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Objective:To explore the group modules of Chinese medicine and western medicine for the treatment of bronchitis patients with Xiyanping injection based on the real world to provide references for the clinical treatment of bronchitis with Chinese medicine and western medicine. Method:Medical records of 13 874 patients with bronchitis treated by Xiyanping injection were extracted from 29 hospital information systems （HISs） in China，and complex network analysis was carried out using Tabu Search algorithm to obtain the substructure and associated information of core drug combination of Xiyanping injection for the treatment of bronchitis and to analyze clinical medication protocols. Result:Medication protocols for the pathogens of bronchitis are listed below： Xiyanping injection + cefuroxime for bacterial infection. Xiyanping injection + interferon for viral infection. Xiyanping injection + azithromycin for mycoplasma infection. According to the clinical symptoms and complications of bronchitis， the appropriate medication protocols were as follows： Xiyanping injection + ambroxol + Feilike mixture + ibuprofen for uncomplicated bronchitis. Xiyanping injection + ipratropium bromide + budesonide + salbutamol for asthmatic bronchitis. Xiyanping injection + mannitol + furosemide + phenobarbital + gangliosides + immunoglobulin for bronchitis complicated with viral encephalitis. Xiyanping injection + creatine phosphate sodium + vitamin C for bronchitis complicated with viral myocarditis. The combined medication of Chinese medicine for the treatment of bronchitis was adopted based on its characteristics of traditional Chinese medicine. Conclusion:The data of this study were derived from the real world. The combined medications protocols of Xiyanping injection targeting the clinical symptoms and complications of bronchitis were extracted and summarized. However， it is necessary to formulate an individualized medication protocol according to the specific condition.
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Xiyanping injection, a traditional Chinese medicine injection made of andrographolide sulfonate, consisting of well-defined ingredients with antiviral, antibacterial, anti-inflammatory and antipyretic efficacy, has been widely used for treating infectious diseases of respiratory and digestive systems. However, its wide applications may easily lead to unreasonable clinical medication. In order to guide the precise clinical application and rational use of Xiyanping injection, experts in related fields conducted systematically literature review, evaluated and deliberated the application of Xiyanping injection in treating acute infectious diseases using evidence-based medicine method, and jointly drafted the consensus to summarize types of acute infectious diseases in children and adults that can be treated with Xiyanping injection, and recommend the intervention time, usage and dosage, course of treatment and combined medication of the injection. Besides, the consensus elucidates the safety, precautions and contraindications of the injection, so as to provide guidance for clinical use.
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Since December 2019, coronavirus disease 2019 (COVID-19) has spread rapidly in China. National Health Commission of the People’s Republic of China and local departments have released a number of diagnosis and treatment plans for COVID-19. Some plans recommend Xiyanping Injection for the clinical treatment of COVID-19. The active component of the drug is the total sulfonate of andrographolide, which is a derivative of andrographolide. This paper summarized the pharmacological action and clinical application of andrographolide, and proposed that it has the functions of clearing heat and detoxification, anti-bacterial and anti-inflammatory, and definite therapeutic effect on respiratory system diseases including viral pneumonia and upper respiratory tract infection, and a large number of clinical data have been accumulated. Andrographolide has a potential antiviral effect on the treatment of COVID-19, and can reduce the level of inflammation in patients, improve respiratory symptoms, inhibit concurrent bacterial infection, and improve the body immunity. At the same time, it will not bring the immunosuppressive effect of hormone drugs, and the incidence of adverse reactions is low. In addition, Andrographolide has certain hepatoprotective effects and clinical value for treating cardiovascular diseases in clinical experience, suggesting that it may have some protective effects on drug-induced liver injury, heart injury and liver injury caused by durgs against COVID-19, but further clinical verification is needed. The pharmacological action and clinical application of andrographolide are summarized. This paper also analyzes the etiology, pathogenesis and dialectical treatment of COVID-19 from the perspective of traditional Chinese medicine, and points out that the treatment of COVID-19 with andrographolide is consistent with the theory of traditional Chinese medicine.
