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This study aims to evaluate the efficacy and safety of Compound Qinlan Oral Liquid in the treatment of acute upper respiratory tract infection. Computer-based online searching of CNKI, VIP, SinoMed, Wanfang, ChiCTR, ClinicalTrials.gov, Cochrane Library, PubMed, EMbase, and Web of Science was performed to retrieve the randomized controlled trial(RCT) regarding Compound Qinlan Oral Liquid in the treatment of acute upper respiratory tract infection. In addition, manual searching of gray literature was conducted. After two evaluators independently selected articles, extracted data, and evaluated the quality of methodology included in the studies, Meta-analysis was carried out in RevMan 5.4 and trial sequential analysis(TSA) in TSA 0.9.5.10 Beta. GRADE profiler 3.6.1 was employed to evaluate the evidence quality. A total of 21 RCTs were included in this study, involving 2 651 patients(1 330 patients in the observation group and 1 321 patients in the control group). Meta-analysis showed that compared with conventional western medicine alone, Compound Qinlan Oral liquid improved the total response rate(RR=1.15, 95%CI[1.12, 1.19], P<0.000 01) without increasing the incidence of adverse reactions(RR=0.77, 95%CI[0.47, 1.25], P=0.16). The results of subgroup analysis are described as follows:(1) Compared with conventional western medicine alone, Compound Qinlan Oral Liquid improved the total response rate(RR=1.10, 95%CI[1.05, 1.14], P<0.000 01) and shortened the time to symptom relief(SMD=-0.76, 95%CI[-1.02,-0.51], P<0.000 01). There was no significant difference in the incidence of adverse reactions between the two groups(RR=1.16, 95%CI[0.54, 2.47], P=0.71).(2) Compared with conventional western medicine alone, Compound Qinlan Oral Liquid + conventional western medicine improved the total response rate(RR=1.20, 95%CI[1.15, 1.25], P<0.000 01), decreased traditional Chinese medicine(TCM) syndrome scores(MD=-0.58, 95%CI[-0.75,-0.41], P<0.000 01), shortened the time to symptom relief(SMD=-2.44, 95%CI[-3.09,-1.80], P<0.000 01) and physical sign improvement(MD=-2.57, 95%CI[-4.11,-1.04], P=0.001), lowered the serum levels of inflammatory cytokines(SMD=-2.16, 95%CI[-2.61,-1.70], P<0.000 01), improved respiratory function indicators(SMD=1.48, 95%CI[1.00, 1.96], P<0.000 01), and enhanced the humoral immunity(MD=0.94, 95%CI[0.69, 1.18], P<0.000 01). There was no significant difference in the incidence of adverse reactions between the two groups(RR=0.57, 95%CI[0.29, 1.09], P=0.09). TSA showed that the cumulative Z curve of total response rate crossed the traditional threshold and TSA threshold, further confirming the clinical efficacy of Compound Qinlan Oral Liquid. The GRADE graded the evidence of the above outcome indicators as low or extremely low, and yielded weak recommendation. Compared with conventional western medicine alone, Compound Qinlan Oral Liquid can improve the total effective rate and reduce the time to symptom relief. The combination of Compound Qinlan Oral Liquid and conventional western medicine can improve the total response rate, mitigate the symptoms and improve the physical signs, reduce inflammation, and improve respiratory function and immunity of the patients with acute upper respiratory tract infection. In view of the limited number and quality of the included studies, the above conclusions still require high-quality RCT to provide evidence support.
