networks. Result A total of 102 bioactive compounds were identified. Among them, 886 compounds-related and 6258 pharyngitis-related genes were identified, including 387 overlapping genes. Sixty-three core targets were obtained, including ALB, PPARγ, MAPK3, EGF, and PTGS2. Signaling pathways closely related to mechanisms of SXZKF for pharyngitis were identified, including serotonergic synapse, VEGF signaling pathway, Fc epsilon RI signaling pathway, Ras signaling pathway, MAPK signaling pathway, and influenza A. Conclusion This is the first identification of in-depth study of SXZKF against pharyngitis using network pharmacology. This new evidence could be informative in providing new support on the clinical effects of SXZKF on pharyngitis and for the development of personalized medicine for pharyngitis.
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Chen YH, Luo R, Lei SS, Li B, Zhou FC, Wang HY, Chen X, He X, Wang YZ, Zhan LH, Lu TT, Su J, Yu QX, Li B, Lv GY, Chen SH. Anti-inflammatory effect of Ganluyin, a Chinese classic prescription, in chronic pharyngitis rat model. BMC Complement Med Ther 2020; 20:265. [PMID: 32859182 PMCID: PMC7456022 DOI: 10.1186/s12906-020-03057-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 08/19/2020] [Indexed: 12/28/2022] Open
Abstract
Background Ganluyin (GLY) is a famous classical prescription with a long history of use as a treatment for inflammatory conditions such as chronic pharyngitis (CP) in many parts of China. However, it has not been developed as a modern pharmaceutic and its anti-inflammatory mechanisms remain unclear. The aim of this study was to assess the anti-inflammatory efficacy of GLY and potential mechanisms in a rat model of CP. Methods The chemical profile of GLY was analyzed by HPLC-UV. We used a mouse model of ear edema and a rat model of paw edema. Specifically, xylene was used to induce edema on the surface of one ear in mice, and carrageenan was injected subcutaneously into the right hind paws of rats to induce paw edema. The paw thickness, ear weight, and ear perfusion were measured and recorded. The CP model in rats was induced by irritating the throat with 5% ammonia and was used to evaluate the therapeutic efficacy of GLY. Levels of interleukin-6 (IL-6), interleukin-1β (IL-1β), tumor necrosis factor (TNF-α), and prostaglandin E2 (PGE2) were measured by ELISA in serum, and protein expression of cyclooxygenase-2 (COX-2) and nuclear factor kappa-B p65 (NF-κB p65) in the throat were detected by immunohistochemistry and Western blot to evaluate the anti-inflammatory mechanism of GLY. Hematological assays were also conducted. Results There were four flavonoids identified in GLY: naringin, neohesperidin, baicalin, and wogonoside. The oral administration of GLY showed a significant inhibitory effect on xylene-induced ear swelling and ear blood flow in mice and significantly ameliorated rat right hind paw edema at doses of 6.2 and 12.4 g/kg. Mechanistic studies found that the anti-inflammatory activity of GLY was related to the inhibition of pro-inflammatory cytokines such as IL-1β, IL-6, TNF-α, and PGE2 and that GLY reduced the expression of COX-2 and NF-κB p65 proteins in the throat, attenuated throat injury, and reduced inflammatory exudates. Hematological analysis showed that treatment with GLY prevented increases in white blood cell (WBC), neutrophil (NEUT), lymphocyte (LYMPH) and monocyte (MONO) levels. Conclusions These studies indicated that GLY has beneficial anti-inflammatory effects on CP and that it acts through reducing pro-inflammatory factors such as IL-1β, IL-6, TNF-α, and PGE2, as well as decreasing WBC, NEUT, LYMPH and MONO levels and decreasing the expression of COX-2 and NF-κB p65 proteins. These findings may lay the groundwork for further studies of GLY as a suitable candidate for the treatment of inflammatory diseases such as CP.
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Affiliation(s)
- Ye-Hui Chen
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Rong Luo
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Shan-Shan Lei
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Bing Li
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Fu-Chen Zhou
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Hui-Ying Wang
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Xue Chen
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Xinglishang He
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Yu-Zhi Wang
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Liang-Hui Zhan
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Ting-Ting Lu
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China
| | - Jie Su
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People's Republic of China
| | - Qiao-Xian Yu
- Zhejiang Senyu Co., Ltd, Yiwu, Zhejiang, 322099, People's Republic of China
| | - Bo Li
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China.
| | - Gui-Yuan Lv
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, People's Republic of China.
| | - Su-Hong Chen
- Zhejiang University of Technology, Hangzhou, Zhejiang, 310014, People's Republic of China.
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Ni L, Chen L, Huang X, Han C, Xu J, Zhang H, Luan X, Zhao Y, Xu J, Yuan W, Chen H. Combating COVID-19 with integrated traditional Chinese and Western medicine in China. Acta Pharm Sin B 2020; 10:1149-1162. [PMID: 32834946 PMCID: PMC7319939 DOI: 10.1016/j.apsb.2020.06.009] [Citation(s) in RCA: 97] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/02/2020] [Accepted: 06/08/2020] [Indexed: 12/24/2022] Open
Abstract
COVID-19, an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread throughout the world. China has achieved rapid containment of this highly infectious disease following the principles of early detection, early quarantine and early treatment with integrated traditional Chinese and Western medicine. The inclusion of traditional Chinese medicine (TCM) in the Chinese protocol is based on its successful historic experience in fighting against pestilence. Current findings have shown that the Chinese medicine can reduce the incidence of severe or critical events, improve clinical recovery and help alleviate symptoms such as cough or fever. To date there are over 133 ongoing registered clinical studies on TCM/integrated traditional Chinese and Western medicine. The three Chinese patent medicines (Lianhua Qingwen Keli/Jiaonang (Forsythiae and Honeysuckle Flower Pestilence-Clearing Granules/Capsules), Jinhua Qinggan Keli (Honeysuckle Flower Cold-Relieving Granules) and Xuebijing (Stasis-Resolving & Toxin-Removing) Injection were officially approved by the National Medical Products Administration to list COVID-19 as an additional indication. The pharmacological studies have suggested that Chinese medicine is effective for COVID-19 probably through its host-directed regulation and certain antiviral effects.
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Affiliation(s)
- Liqiang Ni
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Lili Chen
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xia Huang
- Ruijin Hospitol, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Chouping Han
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jianrong Xu
- Department of Phamacology, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Hong Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xin Luan
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Yongfang Zhao
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jianguang Xu
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Weian Yuan
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Corresponding authors.
| | - Hongzhuan Chen
- Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
- Department of Phamacology, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
- Corresponding authors.
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