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To analyze the clinincal application characteristics of Xiyanping Injection in real world. The data of the patients came from the hospital information systerm(HIS) of 29 tertiary hospitals in China from 2006 to 2016. It included three parts about basic information, Western medicine diagnosis information, and doctor advice information. The exploration was conducted for the characteristics of the patients and disease distribution as well as the therapeutic regimen. Apriori algorithm was adopted to establish the models, and Clementing 12.0 was used for a correlation analysis of the comprehensive therapeutic regimen of Xiyanping Injection. There were 194 873 cases in the study. The male to female ratio was 1.44∶1. The median age was 4 years old. The median daily dosage was 200 mg. 46.68% of the patients were administered with 250-500 mg, and 33.07% were 50-100 mg one day. 47.08% of the patients were administered for 4-7 d, and 32.65% of the patients were 1-3 d. In the doctor advice information, the most frequently types of Western medicine, traditional Chinese medicine were mucilagin, heat-clearing agent. Second generation cephalosporins, third generation cephalosporins, compound penicillin were the most common types of antibiotic. Interferon, nucleoside and nucleotide, human immunoglobulin were the most common types of antiviral drug. The mining association rules results were analyzed, finding the application of Xiyanping Injection in severe infectious diseases. To improve respiratory symptoms, Xiyanping Injection treaments were Budesonide + Ipratropium Bromide + Ambroxol. To severe pulmonary infection, the treaments were Dopamine + Ambroxine. To severe hand, foot and mouth disease, the treatments were Namefen + Mannitol. To pulmonary heart failure, the treatments were Dobutamine + Heparin. Based on the results of the real world HIS, we could provide clinical application the idea, and a reference for further excavation of the applicable diseases of Xiyanping Injection.
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Child, Preschool , Female , Humans , Male , China , Drugs, Chinese Herbal , Therapeutic Uses , Injections , Medicine, Chinese Traditional , Respiratory Tract Infections , Drug TherapyABSTRACT
This paper mainly studied the effect of Xiyanping injection on the bacterial endotoxin lipopolysaccharide (LPS)-induced fever in rabbits, preliminarily investigated the mechanisms, and provided pharmacological basis for the clinical application. The rabbit model of endotoxin-induced fever was established by using LPS as the inducer; The changes of rectal temperature were measured; The levels of prostaglandin E2 (PGE2), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and phospholipaseA2 (PLA2) in the serum were measured; The levels of PGE2, cyclic adenosine monophosphate (cAMP), and arginine vasopressin (AVP) in cerebrospinal fluid as well as hypothalamus were detected. The animal welfare and experimental process are in accordance with the regulations of the Animal Ethics Committee of China Pharmaceutical University in this study. The results showed that Xiyanping injection (12.5, 25, and 50 mg·kg-1) could significantly reduce LPS-upregulated body temperature of rabbits, and the duration of action could reach 5.5-8.5 h. At the doses of 25 and 50 mg·kg-1, the antipyretic effect of Xiyanping injection was comparable to that of analgin injection (50 mg·kg-1). Furthermore, Xiyanping injection and analgin injection both reduced the levels of PGE2, IL-1β, TNF-α, and PLA2 in the serum of febrile rabbits to the varying degrees. In addition, Xiyanping injection also down-regulated the levels of PGE2, cAMP, and AVP in the hypothalamus, and PGE2 and cAMP in the cerebrospinal fluid. The level of AVP in the cerebrospinal fluid was up-regulated. This study indicated that Xiyanping injection could significantly improve the endotoxin-induced fever in rabbits, and mechanisms were closely related to the regulation of the levels of PGE2, TNF-α, IL-1β, PLA2, cAMP, and AVP in serum, hypothalamus, and cerebrospinal fluid.
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Xiyanping injection, a traditional Chinese medicine injection made of andrographolide sulfonate, consisting of well-defined ingredients with antiviral, antibacterial, anti-inflammatory and antipyretic efficacy, has been widely used for treating infectious diseases of respiratory and digestive systems. However, its wide applications may easily lead to unreasonable clinical medication. In order to guide the precise clinical application and rational use of Xiyanping injection, experts in related fields conducted systematically literature review, evaluated and deliberated the application of Xiyanping injection in treating acute infectious diseases using evidence-based medicine method, and jointly drafted the consensus to summarize types of acute infectious diseases in children and adults that can be treated with Xiyanping injection, and recommend the intervention time, usage and dosage, course of treatment and combined medication of the injection. Besides, the consensus elucidates the safety, precautions and contraindications of the injection, so as to provide guidance for clinical use.