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Humans , Drugs, Chinese Herbal/therapeutic use , Inflammation/drug therapy , Medicine, Chinese Traditional , Respiratory Tract Infections/drug therapy , Treatment OutcomeABSTRACT
This study systematically sorted out the evidence data of the safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine(TCM) of Reyanning Mixture in the treatment of acute upper respiratory tract infection(heat-toxin attacking lung syndrome) with the qualitative and quantitative evaluation methods adopted. Based on evidence-based medicine, epidemiology, clinical medicine, evidence-based pharmacy, pharmacoeconomics, and health technology evalua-tion(HTA), the clinical value of Reyanning Mixture was evaluated using multi-criteria decision analysis(MCDA) model, Chinese patent medicine clinical evidence, and value evaluation software(CSC v2.0). The SRS monitoring data, Meta-analysis, and other safety evidence showed that the main adverse reactions of Reyanning Mixture were nausea, diarrhea, and rash, and no serious adverse reactions were found. The pharmacovigilance system was sound, and the system was perfect. There was no recall, notification, or interview for unqualified products. Based on the existing research, the evidence was sufficient, and the risk was controllable. Hence, its safety was grade A. Meta-analysis showed that in the treatment of acute upper respiratory tract infection, Reyanning Mixture combined with Amoxicillin Capsules was better than Amoxicillin Capsules alone in shortening the complete fever relief time and improving the cure rate. Besides, it was superior to Shuanghuanglian Granules in shortening the complete fever relief time, cough relief time, nasal congestion relief time, and pharyngeal congestion relief time. The Meta-analysis was conducted based on AMSTAR standard, and its ove-rall quality was proved good. The evidence quality in GRADE system evaluation was medium and low. The quality of evidence was medium, and the clinical value was obvious. Hence, its effectiveness was grade A. The results of pharmacoeconomic research showed that compared with Amoxicillin Capsules, Reyanning Mixture alone or in combination with Amoxicillin Capsules had cost-effectiveness advantages in the treatment of acute upper respiratory tract infection, and the results were stable in sensitivity analysis. According to the CASP economic evaluation checklist, the research problems were clear and the results were reliable. As revealed by the comprehensive evaluation, the evidence quality was sufficient and the result was clear. Its economy was grade B. Reyanning Mixture had multiple therapeutic targets like anti-virus, anti-bacteria, antipyresis, and anti-cough, with good clinical innovation. There were many innovative initiatives in ensuring drug supply, especially at the grass roots, drug safety, and effectiveness, and also multiple innovative contributions to production technology, quality control, scientific and technological research and development, and enterprise management and marketing. Therefore, its innovation was grade B. The dosage form of Reyanning was mixture, which made it convenient for storage and transportation. The usage was easy to be mastered and accepted by doctors and nurses, exhibiting good suitability for clinicians, nurses, pharmacists, and patients who received this drug and basically meeting the needs of clinical medication. The suitability was grade B. The average daily cost of this drug was 8.082 yuan, and the price was low. The treatment cost accounted for a small proportion of the annual disposable income of urban and rural residents, indicating that it was affordable. Reyanning Mixture was available in 31 provinces, cities and autonomous regions, covering 6 910 hospitals. The allocation of hospitals at all levels was more than 50%. There was no shortage or supply restriction of medicinal material resources. The annual production capacity was sufficient to meet the supply demand, so its accessibility was grade A. Reyanning Mixture, sourced from "pneumonia Ⅲ", has been subjected to a real-world study of its clinical application, with 4 367 cases involved, and the characteristic of TCM was grade B. The comprehensive evaluation results demonstrated that the clinical value score of Reyanning Mixture in the treatment of acute upper respiratory tract infection(heat-toxin attacking lung syndrome) was 0.80, making it rated class A. According to the Guidelines for Management of Comprehensive Clinical Evaluation of Drugs(trial version 2021), it is recommended to convert it into the relevant policy results of basic clinical medication management according to the procedures.
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Humans , Hot Temperature , Lung , Medicine, Chinese Traditional , Respiratory Tract Infections/drug therapy , SyndromeABSTRACT
Objective To explore the correlation between acute upper respiratory tract infection and meteorological factors in Zigong area from 2016 to 2021. Methods All acute upper respiratory tract infection cases from the Emergency Department of the First People's Hospital of Zigong City from 2016 to 2021 and meteorological data (including but not limited to temperature, relative humidity, air pressure, sunshine time, wind speed, etc.) during the same period were collected. Cases were screened from emergency electronic data, and medical records that met the criteria were included in this study to analyze the relationship between acute upper respiratory tract infection and meteorological factors. Results A total of 5 608 patients were enrolled in this study, including 3,893 males (69.42%) and 1,715 females (30.58%), with an average age of 50.17±9.81 years. The predisposing factors were climate change in 2331 cases (41.57%), history of chronic respiratory diseases in 1458 cases (26.00%), low immune function in the elderly or young children in 1106 cases (19.72%), vitamin deficiency in 512 cases (9.13%), and others in 201 cases (3.58%). Acute upper respiratory infections in Zigong area occurred all year round. Spring had more respiratory infections than other seasons, and the season with the fewest infections was autumn. Among them, May had the highest number of cases (650 cases), followed by January (592 cases). September had the least number of cases (475 cases), followed by August (480 cases). The daily incidence of upper respiratory tract infection in this area was negatively correlated with daily average temperature, sunshine duration and daily precipitation (rdaily average temperature=-0.635, Pdaily average temperature=0.027; rsunshine duration=-0.678, Psunshine duration=0.015; rday precipitation=-0.691, pday precipitation=0.013), and positively correlated with the daily temperature range and 24 hrs pressure change (rtemperature daily range=0.644, Ptemperature daily range=0.024; r24hrs change pressure=0.579, P24hrs change pressure=0.049). AURI-induced complications were negatively correlated with daily average temperature (rdaily average temperature=-0.718, P daily average temperature=0.009), and positively correlated with daily temperature range (rtemperature daily range=0.651, Ptemperature daily range=0.022). The analysis of multi-factor regression integration showed that the consistency of the test results exceeded 70%, and it exceeded 85% at the same level or adjacent levels. Conclusion From 2016 to 2021, acute upper respiratory tract infection occurs throughout the year in Zigong, with the most in spring and the least in autumn. May and September are the two months with the highest and lowest number of cases, respectively. The number of cases is affected by the average daily temperature, sunshine duration, daily precipitation, daily temperature range and 24hrs variable pressure. The establishment of a respiratory medical weather forecast model by season has a strong forecasting ability for the number of acute upper respiratory infections.
