Network Meta-analysis of 14 oral Chinese patent medicines combined with Azithromycin in treatment of mycoplasma pneumonia in children / 中国中药杂志

To systematically evaluate the clinical efficacy of 14 oral Chinese patent medicines combined with Azithromycin in the treatment of mycoplasma pneumonia in children with network Meta-analysis. Computer retrieval was performed for such databases as CNKI, VIP, Wanfang, CBM, PubMed, EMbase and Cochrane Library to screen out randomized controlled trials of oral Chinese patent medicines combined with Azithromycin in the treatment of mycoplasma pneumonia in children from the time of database establishment to September 2020. The included studies were evaluated by the Cochrane Risk Assessment tool. Stata 14.0 and Review Manager 5.3 software were used for data statistical analysis. A total of 60 RCTs were included in this study, involving 14 oral Chinese patent medicines. The efficacy ranking based on network Meta-analysis was as follows:(1)in terms of total effective rate, top five Chinese patent medicines in surface under the cumulative ranking curve(SUCRA) were Xiao'er Xiaoji Zhike Oral Liquid, Xiao'er Chiqiao Qingre Granules, Xiao'er Feike Granules, Pudilan Xiaoyan Oral Liquid and Lanqin Oral Liquid;(2)in terms of antifebrile time, top five Chinese patent medicines in SUCRA were Huaiqihuang Granules, Xiao'er Magan Granules, Xiao'er Kechuanling Granules/Oral Liquid, Shuanghuang-lian Oral Liquid for children and Xiao'er Xiaoji Zhike Oral Liquid;(3)in terms of cough disappearance time, top five Chinese patent medicines in SUCRA were Xiao'er Magan Granules, Huaiqihuang Granules, Xiao'er Chiqiao Qingre Granules, Xiao'er Feire Kechuan Oral Liquid and Xiao'er Kechuanling Granules/Oral Liquid;(4)in terms of rale disappearance time, top five Chinese patent medicines in SUCRA were Xiao'er Magan Granules, Huaiqihuang Granules, Xiao'er Feire Kechuan Oral Liquid, Shuanghuanglian Oral Liquid for children and Yupingfeng Granules. The results showed that on the basis of the use of Azithromycin, combined administration with oral Chinese patent medicines could improve the overall clinical efficacy in the treatment of mycoplasma pneumonia in children. However, due to the large differences in the quality and the number of included studies among various therapeutic measures, the ranking results of SUCRA of Chinese patent medicines need to be verified by high-quality multi-center, large-sample, randomized double-blind trials in the future.

Exploring material basis and mechanism of Lianhua Qingwen Prescription against coronavirus based on network pharmacology / 中草药

Objective: To explore the active compounds and mechanism of Lianhua Qingwen Prescription for the treatment of coronavirus, and provide a reference for the treatment of COVID-19. Methods: With the help of TCMSP, Batman, Swiss Target Prediction and other databases, the chemical constituents and targets of Lianhua Qingwen Prescription were retrieved. Coronavirus disease targets were screened by GeneCards. Cytoscape software was used to construct a “drug-component-target-disease” interaction network map and potential target interactions, and the action mechanism was predicted through enrichment analysis. The main active ingredients of Lianhua Qingwen Prescription were verified by molecular docking with Mpro and ACE2. Results: A total of 100 active ingredients, 636 drug targets, and 347 disease targets were excavated, and 67 drug-disease common targets were obtained. The key targets involved PTGS2, IL6, CASP3, MAPK1, EGFR, ACE2, etc. A total of 1 946 entries were obtained by GO enrichment analysis, which mainly involved T cell activation, viral receptors, and inflammatory responses. KEGG pathway enrichment screened 166 signaling pathways, including renin-angiotensin system, Toll-like receptor signaling pathway, JAK-STAT signaling pathway, T cell receptor signaling pathway, TNF signaling pathway and so on. The molecular docking results showed that kaempferol, quercetin and luteolin had good binding ability with Mpro; And glycyrrhetinic acid, stigmasterol, indigo had good binding ability with ACE2. Conclusion: Lianhua Qingwen Prescription acts on coronavirus through multiple components, multiple targets, and multiple pathways. The main components have good binding ability with Mpro and ACE2, so as to have a therapeutic effect on COVID-19.