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Objective: To observe the anti-inflammatory and anti-mycoplasma effects and safety of Xiyanping Injection on mycoplasma pneumonia in children, and to explore the mechanism of treatment of mycoplasma pneumonia, so as to provide a new basis for clinical treatment. Methods: A total of 72 children with mycoplasma pneumonia were randomly divided into treatment group and control group, 36 cases in treatment group and 36 cases in control group. The control group was treated with Azithromycin. The treatment group was treated with Xiyanping intravenous drip on the basis of the control group and observed for 7 to 11 d. The therapeutic effects of TCM syndromes, the disappearance time of fever and cough were compared between the two groups to detect serum levels of inflammatory factors. Results: After 7 to 11 d of treatment, the symptoms of the two groups were improved, and the marked efficiency of the treatment group was significantly better than that of the control group (P 0.05). There was no significant difference in serum IL-10, IL-2, IL-4, and IFN-γ between the two groups after treatment (P > 0.05). Conclusion: Xiyanping Injection combined with Azithromycin can significantly improve the clinical symptoms of mycoplasma pneumonia in children with wind-heat stagnation of lung syndrome and phlegm-heat obstruction of lung syndrome, and improve the curative effect of traditional Chinese medicine syndromes,with better safety and no obvious adverse reactions.
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Xiyanping Injection is a commonly used medicine in clinical treatment,which is recommended by many pediatric disease guidelines/consensus. However,the instraction is relatively simple and lack of guidance for clinical application,which affects the efficacy and brings safety risks. Therefore,more detailed clinical guidance is urgently needed. This consensus is formulated by clinical experts of traditional Chinese medicine and Western medicine in pediatrics. This consensus follows Manual for the clinical experts consensus of Chinese patent medicine which published by China Association of Chinese Medicine. The study identified clinical problems using clinical investigation,searched the literature based on PICO clinical problems,using GRADE system to carry out evidences evaluation,classification and recommendation,and adopted the nominal grouping method to reach expert consensus. The consensus combines evidence-based evidence with expert experience,sufficient evidence of clinical problems would lead to " recommendations",and clinical problems with insufficient evidence will lead to " consensus suggestions". This expert consensus recommends the indications,intervention time for treatment,route of drug administration,dose conversion,the indications of being used alone,suitability and taboos of medicine combination,and introduces the safety and clinical application,to provide reference for clinical using.
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Child , Humans , China , Consensus , Drugs, Chinese Herbal , Therapeutic Uses , Injections , Medicine, Chinese Traditional , Nonprescription Drugs , PediatricsABSTRACT
To systemically evaluate the safety and efficacy of Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children. PubMed, Wanfang Data, CNKI, VIP and CBM were used to search for the clinical randomized controlled trials on Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children from database establishment to July, 2017. The papers were screened according to the established inclusion and exclusion criteria, and then the quality of the included studies was evaluated to extract valid data for Meta-analysis by using Revman 5.3 software. A total of 31 clinical randomized controlled trials were included, involving 2 881 patients. Meta-analysis showed that as compared with azithromycin alone, the combination of azithromycin with azithromycin had obvious advantages in the total effective rate（OR=5.42,95%CI[3.98,7.38],<0.000 01）, fever clearance time（MD=-1.29,95%CI[-1.51,-1.08],<0.000 01）, cough disappearance time （MD=-1.72,95%CI[-1.99,-1.46],<0.000 01）, lung wet rales disappearance time（MD=-1.51,95%CI[-1.88,-1.14],<0.000 01）, chest X-ray recovery time（MD=-2.72,95%CI[-3.82,-1.63],<0.000 01）, shortening the hospital stay（MD=-1.88,95%CI[-2.26,-1.50],<0.000 01）, reducing the incidence of adverse reactions（MD=0.51,95%CI[0.33,0.79],=0.002）, and other aspects, with statistically significant difference. Based on the existing evidences, Xiyanping injection combined with azithromycin in the treatment of mycoplasmal pneumonia in children can significantly improve the overall clinical efficiency, shorten the hospital stay and reduce the incidence of adverse reactions. However, the clinical trials of existing small randomized controlled trials have low quality of methodology and require a large sample of high quality clinical trials for further validation.