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Objective:To investigate the distribution and epidemic characteristics of respiratory pathogens in children before and after COVID-19 epidemic in Lanzhou.Methods:Two hundred and eighty-six children hospitalized with acute upper respiratory tract infection in Central Hospital of Gansu Province and Gansu Maternal and Child Health Hospital from October to November of 2020 and October to November of 2021 were selected respectively as the research objects, and a retrospective analysis was made.IgM antibodies of nine pathogens, including influenza virus A(IVA), influenza virus B(IVB), parainfluenza virus(PIV), adenovirus(ADV), mycoplasma pneumoniae(MP), chlamydia pneumoniae(CP), respiratory syncytial virus(RSV), echovirus(ECHO)and coxsackie virus B(CVB), were detected, and the basic information and epidemic characteristics were statistically analyzed.Results:The total positive rates of IgM antibodies of nine pathogens before and after the epidemic in COVID-19 were 31.8%(91/286)and 5.9%(17/286)respectively, after the epidemic, the detection rates dropped significantly, and there was significant difference among them( χ2= 62.505, P<0.05); After the epidemic, the detection rates of ADV, MP and CVB were all lower than those before the epidemic, and there were significant differences among these groups( χ2= 39.281, 12.167, 10.155, all P<0.05). The positive detection rates in the age group of 1 month ~1 year, ~3 years, ~6 years and>6 years before the outbreak were 37.4%(37/99), 38.3%(36/94), 16.7%(12/72)and 28.6%(6/21)respectively, and there were significant differences among these groups( χ2=34.055, P<0.05); Among them, the detection rates of MP in the age group 1 month ~1 year, ~3 years, ~6 years and>6 years were 16.2%(6/37), 25.0%(9/36), 16.7%(2/12)and 100%(6/6)respectively, and there were significant differences among these groups( χ2=10.289, P<0.05); CVB was not detected in>6 years group, the positive detection rates of CVB were 16.2%(6/37), 22.2%(8/36)and 25.0%(3/12)in the age group of 1 month ~1 year, ~3 years, ~6 years respectively, and there were significant differences among these groups( χ2= 27.742, P< 0.05). After the epidemic, the positive detection rates of the patients in the age group of 1 month ~1 year, ~3 years, ~6 years and>6 years were 5.9%(4/68), 4.0%(3/75), 5.7%(6/106)and 10.8%(4/37), with no statistical significance( χ2=2.235, P>0.05); Among them, the positive rates of IVB were 25.0%(1/4), 33.3%(1/3)and 66.7%(4/6)in the age group of 1 month ~1 year, ~3 years, ~6 years respectively, and in the age group>6 years was not detected, and there were significant differences among these groups( χ2= 96.022, P< 0.05). The detection rates of mixed infection of pathogens before and after the epidemic were 5.6%(16/286)and 0.3%(1/286)respectively, with no statistical significance( χ2= 2.314, P>0.05). Conclusion:The distribution of common pathogens of acute upper respiratory tract infection among children in Lanzhou was different before and after COVID-19 epidemic.
