Qualitative analysis of chemical components in Lianhua Qingwen capsule by HPLC-Q Exactive-Orbitrap-MS coupled with GC-MS

The Lianhua Qingwen(LHQW) capsule is a popular traditional Chinese medicine for the treatment of viral respiratory diseases.In particular,it has been recently prescribed to treat infections caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).However,due to its complex composition,little attention has been directed toward the analysis of chemical constituents present in the LHQW capsule.This study presents a reliable and comprehensive approach to characterizing the chemical constituents present in LHQW by high-performance liquid chromatography-Q Exactive-Orbitrap mass spectrometry(HPLC-Q Exactive-Orbitrap-MS) coupled with gas chromatography-mass spectrometry(GC-MS).An automated library alignment method with a high mass accuracy(within 5 ppm) was used for the rapid identification of compounds.A total of 104 compounds,consisting of alkaloids,flavonoids,phenols,phenolic acids,phenylpropanoids,quinones,terpenoids,and other phytochemicals,were successfully characterized.In addition,the fragmentation pathways and characteristic fragments of some representative compounds were elucidated.GC-MS analysis was conducted to characterize the volatile compounds present in LHQW.In total,17 compounds were putatively characterized by comparing the acquired data with that from the NIST library.The major constituent was menthol,and all the other compounds were terpenoids.This is the first comprehensive report on the identification of the major chemical constituents present in the LHQW capsule by HPLC-Q Exactive-Orbitrap-MS,coupled with GCMS,and the results of this study can be used for the quality control and standardization of LHQW capsules.

Network pharmacological approach to explore the mechanisms of Lianhua Qingwen capsule in coronavirus disease 2019

Background:This study aimed to explore the molecular mechanisms of the active compounds of Lianhua Qingwen capsule in the treatment of coronavirus disease 2019 by using systemic pharmacology approach.Methods:In this study,network pharmacology methodology was applied,including active chemical component screening,target gene prediction,herbal-compound and compound-target gene network construction,gene enrichment analysis,pathway enrichment analysis and network analysis.Results:Network analysis showed that 3 bioactive ingredients(quercetin,kaempferol,AC1LIUG4)were screened as pivotal ingredients.30 target genes were identified as the anti-coronavirus disease 2019 of Lianhua Qingwen capsule.Among the targets,tumor necrosis factor,JUN(transcription factor AP-1),interleukin 6,vascular endothelial growth factor A,interleukin 1B,interleukin 2,mitogen-activated protein kinases 1 were regulated by various compounds and screened as the core genes of protein-protein interaction network.Nineteen signaling pathways screened by Kyoto Encyclopedia of Genes and Genomes pathway enrichment(P<0.05)were enriched on various inflammatory signaling pathways such as interleukin 17 signaling pathway,NF-κB signaling pathway,tumor necrosis factor signaling pathway and C-type lectin receptor signaling pathway.Conclusion:The bioactive compounds in Lianhua Qingwen capsule may have a therapeutic effect on coronavirus disease 2019 by inhibiting cytokine storms by regulating multiple inflammatory signaling pathways.

Analysis of the Real-world Efficacy of Lianhua Qingwen Capsule(莲花清瘟胶囊)in the Treatment of Upper Respiratory Tract Infection

Objective:To explore the efficacy of Lianhua Qingwen Capsule(莲花清瘟胶囊)on upper respiratory tract infection,to understand the impact of Lianhua Qingwen Capsule(莲花清瘟胶囊)on the treatment outcome of upper respiratory tract infection,and provide reference for rational clinical drug use.Methods:The HIS database based on 18 large third-grade class-A hospitals was selected to match 1:1 for upper respiratory tract infection patients using and without Lianhua Qingwen Capsule(莲花清瘟胶囊)according to certain standards.The recombination of treatment outcome as"recovery"and"improvement"in the database was defined as effective treatment,"ineffectiveness","death"and"other"as ineffectivetreatment populations,and the effectiveness of treatment outcomes in the remerged 2 groups was compared by propensity score method.Results:After matching,454 cases were in both the patients treated by(experimental group)and without(control group)Lianhua Qingwen Capsule(莲花清瘟胶囊).Analysis was performed by three Logistic regression methods,all showing regression coefficients greater than 0 and statistically significant differences(P<0.05).Conclusion:Patients with upper respiratory tract infection treated by Lianhua Qingwen Capsule(莲花清瘟胶囊)are more effective than that without Lianhua Qingwen Capsule(莲花清瘟胶囊),it can improve the clinical efficacy of patients with upper respiratory tract infection。

Retrospective analysis of the efficacy of traditional Chinese medicine Lianhua Qingwen Capsule for the treatment of novel coronavirus-infected pneumonia

Objective:The aim of this study was to evaluate the clinical efficacy of traditional Chinese medicine Lianhua Qingwen Capsule(LQC)for the treatment of novel coronavirus-infected pneumonia by a retrospective analysis of confirmed COVID-19 cases,thereby providing a reference for clinical treatment.Methods:We retrospectively analyzed the clinical data of patients with confirmed NCIP treated at the Hanchuan Hospital of People’s Hospital of Wuhan University of China between January 21 and January 30,2020.A total of 32 patients were included in the treatment group,who received routine treatment plus LQC(1 packet,tid),and 32 patients were included in the control group,who received routine treatment alone.The data about response rate of respiratory symptoms were compared and analyzed between the two groups.Results:No significant between-group difference was observed in baseline data.The response rates for fever were 84.4%in the treatment group and 56.3%in the control group;for cough,the response rates were 47.8%and 7.4%in the treatment group and the control group,respectively(P<0.05).The response rates for expectoration were 71.4%in the treatment group and 11.8%in the control group;for shortness of breath,the response rates were 78.6%and 0%in the treatment group and the control group,respectively(P<0.05).The average duration of symptoms like fever,cough,fatigue and expectoration in the treatment group were shorter than that in the control group(P<0.05).There was no significant difference in the incidence rate between LQC and control group.Conclusion:Traditional Chinese medicine LQC significantly improved fever,cough,expectoration,and shortness of breath in patients with confirmed COVID-19,thereby providing preliminary evidence for clinical treatment.

