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ObjectiveThrough a randomized， double-blind， double-simulation， positive-control， multicenter design， this study aimed to analyze the relationship between the dosage， efficacy， and safety of Pudilan anti-inflammatory oral liquid in treating acute pharyngitis/tonsillitis in adults caused by bacterial infection and validate the regulatory effect of Pudilan anti-inflammatory oral liquid on inflammatory markers such as serum amyloid A （SAA）， C-reactive protein （CRP）， white blood cells （WBC）， neutrophil percentage （NE%）， and erythrocyte sedimentation rate （ESR）， thereby exploring the feasibility of using Pudilan anti-inflammatory oral liquid as a substitute for antibiotics in the treatment of infectious diseases and providing a basis for rational clinical medication. MethodUsing a stratified randomized， double-blind， double-simulation， positive-control， multicenter design， 220 participants were enrolled from nine centers. The participants were randomly divided into three groups at 1∶1∶1 — a Pudilan anti-inflammatory oral liquid 20 mL group （73 cases）， a Pudilan anti-inflammatory oral liquid 10 mL group （73 cases）， and a control group （amoxicillin group， 74 cases）. The treatment course was 7 days. The study observed parameters including the total effective rate of sore throat， onset and disappearance time of sore throat， health status score， treatment time， and inflammation markers. Result①Dataset division： The 211 cases were included in the full analysis dataset （FAS）， 208 cases were included in the per-protocol dataset （PPS）， and 218 cases were included in the safety dataset （SS）. ② Efficacy evaluation： There were statistically significant differences （P<0.05） in the comparison of the three groups regarding the total effective rate of sore throat， disappearance time of sore throat， and health status. Both the 20 mL and 10 mL groups were non-inferior to the control group， and there was a statistically significant difference between the 20 mL and 10 mL dosage groups （P<0.05）. There was no statistically significant difference in the comparison of onset time of sore throat among the groups. CRP， WBC， and NE% of patients in all three groups significantly decreased on the 7th day of treatment compared with those before treatment （P<0.01）. ③Safety evaluation： Adverse events mainly occurred in various examination indicators. There were no statistically significant differences in the comparison between groups， and no adverse reactions or serious adverse events occurred. ④Economic evaluation： The increased cost of the 10 mL and 20 mL dosage groups was entirely justified as compared with that in the control group. When comparing the 10 mL and 20 mL dosage groups， the 10 mL dosage group was deemed less advantageous. ConclusionPudilan anti-inflammatory oral liquid can be used alone as an alternative to antibiotics in the treatment of acute pharyngitis/tonsillitis caused by bacterial infection. It demonstrates good safety and can lower inflammation markers such as CRP， WBC， and NE%， suggesting its potential to reduce the body's inflammatory response. Its mechanism of action may be related to its multi-target regulatory mechanism.
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ObjectiveTo comprehensively evaluate the clinical application value of four types of Jinsang Kaiyin preparation（JSKYs） and the other two Chinese patent medicines（CPMs） in the treatment of acute pharyngitis/laryngitis，so as to provide evidence for their rational clinical use and regulatory decision-making. MethodAccording to the guideline for clinical comprehensive evaluation of CPM，the effectiveness，safety，economy，innovation，suitability and accessibility of four JSKYs and the other two CPM in the treatment of acute pharyngitis/laryngitis were comprehensively evaluated，which were ranked based on the quantitative scoring tool. Result① Effectiveness：Compared with the control group，JSKYs can improve the total effectiveness rate of acute pharyngitis/laryngitis and improve the symptoms. Network meta-analysis showed that the probability of JSKY ranked the first in terms of total effectiveness rate.② Safety：JSKYs did not show acute toxicity and long-term toxicity. The main adverse reactions were skin rash，abdominal pain，diarrhea，nausea and vomiting，etc，which were similar with the other two CPM.③ Economy：For patients with acute laryngitis（wind heat syndrome），compared with drug A，JinsangKaiyin capsule has the comparable cost-effectiveness. For patients with acute pharyngitis（wind heat syndrome），compared with drug B，JinsangKaiyin capsul has low cost and better effectiveness.④ Innovation：Compared with the other two CPM，the indications of JSKYs have their own unique population. JSKYs have six patent approval certifications and has been approved for sale in the Philippines.⑤ Suitability：Compared with the other two CPM，the investigated doctors，pharmacists and patients all believed that the instruction of JSKY was clearer and easier to understand，the use and storage conditions were more convenient，etc.⑥ Accessibility：JSKYs are included in the category B of the National Basic Medical Insurance（2022 edition），which has good cost-effectiveness and affordability for medical insurance and self paid patients. JSKYs do not contain endangered animals and plants. The supply of raw materials can meet the demand of production at present. ConclusionAs for the drug value calculation，JSKY obtained the highest score. Based on all dimensions of evidence，expert consensus on JSKY is class A，which can be directly converted into decision making.