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Objective To understand the status of acute upper respiratory tract viral and bacterial infections in children in Chengdu and to analyze its epidemiological characteristics. Methods From April 2018 to April 2020, 1,324 children with acute upper respiratory tract infection admitted to Chengdu Second People's Hospital were enrolled in the study. Pathogens from throat swab specimens were cultured, isolated, and identified. Results Among 1 324 specimens, the detection rate of bacterial and viral infection was 76.44% (1 012/1 324). The detection rate of simple viral infection was 50.40%, the detection rate of simple bacterial infection was 16.21%, and the detection rate of mixed infection was 33.40%. Haemophilus influenzae was the main bacterial type and respiratory syncytial virus A was the main virus type. The positive rate of upper respiratory tract viral infection among children with different ages was significantly different (P<0.05). The positive rate of viral and bacterial upper respiratory tract infection showed a statistically significant difference among different infection seasons (P<0.05). In addition, the positive rate of viral upper respiratory tract infection among children from different districts had statistically significant difference (P<0.05). Conclusion Children with upper respiratory tract infections in Chengdu area are mainly viral infections. Haemophilus influenzae and respiratory syncytial virus A are the main pathogens of upper respiratory tract infections in children. 0~1 year old is the age with the highest incidence of upper respiratory tract bacterial infection, while 1~4 years old is the age with the highest incidence of virus infection. Children in urban areas and in winter have higher positive rates of upper respiratory tract infections.
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Objective To investigate the virus epidemiological characteristics in patients with acute upper respiratory tract infection, so as to provide a basis for clinical treatment. Methods A total fo 1 306 inpatients or outpatients with acute upper respiratory tract infection in our hospital from January 2017 to January 2020 were enrolled. The respiratory viruses in nasopharyngeal swab samples were detected by fluorescence immunoassay. The detection rate, clinical characteristics, seasonal distribution, and age distribution of each virus were analyzed. Results In 1 306 patients with acute upper respiratory tract infection, 679 cases were positive for virus culture, with a total positive detection rate of 51.99%. Among the single virus infections, 463 cases were positive for FluV, with a positive detection rate of 35.45%. Five different virus infections showed significant difference among 0 ~ years old, 14 ~ years old, 50 ~ years old and 65 ~ years old groups (P<0.05). The positive detection rates of FluV, PIV, RSV, and RV were the highest in the 0 ~ years old group, while ADV detection rate was the highest in the 65 ~years old group. The distribution of the 5 different viruses in spring, autumn and winter was significantly different (P<0.05). Conclusion Acute upper respiratory tract infection is mainly caused by a single virus, and different viruses has significant differences in age and seasonal distribution.
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Objective To investigate the clinical efficacy and safety of Xiao'er Chiqiaoqingre granule in the treatment of acute upper respiratory tract infection.Methods From January 2017 to December 2017,a total of 116 children with upper respiratory tract infection in Taizhou Integrated Traditional Chinese and Western Medicine Hospital were selected and randomly divided into control group and observation group according to different treatment regimens,with 58 cases in each group.The control group was given ribavirin granules,ibuprofen suspension drops for treatment.The observation group was given Xiao'er Chiqiaoqingre granule on the basis of the control group.The two groups were treated for 5 days,then the clinical effect,the improvement of clinical symptoms,the time of cure,the level of serum cytokines and safety were compared between the two groups.Results After treatment,the cure rate of the observation group was 96.6％,which was significantly higher than 81.0％ of the control group (P ＜0.05).The antipyretic time,cough disappeared time,healing time in the observation group were (1.4 ± 0.5) d,(2.1 ± 0.4) d,(4.5 ± 1.4) d,respectively,which were significantly shorter than those in the control group[(2.6 ± 0.9) d,(3.4 ± 1.1) d,(5.8 ±1.9) d] (all P ＜ 0.05).The throat irritation subsided time of the observation group was (3.5 ± 1.1) d,which of the control group was (3.8 ± 1.3) d,the difference was not statistically significant (P ＞ 0.05).The serum levels of IL-6,IL -10 and TNF-in the observation group were (108.45 ± 25.61) μg/L,(34.88 ± 9.07) μg/L,(1.26 ± 0.86) mg/mL,respectively,which were significantly lower than those in the control group[(129.27 ± 28.31) μg/L,(43.27 ±10.09)μg/L,(2.11 ± 1.03)mg/mL] (all P ＜ 0.05).There were no other serious adverse reactions in the two groups.Conclusion Xiao'er Chiqiaoqingre granule in the treatment of acute upper respiratory tract infection can significantly improve clinical symptoms,improve clinical curative effect,and has good safety and certain clinical value.