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To electronically search databases including PubMed, MEDLINE, Web of Science, CBM, CNKI, VIP, Wanfang Data for randomized controlled trials (RCTs) of Xiyanping Injection for adult community acquired pneumonia patients from inception to August, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then RevMan 5.3 software was used for data analysis. Seventeen RCTs involving 1924 patients with adult community acquired pneumonia were included. The results of meta-analysis showed that Xiyanping Injection combined with antibiotic group was superior to the antibiotic drugs group (RR = 1.20, 95% CI 1.15 to 1.25, P < 0.000 01) in treatment adults with community acquired pneumonia. At the same time, it can improve the symptoms of cough and shorten the duration of fever and the duration of hospitalization. In terms of safety, there were 26 cases of adverse reactions in the antibiotic group. The primary adverse reactions were gastrointestinal reaction, dizziness, rash, and phlebitis, and reactions were mild and self-healing. There are 30 adverse reactions cases in the combination group, and the types and levels of reaction are same as antibiotic group. Moreover, the current evidence showed that the combination of Xiyanping Injection and conventional antibiotic drugs in the treatment of community acquired pneumonia may significantly improve the curative effect compared with only antibiotics. Rare adverse reactions occurred and safety evaluation was acceptable. However, due to the low methodological quality of the enrolled studies, more clinical research is needed to further verify the results of this work.
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Objective To investigate the effectiveness and safety of Xiyanping Injection for the treatment of children with acute suppurative tonsillitis, so as to provide evidence for the prevention and treatment of pediatric acute suppurative tonsillitis with traditional Chinese medicine. Methods Two hundred children with acute suppurative tonsillitis were randomly divided into treatment group and control group, 100 cases in each group. The control group was given routine western medicine treatment, and the treatment group was given Xiyanping Injection based on the treatment for the control group. The treatment lasted for 5 days. The clinical outcomes covered the course of disease, the overall efficacy, adverse reaction, and time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion, as well as the changes of white blood cell count, hyper-sensitivity C reactive protein, alanine aminotransferase, creatinine and creatine kinase levels before and after treatment. Results (1) After treatment, the total effective rate of the treatment group was 97.0% and that of the control group was 87.0%, the difference being significant (P 0.05). No adverse reactions of rash, nausea, vomiting, diarrhea, chest distress, shortness of breath, or drug fever were found in the two groups. Conclusion Xiyanping Injection is effective and safe for the treatment of children with acute suppurative tonsillitis by increasing the total efficiency, reducing the time for the subsiding of fever, sore throat, swollen tonsils and purulent secretion, shortening hospitalization time, and decreasing white blood cell count and hyper-sensitivity C reactive protein level. No obvious hepato-renal function damage occurred during the medication.
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Objective: To study the antibacterial activity in vitro of Xiyanping injection combined with cefoxitin, cefuroxime, ceftriaxone, cefmenoxime, amikacin, levofloxacin and meropenem against staphylococcus aureus, escherichia coli, klebsiella pneumoniae, pseudomonas aeruginosa and acinetobacter bauman.Methods: Minimum inhibitory concentration (MIC) of the 7 kinds of antimicrobial agents used individually or combined with Xiyanping injection on germs were determined respectively on 96 plates by using the agar dilution method and the checkerboard method.Fractional inhibitory concentration index (FICI) was calculated to evaluate the antibacterial activity of Xiyanping injection combined with the 7 kinds of antimicrobial agents in vitro.Results: MIC of Xiyanping injection combined with cefoxitin was the same as that of cefoxitin used individually on escherichia coli.MIC of levofloxacin combined with Xiyanping injection showed no difference with that of levofloxacin used individually on klebsiella pneumoniae.Besides, Xiyanping injection could increase the MIC of the other antimicrobial agents on germs.Conclusion: Xiyanping injection combined with antimicrobial agents on staphylococcus aureus, escherichia coli, klebsiella pneumoniae shows antagonistic and irrelevant relationship.