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Objective:To explore the effective dose range of Kaihoujian throat spray (for children) in treating acute pharyngitis and acute tonsillitis, in order to provide the reference for the usage and dosage in clinic. Method:A total of 160 juvenile SD rats were divided into 16 groups according to the body mass grade, namely normal group, model group, amoxicillin or ribavirin group, compound Yizhi Huanghua group and different doses of Kaihoujian (for children) groups. The different doses of Kaihoujian (for children) groups were divided into 12 treatment groups based on 2 sprays/time, 4 times/day, 4 sprays/time, 4 times/day, 6 sprays/time, 4 times/day, 8 sprays/time, 4 times/day, 2 sprays/time, 6 times/day, 4 sprays/time, 6 times/day, 6 sprays/time, 6 times/day, 8 sprays/time, 6 times/day, 2 sprays/time, 8 times/day, 4 sprays/time, 8 times/day, 6 sprays/time, 8 times/day, and 8 sprays/time, 8 times/day. Except for normal group, all of the remaining groups were included in three animal models, namely 5%ammonia-induced acute pharyngitis in rat, B type streptococcus haemolyticus-induced acute pharyngitis and tonsillitis in rabbit, and adenovirus-induced acute pharyngitis in mice. Then the optimal usage and dosage of Kaihoujian throat spray (for children) were evaluated based on pharyngeal lesion score and htoxylin eosin(HE) staining. Result:There were significant differences in pharyngeal and tonsil lesions between the model group and the normal group (PPPConclusion:The clinical usage and dosage of Kaihoujian throat spray (for children) in treating acute pharyngitis and tonsillitis were suggested to be 2 sprays/times, 6~8 times/day for 1~3 year-old children; 3~6 sprays/times, 6~8 times/day for 4~6 year-old children and 5~8 sprays/times, 6~8 times/day for 7~12 year-old children.
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@#In order to investigate the therapeutic effects of scutellarein on acute pharyngitis, 60 rats were randomly divided into five groups: blank group, model group, low-dose scutellarein group, high-dose scutellarein group and positive drug group. HE staining, blood-cell-analyzer, IL-6, IL-1β and TNF-α ELISA kit were used to study the effects of scutellarein on acute pharyngitis in pharyngeal tissue morphology, the counts of white blood cells and neutrophil and the serum concentrations of TNF-α, IL-1β and IL-6. Meanwhile, forty mice were randomly divided into four groups: blank group, low-dose scutellarein group, high-dose scutellarein group and positive drug group. Then, hot plate and writhing test of mice were carried out to study the analgesic effects of scutellarein. Results showed that, compared to the model group, scutellarein improved the physical status of acute pharyngitis rats, reduced the number of white blood cells significantly(P< 0. 05)and decreased the number of neutrophils and the levels of TNF-α, IL-1β and IL-6 in rats serum significantly(P< 0. 01). Meanwhile, scutellarein dramatically improved the pain threshold in hot plate test and decreased the number of writhing mice(P< 0. 01). It can be concluded that scutellarein can be used to treat acute pharyngitis with its anti-inflammatory and analgesic effect.