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Expert Consensus on the Application of Chinese Patent Medicine for Acute Upper Respiratory Tract Infection was established under the joint sponsorship of Specialty Committee of Emergency of World Federation of Chinese Medicine Societies, Emergency Physician Branch of Chinese Medical Doctor Association, Emergency Medicine Professional Committee of Chinese Association of Integrative Medicine and Chinese Emergency Medical Parternerships. In the consensus, the Chinese patent medicines for treatment of acute upper respiratory tract infection (AURI) were summarized and analyzed, and after the expert writers had discussed the contents of the consensus together, they decided to formulate the experts' consensus related to the AURI, expecting to provide a reference to the clinical treatment of this disease.
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OBJECTIVE: To investigate the usage of antimicrobial in outpatients with laboratory-confirmed influenza in a children′s hospital during the flu season, and to provide evidence for scientific antimicrobial stewardship. METHODS: During the 2017-2018 flu season, medical records of laboratory-confirmed influenza positive cases in our hospital were reviewed to collect information including prescription of antimicrobial, laboratory data; and the rationality of the use of antimicrobial was evaluated based on clinical diagnosis. Logistic regression was used to establish the prediction model of antimicrobial usage, which was used to test the factors affecting usage of antimicrobial in outpatients with influenza infections. RESULTS: Among 201 confirmed-influenza cases, 107 (53.2%) were prescribed antimicrobial (at least one drug), and 92 (86.0%) were treated irrationally. In most patients, macrolides and the third generation of cephalosporins were used; and the most frequently used antimicrobials were azithromycin, cefixime and clarithromycin. According to the prediction model, the use of antimicrobial was significantly associated with abnormal C-reactive protein (CRP) level in children (adjusted OR=4.697; 95%CI: 2.187-10.090) and negative results of rapid influenza diagnostic test (RIDT) (adjusted OR=2.228; 95%CI:1.058-4.692); age, onset season, use of anti-influenza virus drugs, white blood cell counting, proportion of neutrophils, RIDT positive results, a clinical diagnosis of influenza and influenza typing were not risk factors. CONCLUSION: The rate of antimicrobial usage in out patients with in fluenza is high, and the management department should take targeted measures to reduce the unreasonable use of antimicrobial.
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OBJECTIVE: To evaluate the efficacy,safety and tolerability of recombinanat human interferon α2 b(rhIFNα2b)spray in treatment of acute upper respiratory tract infection(except the flu)in children. METHODS: In total,575 children who met the inclusion criteria were enrolled from January,2019 to July,2019. They were divided into rhIFNα2b spray group(291 cases)and ribavirin group(284 cases). The children in rhIFNα2b spray group were given the rhIFNα2b spray(P.putida),and those in ribavirin groups were treated with the ribavirin spray. The curative effect and safety between the two groups were compared. RESULTS: The per-protocol set(PPS) comprised 448 patients(233 in the rhIFNα2b spray group,215 in the ribavirin group). The primary efficacy endpoint was antipyretic time which in rhIFNα2b spray group(25.0 h)was significantly shorter than that in the ribavirin group(33.6 h)(P=0.0001). In the comparison of symptomatic relief time,the relief time of nasal congestion,runny nose,sore throat and cough in rhIFNα2b spray group was shorter than that in ribavirin group(P<0.05). The recovery time in the rhIFNα2b spray group was 92 h,which showed significant decrease compared with the ribavirin group(112 h)(P<0.0001). The incidence of adverse events had no statistical differences between the two groups(P=0.2461). CONCLUSION: The rhIFNα2b spray treatment for acute upper respiratory tract infection in children is proved to be significantly effective;particularly,it can evidently relieve fever symptoms and promote the disappearance of nasal and pharyngeal symptoms. It has good safety and tolerability,so the rhIFNα2b spray is worthy to be promoted in clinical application.