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Objective To explore the clinical effect of Xiyanping injection combined with bifidobacterium in the treatment of infantile virus diarrhea.Methods 80 cases of infantile virus diarrhea were selected,they were randomly divided into control group and research group according to the digital table,40 cases in each group.The control group received intravenous drip ribavirin treatment,the research group received treatment of intravenous drip Xiyanping injection combined with bifidobacterium at the same time.The symptoms disappear time(time of diarrhoea,antifebrile time),length of hospital stay and clinical curative effect were observed and compared between the two groups.Results The indicator of symptoms disappear time (time of diarrhoea,antifebrile time) and length of hospital stay of the research group were (2.19 ±0.43)d,(1.75 ±0.36)d,(4.13 ±0.85)d,respectively,which were shorter than those of the control group [(4.89 ± 0.61) d,(3.68 ± 0.52) d,(7.91 ± 1.13) d],the differences were statistically significant(t =22.89,19.30,16.90,all P ＜ 0.01).The total effective rate of the research group was 97.5％,which was significantly higher than 72.5％ of the control group (x2 =24.5,P ＜ 0.01).Conclusion Xiyanping injection combined with bifidobacterium in the treatment of infantile virus diarrhea has significantly shorter antidiarrheal time,antifebrile time,length of hospital stay than ribavirin,the clinical curative effect is distinct,which is worthy of clinical popularization and application.
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Objective To observe the clinical effect of Qingfei Oral Liqulid and Xiyanping Injection in the treatment of children with human bocavirus pneumonia. Methods Children with human bocavirus pneumonia (59 cases) were randomly divided into treatment group and control group. The cases in the treatment group were treated with Qingfei Oral Liqulid and Xiyanping Injection, and those in the control group were given Ambroxol and Clenbuterol oral solution and Ribavirin injection. The comprehensive efficacy, before and after treatment of primary symptoms scores, secondary symptoms scores, and total scores of symptoms were observed. Results The treatment group had superior comprehensive efficacy over the control group (P < 0.05). Both groups had reduced scores for primary symptoms and secondary symptoms and total scores for symptoms after treatment (P < 0.05). The decreases in the scores for primary symptoms and secondary symptoms and the total scores for symptoms after treatment were larger in the treatment group than those in the control group (P < 0.05). Conclusion Qingfei Oral Liqulid and Xiyanping Injection had definitive efficacy in the treatment of human bocavirus pneumonia in children.
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OBJECTIVE:To explore and analyze signals of Xiyanping injection-induced urticaria from spontaneous reporting system database of Jiangxi province. METHODS:The continuous ADR report monitoring data were collected from spontaneous re-porting system of Jiangxi province,and established database. Bayesian confidence propagation neural network(BCPNN) method was used to calculate information component,IC value of Xiyanping injection-induced urticaria. The year-to-year changes of IC val-ue and its interval were analyzed. RESULTS:A total of 328324 ADR reports were collected in Jiangxi province during 2004-2016. The IC value of Xiyanping injection-induced urticaria detected by BCPNN method was 1.10(the lower limit of IC value was 0.65, and upper limit was 1.54),i.e. there was signal and the IC value ranged from-0.87 to 1.65. CONCLUSIONS:The results of BCPNN method suggest that urticaria is a warning signal of Xiyanping injection. The risk is increasing gradually,and prediction precision increase with the addition of report quantity.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Chinese medicine (CM) plus Western medicine (WM) in the treatment of pediatric patients with severe hand, foot and mouth disease (HFMD) by conducting a prospective, controlled, and randomized trial.</p><p><b>METHODS</b>A total of 451 pediatric patients with severe HFMD were randomly assigned to receive WM therapy alone (224 cases, WM therapy group) or CM [Reduning Injection ( ) or Xiyanping Injection ()] plus WM therapy (227 cases, CM plus WM therapy group) for 7-10 days, according to a web-based randomization system. The primary outcome was fever clearance time, which was presented as temperature decreased half-life time. The secondary outcomes included the rate of rash/herpes disappearance within 120 h, as well as the rate for cough, runny nose, lethargy and weakness, agitation or irritability, and vomiting clearance within 120 h. The drug-related adverse events were also recorded.