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The purpose of this study is to analyze the obstructive factors of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for acute pharyngitis, and summarize the revision suggestions for follow-up revision and promotion. Clinical physicians from 181 hospitals in 27 regions of China were selected to complete the online questionnaire survey for statistical analysis of obstructive factors. We collected 501 copies of the applicability evaluation questionnaire and 503 copies of the application evaluation questionnaire. The obstructive factors mainly focused on limitation of the Guideline, inconvenience of access, particularity of primary medical structure and uneven distribution of surveyed subjects. As for amendments, it was suggested to improve the syndrome differentiation, indications, prescriptions, and add characteristic TCM therapies in Chinese medicine; it was suggested to clarify the time to use antibiotics in Western medicine. According to the results of this study, the relevant contents of the Guideline should be further improved so as to be better applied in clinical practice.
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Humans , Anti-Bacterial Agents , China , Drugs, Chinese Herbal , Medicine, Chinese Traditional , Pharyngitis , Drug TherapyABSTRACT
Objective To discuss the clinical curative effects of Kaihoujian spray in the treatment of acute suppurative tonsillitis in children. Methods 120 cases of pediatric patients with acute suppurative tonsillitis were selected and randomly divided into the observation group and the control group (60 cases in each group); the control group were given conventional western medicine treatment, while the observation group received Kaihoujian spray on the basis of the control group treatment; clinical symptoms and curative effects of the two groups were evaluated and compared. Results In the observation group, sore throat and fever disappearance time, purulent secretion, tonsil swelling disappearance time and hemogram recovery time were all significantly shorter than those in the control group (P<0.05); after 3 courses of treatment, in the two groups, children temperature, sore throat, tonsil fester and tonsil swollen main symptom scores were all significantly decreased (P<0.05), but the observation group decreased more obviously (all P<0.05). After treatment, C-reactive protein, white blood cell count, neutrophils of the two groups all significantly reduced (P < 0.05), but the observation group decreased more obviously (all P<0.05). Conclusion Using Kaihoujian spray to treat acute suppurative tonsillitis could significantly improve the clinical symptoms and signs, whose clinical curative effect is good, and has no adverse reactions.
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Objective: To evaluate the efficacy and safety of different dosages of Pudilan Xiaoyan Oral Liquid (PXOL) in treatment of infantile acute pharyngitis-tonsillitis with lung-stomach excess-heat syndrome. Methods: A randomized controlled, double-blind, positive drug parallel controlled, and multi-center clinical trial was conducted. Totally 324 children from seven research centers were included, 108 cases in experimental high dose group (A Group), 108 cases in experimental low dose group (B Group), 54 cases in positive medicine group (Xiaoer yanbian Granula, C Group), and 54 cases in placebo group (D Group), with the ratios of 2:2:1:1.5 in a course. Results: (1) Totally 317 cases were in full analysis set (FAS), 284 cases in per-protocol set (PPS) and 324 cases in Safety Set (SS). (2) Evaluation on effectiveness: There was significant difference (P<0.001) between each two groups in the total effective rate of pharyngalgia and pharyngeal swelling. A Group and B Group were both superior to D Group, and were non-inferior to C Group. B Group was non-inferior to A Group. There was significant difference (P<0.001) between each two groups in total effective rate of syndrome of traditional Chinese medicine. There was significant difference (P<0.05) between each two groups in the median time of improving pharyngalgia syndrome. There was significant difference (P<0.001) between each two groups in the median time of pharyngalgia syndrome disappearing. There were significant differences (P<0.05) between each two groups in total effective rate of halitosis, cough, thirst, deep-colored urine, and dry stool. The analysis on PPS agrees with that of FAS. (3) Evaluation on safety: No adverse reactions in clinical significant laboratory examination were found during the trial. Conclusion: High and low dosages of PXOL show advantages over placebo and are non-inferior to the positive medicine Xiaoer Yanbian Granula. High dose group does not show advantage comparing with low dose group. No adverse reactions are found during the trial. Low dose therapy is recommended.