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OBJECTIVE: To investigate the time of clinical symptom disappearance, therapeutic efficacy and safety of Pudilan xiaoyan oral liquid and its effects on immune factors in the treatment of pediatric acute upper respiratory tract infection. METHODS: A total of 142 children aged 3-17 with acute upper respiratory tract infection selected from Chongqing Jiulongpo District Second People's Hospital during May 2015-May 2016 were divided into observation group (72 cases) and control group (70 cases) according to random number tablet. Both groups received symptomatic treatment as antivirus, antipyretic. Observation group was additionally given Pudilan xiaoyan oral liquid 10 mL each time, 3 times a day, treated for consecutive 7 d. The defervescence time, the disappearance time of rhinobyon, coughing, diarrhea and pharynx swelling were compared between 2 groups. The levels of TNF-α, IL-6 and immune factors (CD3+, CD4+ and CD4+/CD8+) were determined in 2 groups before and after treatment. Clinical efficacies and the occurrences of ADR were observed in 2 groups. RESULTS: Compared to control group, the defervescence time, the disappearance time of rhinobyon, coughing, diarrhea, pharynx red and swelling were significantly shortened in observation group (P<0. 05). Before treatment, there was no statistical significance in the serum levels of TNF-α, IL-6 or immune factors between 2 groups (P>0. 05). After treatment, the serum levels of TNF-α and IL-6 in 2 groups were significantly lower than before treatment (P<0. 05). The serum levels of CD3+, CD4+ and CD4+/CD8+ were significantly higher than before treatment of each group (P<0. 05), while the improvement of observation group was significantly better than that of control group (P<0. 05). Total response rate of observation group was significantly higher than that of control group (P<0. 05), but there was no statistical significance in the incidence of ADR between 2 groups (P>0. 05). CONCLUSIONS: Pudilan xiaoyan oral liquid can shorten the time of acute upper respiratory tract infection disapperance as defervescence, nasal congestion and cough. It combined with antiviral drug is better than antiviral drug alone, but antiviral drug combined with it or alone have same safety.
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OBJECTIVE: To investigate the use of antibacterials for patients with acute upper respiratory tract infections(AURIs) in community health care institutions in Dongcheng district, so as to provide references for rational use of antibacterials in primary health care institutions. METHODS: All the outpatient prescriptions of AURIs patients from 65 primary health care institutions in Dongcheng district in 2016 were selected. The antibacterial and multiple antibacterial prescription rate were analyzed from the perspective of drug categories, patients′ and doctors′ characteristics. RESULTS: This study included 164 575 AURIs prescriptions of community health care institutions in Dongcheng district in 2016. The antibacterial prescription rate(APR)was 12.1% and the multiple antibacterial prescription rate(MAPR) was 0.6%. The top antibacterials in the list of varieties were second generation cephalosporin(60.2%) and macrolide(16.2%), the penicillin preferred by the guidelines were not used. The APR for the male and patients with acute laryngitis or acute tonsillitis was higher. Compared with patients 18-50 years old,the use and combination of antibacterials for patients >50 years old werehigher(P<0.05).There were significant differences in the use and combination of antibacterials among doctors of different genders, education and titles(P<0.05). CONCLUSION: The issue of antibacterial abuse in the AURIs treatment in primary health care institutions should be given sufficient attention. Regular standardized antibacterial treatments training and continuing education for all doctors in primary health care institution are necessary.
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OBJECTIVE:To evaluate the economical efficiency of 3 therapeutic plans for acute upper respiratory tract infec-tion caused by group A β-hemolytic streptococcal (GAS). METHODS:In retrospective study,71 GAS positive patients with acute upper respiratory tract infection in our hospital during Mar. 2014-Mar. 2016 were selected and divided into group A(16 cases),B(30 cases),C(25 cases)according to medication method. Group A,B,C were given intramuscular injection of ben-zathine benzylpenicillin(1200000 U),oral administration of penicillin V potassium(0.5 g,q8 h,10 d)or oral administration of amoxicillin sulbactam(0.5 g,bid,10 d),respectively. Clinical efficacy and bacterial clearance were observed,and econom-ics of 3 therapeutic plans were evaluated. RESULTS:The cure rates of 3 groups were 87.50%,90.00%,and 92.00%;bacterial clearance rates were 88.24%,87.87%,and 92.59%,respectively;there was no statistical significance(P>0.05). Cost-minimi-zation analysis was adopted for pharmacoeconomic evaluation. The costs of 3 groups were 237.79,279.49,400.40 yuan,respec-tively. The cure rate and bacterial clearance rate of therapeutic plan C were the highest,but its cost also was the highest. The re-sults of sensitivity analysis were consistent with the results of cost-minimization analysis. CONCLUSIONS:The intramuscular in-jection of benzathine benzylpenicillin can be served as first choice therapeutic plan for recurrent upper respiratory tract infection caused by GAS and patients with rhenmatic fever risk. The patients who are reluctant to be treated with penicillin but guarantee medication time can take penicillin V potassium orally. The patients with poor efficacy of common penicillin can take amoxicillin sulbactam pivoxil.