</p><p><b>RESULTS</b>The temperature decreased half-life time was 40.4 h in the WM therapy group, significantly longer than 27.2 h in the CM plus WM therapy group (P<0.01). Moreover, the rate for rash/herpes disappearance within 120 h was 43.6% (99/227) in the CM plus WM therapy group, significantly higher than 29.5% (66/224) in the WM therapy group (P<0.01). In addition, the rate for cough, lethargy and weakness, agitation or irritability disappearance within 120 h was 32.6% (74/227) in the CM plus WM therapy group, significantly higher than 19.2% (43/224) in the WM therapy group (P<0.01). No drug-related adverse events were observed during the course of the study.</p><p><b>CONCLUSION</b>The combined CM and WM therapy achieved a better therapeutic efficacy in treating severe HFMD than the WM therapy alone. Reduning or Xiyanping Injections may become an important complementary therapy to WM for relieving the symptoms of severe HFMD. (Registration No. NCT01145664).</p>
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Objective To investigate the effect of the serum Clara cell secretory protein and IL-6 levels by Xiyanping injection adjuvant therapy in children with mycoplasma pneumonia .Methods 72 cases of children with mycoplasma pneumonia from October 2014 to August 2015 in our hospital department of pediatrics were selected and randomly divided into the control group and the experiment group ,36 cases in each group.The control group were treated by erythromycin erythromycin, and azithromycin, the experiment group were treated on the base of the control group with Xiyanping injection.two groups of patients were treated for two cycles.The CRP, PCT, CCSP, IL-6 and adverse reactions were compared after treatment. Results After treatment,the clinical total effective rate in experimental group was higher than in control group (P<0.05),the CRP,PCT,CCSP and IL-6 levels were lower(P<0.05).The incidence of adverse reactions in the experimental group 8.33%was obviously lower than that of the control group 19.44% (P<0.05).Conclusion Xianyanping injection adjuvant treatment of mycoplasma pneumonia in children with significant clinical efficacy,can significantly increase serum Clara cell secretory protein levels,reduce CRP, PCT, IL-6 levels,improve clinical symptoms and with high safety.
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OBJECTIVE:To compare cost-effectiveness of Xiyanping injection and Ribavirin injection in the treatment of com-mon type hand-foot-mouth disease (HFMD) in children,and to provide evidence for rational drug use in the clinic. METHODS:The literatures about Xiyanping injection in the treatment of common type HFMD in children using Ribavirin injection as control were retrieved from CNKI,VIP,Wanfang,PubMed,Cochrane library and other databases. The decision tree was established with TreeAge Pro 2011 software to conduct cost-effectiveness analysis. Tornado diagram was used to analyze sensitive factors;single fac-tor and double factors sensitivity analysis were also conducted. RESULTS & CONCLUSIONS:The total cost of Xiyanping injection and Ribavirin injection were 2 887.53 and 3 058.72 yuan,respectively. The total effective rates were 92.49% and 78.12%. Xiyan-ping injection shows cost-effectiveness advantage. The results of cost-effectiveness analysis were supported by sensitivity analysis.
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Objective Zika virus disease is an acute infectious disease caused by Zika virus transmitted through Aedes mosquitoes. To explore the therapeutic effect of integrated traditional Chinese and Western Medicine for Zika virus disease, the treatment process of the first imported case in China was reviewed. Methods The first imported Zika virus disease in China was admitted to Ganxian People's Hospital in Jiangxi Province on February 6th, 2016, and the patient received isolation treatment for 9 days and cured later. The effect of antiviral treatments including Xiyanping injection was evaluated based on clinical diagnosis and treatment process of the patient. Results A 34-year old male patient was admitted with chief complaint of fever for 9 days, orbital pain and itching rash for 4 days on February 6th, 2016. ① Epidemiological characteristics: the patient was bitted by mosquitoes during his business trip in Venezuela since January 1st, where Zika virus disease was spreading. On January 20th he had dizziness without fever, and the symptom disappeared after taking medicines without details. Paroxysmal dizziness, chills and mild fever without myalgia was experienced on January 28th. On February 3rd small red rash appeared in the neck, spreading to anterior part of chest, limbs and trunk, and the fever, fatigue, nausea was continued, and a new symptom of paroxysmal pain in back of ears and orbits appeared, during which he had not go to hospital. The symptoms relieved on February 4th. He