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This paper systematically studies relevant literatures at home and abroad in recent years. China National Knowledge Internet (CNKI) was used to collect the literatures for acute pharyngitis treated with traditional Chinese medicine from January 1, 2006, to December 31, 2016, and the bibliometric method was employed for statistical analysis. A total of 493 papers were preliminarily selected. According to the inclusion criteria and exclusion criteria, 182 eligible articles were selected. According to the evaluation and analysis of the literatures, the Guidelines for Clinical Research of New Drugs is currently used as the common standards for the diagnosis and treatment of acute pharyngitis; Chinese patent medicines are the main traditional Chinese medicine for treating this disease; Decoctions for treatment of this disease include Lonicerae Japonicae Flos, Scutellariae Radix, Platycodonis Radix, Forsythiae Fructus, Glycyrrhizae Radix et Rhizoma, Scrophdlariae Radix, Isatidis Radix, and Ophiopogonis Radix; The bloodletting puncture is the common external therapy. Traditional Chinese medicine and Western medicine have their own characteristics in the treatment of this disease. Western medicine for the treatment of acute pharyngitis are mainly antiviral, antibiotic and glucocorticoid drugs, whose disadvantages are toxicity, side effects, drug resistance and double infections. Traditional Chinese medicine doctors have rich experiences in the treatment of the disease, which is characterized by treatment determination based on syndrome differentiation, safe and reliable medication, significant curative effect, low drug resistance, and wide varieties of traditional Chinese medicine forms, convenient portability and taking, low price, and low toxic and side effects. It is an arduous and significant task to explore traditional Chinese medicine, and study and develop new-type effective drugs.
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La faringoamigdalitis aguda es una de las enfermedades más comunes en niños y adolescentes. La etiología más frecuente es la viral, seguida por la bacteriana. Entre las causas bacterianas, el principal agente es el estreptococo beta hemolítico del grupo A. Una complicación infrecuente de los procesos infecciosos faríngeos es la tromboflebitis séptica de la vena yugular interna. El diagnóstico se sospecha ante la tumefacción laterocervical unilateral de carácter inflamatorio. Se confirma mediante tomografía computada con contraste. El tratamiento consiste en la administración prolongada de antibióticos; el uso de anticoagulantes es controvertido. El diagnóstico precoz y el tratamiento apropiado son esenciales para evitar la oclusión vascular persistente y la progresión del trombo, que puede ocasionar émbolos pulmonares. Presentamos a una adolescente con tromboflebitis de la vena yugular interna secundaria a faringoamigdalitis aguda estreptocócica, con el objetivo de describir las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de esta rara complicación vascular.
Acute pharyngotonsillitis is one of the most common diseases in children and adolescents. The most frequent etiology is virus, followed by bacteria. The main bacterial agent is beta hemolytic Streptococcus group A. A rare complication of pharyngeal infectious processes is septic thrombophlebitis of the internal jugular vein. The diagnosis is suspected in the presence of an inflammatory unilateral neck swelling. The diagnosis is confirmed by contrast computed tomography. Treatment consists of prolonged administration of antibiotics, being the use of anticoagulants controversial. Early diagnosis and appropriate treatment are essential to prevent persistent vascular occlusion and progression of the thrombus, which can cause pulmonary emboli. In the present study, we present a teenager with thrombophlebitis of the internal jugular vein secondary to acute streptococcal pharyngotonsillitis. Clinical manifestations, diagnostic methods and treatment of this rare vascular complication are described herein.
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Humans , Female , Adolescent , Thrombophlebitis , Pharyngitis , Venous Thrombosis , Jugular VeinsABSTRACT
Objective:To observe the clinical efficacy and safety of Bianyan oral liquids in the treatment of acute pharyngitis. Methods:The clinical data of 200 patients with acute pharyngitis in the outpatient department of traditional Chinese medicine in our hospital from September 2010 to June 2012 were analyzed. They were divided into the control group with 100 cases and the observation group with another 100 cases. The control group was given Jinlianhua granules, while the observation group was received Bianyan oral liquids. After 5 days, the symptom score, effective rate, changes in accompanied symptoms and safety index were observed and com-pared. Results:The symptom score and effective rate of the observation group were better than those of the control group (P<0. 05), and the improvement in defecation was better than that of the control group (P<0. 05) as well. There were two cases in the observation group suffered nausea and stomachache, and one case in the control group suffered diarrhea while no untoward effect emerged. Conclu-sion:Bianyan oral liquids with the effects of heat-clearing and detoxicating, nourishing yin and fluid and treatment both manifestation and root cause show significant effect in the treatment of acute pharyngitis.