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Objective To learn quality of life of acute upper respiratory tract infection patients and their influence factors.Methods We conducted questionnaire investigation on acute upper respiratory tract infection patients from five hospitals,respectively located in Wuhan,Hefei and Jinhua.The scale we used is EQ-5D.We calculated EQ-5D score through three different integration systems,which are from China,Korea and the UK,in order to compare difference among different countries' integration systems.Then econometric model was used to carry out regression analysis on factors affected EQ-5D score.Results 659 samples was included,with 319 from Wuhan,235 from Hefei and 105 from Jinhua.Among EQ-5D five dimensions,the first three dimensions do not have problems.However,81.94％ of the patients have problems in pain/discomfort and 47.8％ of them have problems in anxiety/depression.In regression analysis,location,severity level of disease and whether accompanied by chronic diseases or not have influence on EQ-5D score.Compared with utilities of patients who are suffered from other diseases,utilities of acute upper respiratory tract infection patients are lower than that of cerebral apoplexy,hypertension,coronary heart diseaseand diabetes patients;but are higher than that of Chronic lymphatic filariasis,chronic obstructive pneumonia and rheumatoid arthritis patients.Conclusion Chinese acute upper respiratory tract infection patients mainly have problems in the dimension of pain/discomfort and anxiety/depression.Compared to British integration system,Korean's is more applicable to Chinese population.Acute upper respiratory tract infection patients' utilities are lower than that of healthy population and chronic invalids with no obvious symptoms,and higher than that of chronic invalids with obvious symptoms.
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Objective To systematically review the efficacy and safety of Jinlian Qingre Effervescent Tablet (JQET) compared to Ribavirin for acute upper respiratory tract infection in children.Methods CNKJ,CBM,WanFang Data,VIP,PubMed,EM base,Web of science,and Cochrane Library databases were searched from the date of establishment to December 2016 for all randomized controlled trials (RCTs) and quasi-RCT on the use of JQET in children with acute respiratory infections.Meta-analysis by using Rev Man 5.3.Results A total of seven RCTs involving 782 patients were included,while the group of JQET involving 392 patients,Ribavirin involving 390 patients.The results ofmeta-analysis indicated that the efficacy in Jinlianqingre group was superior to that of Ribavirin control group,such as clinical effectiveness [RR=l.26,95％CI=(1.18,1.34),P＜0.000 01],fever subsidence time [MD=-1.54,95％CI (-1.79,-1.30),P＜0.000 01],the time of subsided cough [MD=-1.53,95％CI (-1.79,-1.27),P＜0.000 01],the disappearance time of pharyngalgia [MD=-1.29,95％CI (-1.88,-0.70),P＜0.000 1],and Pharyngeal congestion disappearance time [MD=-2.80,95％CI(-3.11,-2.49),P＜0.000 01].The difference was statistically significant.There were three adverse reactions reported in JQET group.Conclusion JQET is superior to the Ribavirin control group in clinical effectiveness,fever subsidence time,time of subsided cough,disappearance time of pharyngalgia,and pharyngeal congestion disappearance time to treat acute upper respiratory tract infection in children.However,these results should be carefully interpreted,and this conclusion has to be further verified by high quality,large scale RCTs.
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Objective To evaluate the efficacy and safety of Dextromethorphan Hydrochloride, Chlorphenamine Malente, and Ammonium Chloride Syrup on eliminating or relieving the symptoms of acute upper respiratory infections in children, by comparing with Guaifenesin, Dextromethorphan Hydrobromide, Methylephedrine Hydrochloride, and Chlorphenamine Maleate Syrup. Methods Random, blind and parallel control method was adopted. A total of 253 pediatric patients were recruited in 11 clinical research centers; 127 patients were assigned in experimental group and finally 118 patients were included in the program set analysis (PPS); 126 patients were assigned into control group and finally 116 patients were included in PPS. The experimental group took Dextromethorphan Hydrochloride, Chlorphenamine Malente, and Ammonium Chloride Syrup and control group took Guaifenesin, Dextromethorphan Hydrobromide, Methylephedrine Hydrochloride, and Chlorphenamine Maleate Syrup. All of the patients took as prescribed at least for 3 days but not more than 7 days. Results There was no significant differences in age, sex, and acute upper respiratory tract infection scores between the two groups (P?>?0.05). PPS showed the median time of symptom relief of acute upper respiratory tract infection in experimental group was 51.0 h (95%CI: 43.0-62.0 h) and 56.0 h (95%CI: 48.0-64.0 h) in control group. There was no difference between two groups (P?>?0.05). After calibration of center and baseline effects, the experimental group was not worse than the control group. There was no difference in the score of acute upper respiratory tract infection between two groups (F=0.14, P=0.710). The individual symptoms disappear rate of acute upper respiratory tract infection and the compliance between two groups were similar (P all?>?0.05). Both groups had 7 cases of adverse events, and one case of adverse drug reactions each. Thus, the adverse reaction rates in two groups were 0.8% each. Conclusions Dextromethorphan Hydrochloride, Chlorphenamine Malente, and Ammonium Chloride Syrup can effectively relieve symptoms rapidly in the treatment of children with acute upper respiratory tract infection, and its efficacy and safety were non worse than traditional Guaifenesin, Dextromethorphan Hydrobromide, Methylephedrine Hydrochloride, and Chlorphenamine Maleate Syrup.