returned to Ganxian County on February 5th, he had yellow stool 3 times with normal temperature, without abdominal pain, and red rash still appeared in the neck. He went to Ganxian People's Hospital on February 6th, 2016. ② Clinical manifestation: the vital signs showed a temperature of 36.8 ℃, a pulse rate of 80 bpm, a respiratory rate of 20 bpm, and a blood pressure of 110/70 mmHg (1 mmHg = 0.133 kPa). It was showed by physical examination that red rash appeared in the neck, and no superficial enlarged lymph nodes were found. Bilateral conjunctival congestion was obvious, physiological reflex existed and pathological reflex was not found. ③ Auxiliary lab test and examination: no abnormal finding were revealed throughout examination and laboratory tests, including routine blood test, liver function, renal function, serum myocardial enzyme, electrolyte, blood sugar, C-reactive protein (CRP), troponin I (TnI), and procalcitonin (PCT), except slight prolongation in activated partial thromboplastin time (APTT, 38.6 s) on February 6th; and slightly dense shadow in left lung in lung CT scan, considering inflammatory changes and slight emphysema (especially in the left lower lung) as well as bilateral renal calculus on February 8th. No significant abnormalities were found in electrocardiogram and B ultrasound test of liver, spleen, and pancreas. ④ Virus confirmation: Zika virus nucleic acid was positive reported by Jiangxi Province Center for Disease Control and Prevention (CDC) on February 7th and Chinese CDC on February 9th, respectively, though Dengue virus were negative reported by Ganzhou CDC on February 6th. Right after the first diagnosis, anyone who had been in close contact with the patient received medical monitoring. ⑤Treatment process: on February 6th, symptomatic treatment was prescribed since admitted into the infectious isolation wards and daily intravenous drip of Xiyanping injection 250 mg was prescribed for antiviral therapy. On February 7th, the patient had no fever, with occasional chills, neck rash was disappeared, orbital pain relieved and bilateral conjunctival hyperemia range was paler and narrowed, and his condition improved. Ibuprofen was administered for defervesce 3 times a day when his temperature reached to 37.5 ℃ at 16:00. On February 8th, the patient had no fever, times of chills was significantly reduced, without myalgia and rash, orbital pain and conjunctival hyperemia further recovered. On February 9th, bilateral eyes slightly tingling, mild conjunctival congestion, no fever chills or other discomfort was found. The chloramphenicol eye drops was prescribed for relieving sting pain with conjunctival congestion twice a day as recombinant human interferon alpha eye drops was out of store. The patient was comfortable from February 11th to February 13th. Blood and urine test for Zika were reported negative by the Chinese CDC and Jiangxi Province CDC. Because all the discharge criteria were satisfied, the patient was discharged on February 14th. Conclusions At present, there is no specific effective drug to prevent and treat Zika virus disease effectually. After receiving symptomatic treatment and antiviral treatments including Xiyanping injection, the patient's symptoms were relieved. Zika virus nucleic acid in blood and urine was negative. The patient was discharged. Combination of traditional Chinese medicine and Western medicine maybe a good method to prevent and treat Zika virus disease.
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OBJECTIVE:To systematically review the efficacy and safety of Xiyanping injection versus Ribavirin injection in the treatment of herpangina in children,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,Cochrane Library,EMBase,VIP Database,CJFD,Wanfang Database and CBM,randomized controlled trials (RCT) about efficacy and safety of Xiyanping injection versus Ribavirin injection in the treatment of herpangina in children were collected. Meta-analysis was performed by using Rev Man 5.3 software after data extracting and quality evaluating by modified Jadad. RE-SULTS:Totally 14 RCTs were enrolled,involving 1 939 patients. Results of Meta-analysis showed total effective rate [OR=4.69, 95%CI(3.36,6.55),P<0.001],fever clearance time [MD=-1.36,95% CI(-1.60,-1.12),P<0.001],herpes regression time [MD=-1.34,95%CI(-1.61,-1.06),P<0.001],hospitalization time [MD=-1.88,95% CI(-3.68,-0.07),P=0.04] and sali-vation disappearance time [MD=-1.07,95% CI(-1.30,-0.84),P<0.001] of Xiyanping injection were significantly better than Ribavirin injection,there were statistically significant differences. And there was no significant difference in the incidence of ad-verse reactions [OR=0.56,95% CI(0.31,1.03),P=0.06]. CONCLUSIONS:The efficacy of Xiyanping injection is better than Rib-avirin injection in the treatment of herpangina in children,with similar safety.