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Objective To investigate the sore-throat-relieving, anti-inflammation and antitussive actions of Qingyan mixture on the animal models. Methods Sore-throat-relieving action of Qingyan mixture was observed in SD rats with acute pharyngitis induced by spray of ammonia water at volume fraction of 15%. Anti-inflammation action of Qingyan mixture was observed on mice model of xylene-induced ear edema, and antitussive action of Qingyan mixture was carried out in mice with cough induced by concentrated ammonia spray. Results (1) The results of sore-throat-relieving action of Qingyan mixture showed that the infiltration of inflammatory cells did not happen in the blank control group, but moderate/severe inflammatory cell infiltration was shown in the model group. In the positive group, 4 rats had slight inflammatory cell infiltration while the left 6 rats had no inflammatory cell infiltration. Low-dose Qingyan mixture group had no inflammatory cell infiltration in one rat, and had slight infiltration in 9 rats. In middle-and high-dose Qingyan mixture groups, 4 rats had no infiltration and 6 had slight infiltration, inflammatory cell infiltration was markedly relieved ( P0.05). ( 2) The anti-inflammation rate was 69.8% in the positive control group, and was 27.3%, 60.4%, 60.0% in low-, middle- and high-dose Qingyan mixture groups respectively. The inhibitory effect of middle-and high-dose Qingyan mixture on xylene-induced mice ear edema was similar to that of the positive control group ( P>0.05) . ( 3) The cough-relieving rate was 42.6%, 139.0%, 64.3%, 104.0% in positive control group, and low-, middle-and high-dose Qingyan mixture groups respectively. Mice cough latent was obviously prolonged and cough frequency was decreased in the three Qingyan mixture groups, the differences being significant compared with the model group ( P<0.05 or P<0.01) . Conclusion Qingyan mixture has certain sore-throat-relieving, anti-inflammation and antitussive actions, which can be used for the treatment of patients with actue/chironic laryngitis and the complication of cough.
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Group A β-hemolytic Streptococcus(GAS) can cause a variety of infectious diseases,acute pharyngitis,and impetigo are the most.Non-suppurative complications can be followed after GAS infections,such as acute rheumatic fever,acute glomerulonephritis.GAS pharyngitis has no specific differences with other pathogens.Throat culture or rapid antigen detection test(RADT) should be done to determine whether GAS infections.Children with acute GAS pharyngitis should receive antibiotic therapy.Penicillin is the recommended antimicrobial agent.
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BACKGROUND: Group A streptococcus (GAS) is the most common cause of bacterial pharyngitis in children. Antibiotic resistance rates and emm genotypes of GAS isolated from patients with acute pharyngitis were studied in 2009. METHODS: Throat cultures were taken from 499 children with acute pharyngitis in Jinju, Korea, in 2008-2009. A total of 174 strains (34.9%) of GAS were isolated, and antimicrobial susceptibility testing was performed using the disk diffusion method. The phenotypes of macrolide resistance and macrolide resistance genes were determined. The emm genotypes were identified using PCR and sequencing. The data were compared with those acquired in 2002 in the same region. Data on the annual macrolide production were collected between 1999 and 2008. RESULTS: The resistance rates of GAS to erythromycin, clindamycin, and tetracycline were 4.6%, 2.9%, and 2.3%, respectively. The constitutive resistance rate was 62.5% for the erm(B) gene and 37.5% for the M phenotype of the mef(A) gene. emm4 was most frequently detected (28.2%), followed by emm89 (20.1%). Most of the erythromycin resistant strains had the emm28 genotype. We noted a gradual increase in macrolide production during the study period. CONCLUSIONS: The erythromycin resistance rate of GAS isolated from children with acute pharyngitis was significantly lower in 2009 (4.6%) than in 2002 (44.8%). We observed a remarkable change in the distribution of emm genotypes during the 7-yr period. The significant decline in erythromycin resistance in 2009 might be associated with a prominent decrease in the resistant genotype emm12 (3.4% in 2009 vs. 28.0% in 2002) rather than restriction of macrolide use.