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OBJECTIVE:To observe therapeutic efficacy and safety of Xiaoer jiegan granules with Ribavirin in the treatment of acute upper respiratory tract infection. METHODS:98 patients with upper respiratory tract infection were randomly divided into obser-vation group and control group with 49 cases in each group. Control group was given Ribavirin injection for routine upper respiratory tract antiviral therapy,10-15 mg/kg,added into 5% Glucose injection 250 ml,ivgtt,qd. Observation group was given Xiaoer jiegan granules,1g/time for 1-3 year-old children,2g/time for 4-6 year-old children and 3 g/time for 7-9 year-old,tid. A treatment course of 2 groups lasted for 5 days,both received 2 courses of treatment. Clinical efficacy,cough and other symptoms score,ADR were ob-served in 2 groups. RESULTS:The effective rate of observation group (97.96%) was higher than that of control group (87.76%), with statistical significance(P0.05);after treatment, the scores of fever and cough and other symp-toms in observation group were lower than in control group,with statistical significance(P<0.05). The incidence of ADR in the ob-servation group(6.12%)was significantly lower than in control group(22.45%),with statistical significance(P<0.05). CONCLU-SIONS:Xiaoer jiegan granule with Ribavirin is effective in the treatment of acute upper respiratory tract virus infection,and can im-prove fever,cough and other clinical symptoms,so as to promote better conditions and reduce the occurrence of ADR.
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Objective:To observe the clinical efficacy of Bairui particles in the treatment of children with acute upper respiratory tract infection. Methods:Totally 180 children with acute upper respiratory tract infection were randomly divided into the control group and the study group. The control group was treated with conventional therapy,such as ribavirin(10 mg·kg-1 ·d-1 ,qd)and so on, and the study group received Bairui particles additionally. The improvement time of clinical symptoms,hospitalization time,clinical ef-ficiency and adverse reactions were compared. Results:Except the rale disappearance time,the improvement time of clinical symptoms and hospitalization time in the study group were shorter than those in the control group(P0. 05). Conclusion:Bairui particles are effective for the children with acute upper respiratory tract infection,which are worthy of wide clinical use.
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Objective To explore the relation of the infantile acute upper respiratory tract infection(AURI) with myocardial injury.Methods Creatine kinase (CK) and its isoenzyme(CK-MB),lactate dehydrogenase(LDH),asparatic acid transminase (AST) were tested with the fully automatic analyser and electrocardiogram(ECG) were examined with AURI in 86 cases as experimental group and 30 cases of health infants as control group.Results The abnormal rates of CK,CK-MB,LDH,AST and ECG in the AURI group were higher than those of the control group.Conclusions There is different degree of myocardial injury in some children with AURI, the clinical doctor should pay more attention in the AURI cases companied with the myocardial injury and to prevent myocardial injury complicaton in these cases . [
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Objective To investigate the dynamic changes of myocardial enzymes and it's isoenzyme,eletrocardiogram(ECG) for suffering children of ARI accompanied with myocardial damage and to determine the sensitive indexes of confirmed diagnosis of ARI accompanied with myocardial damage.Methods 117 cases with ARI accompanied with suspected or confirmed myocardial damage were studied,60 healthy age matching children were arranged as control group.Myocardial enzymes and it's isoenzyme ECG in the two groups were dynamic monitored.Then comparing the activities of serum myocardial enzymes and it's isoenzyme.Results Serum CK-MB,LDH-1,AST were significantly higher in ARI group than that in control group(P