不同中成药辅助治疗社区获得性肺炎疗效及安全性的网状Meta分析

目的采用网状Meta分析探讨不同中成药辅助治疗社区获得性肺炎(CAP)的疗效及安全性。方法计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库及PubMed、Web of Science、Embase、the Cochrane Library中公开发表的中成药治疗CAP的随机对照试验(RCTs),检索时限为建库至2023年5月。由2位研究员独立筛选文献,采用Cochrane风险偏倚评估工具RoB 2.0对纳入文献进行方法学质量评价,应用Stata 15.0软件进行网状Meta分析,并绘制漏斗图评估文献发表偏倚。结果最终纳入31篇RCTs,共包含3111例患者。网状Meta分析结果显示,临床总有效率的累积排序概率曲线下面积(SUCRA)排序为:十味龙胆花颗粒>疏风解毒胶囊>连花清瘟胶囊/颗粒>蒲地蓝消炎口服液>西药;退热时间的SUCRA排序为:十味龙胆花颗粒>连花清瘟胶囊/颗粒>疏风解毒胶囊>蒲地蓝消炎口服液>西药;咳嗽消失时间的SUCRA排序为:十味龙胆花颗粒>疏风解毒胶囊=连花清瘟胶囊/颗粒>蒲地蓝消炎口服液>西药;肺部啰音消失时间的SUCRA排序为:十味龙胆花颗粒>疏风解毒胶囊>连花清瘟胶囊/颗粒>西药。与单独西药治疗相比,十味龙胆花颗粒、疏风解毒胶囊、连花清瘟胶囊/颗粒、蒲地蓝消炎口服液联合西药治疗的临床总有效率均较高。与单独西药治疗相比,十味龙胆花颗粒、连花清瘟胶囊/颗粒、疏风解毒胶囊联合西药治疗者的退热时间、咳嗽消失时间、肺部啰音消失时间更短;与连花清瘟胶囊/颗粒、疏风解毒胶囊、蒲地蓝消炎口服液联合西药相比,十味龙胆花颗粒联合西药治疗者退热时间、咳嗽消失时间更短;与疏风解毒胶囊、连花清瘟胶囊/颗粒联合西药相比,十味龙胆花颗粒联合西药治疗者的肺部啰音消失时间更短。研究均未出现严重不良反应。漏斗图结果显示,有少部分散点分布在下部,散点存在不对称性,故文献存在一定的发表偏倚。结论连花清瘟胶囊/颗粒、疏风解毒胶囊、蒲地蓝消炎口服液、十味龙胆花颗粒联合西药治疗CAP均可增强疗效,但十味龙胆花颗粒的治疗效果最好,疏风解毒胶囊次之。

Deciphering suppressive effects of Lianhua Qingwen Capsule on COVID-19 and synergistic effects of its major botanical drug pairs

The COVID-19 pandemic has resulted in excess deaths worldwide.Conventional antiviral medicines have been used to relieve the symptoms,with limited therapeutic effect.In contrast,Lianhua Qingwen Capsule is reported to exert remarkable anti-COVID-19 effect.The current review aims to:1)uncover the main pharmacological actions of Lianhua Qingwen Capsule for managing COVID-19;2)verify the bioactive ingredients and pharmacological actions of Lianhua Qingwen Capsule by network analysis;3)investigate the compatibility effect of major botanical drug pairs in Lianhua Qingwen Capsule;and 4)clarify the clinical evidence and safety of the combined therapy of Lianhua Qingwen Capsule and conventional drugs.Numerous bioactive ingredients in Lianhu Qingwen,such as quercetin,naringenin,β-sitosterol,luteolin,and stigmasterol,were identified to target host cytokines,and to regulate the immune defence in response to COVID-19.Genes including androgen receptor(AR),myeloperoxidase(MPO),epidermal growth factor receptor(EGFR),insulin(INS),and aryl hydrocarbon receptor(AHR)were found to be significantly involved in the pharmacological actions of Lianhua Qingwen Capsule against COVID-19.Four botanical drug pairs in Lianhua Qingwen Capsule were shown to have synergistic effect for the treatment of COVID-19.Clinical studies demonstrated the medicinal effect of the combined use of Lianhua Qingwen Capsule and conventional drugs against COVID-19.In conclusion,the four main pharmacological mechanisms of Lianhua Qingwen Capsule for managing COVID-19 are revealed.Therapeutic effect has been noted against COVID-19 in Lianhua Qingwen Capsule.

连花清瘟颗粒治疗流行性感冒的效果分析

目的 研究连花清瘟颗粒治疗流行性感冒的临床疗效。方法 370例流行性感冒患者,按治疗方法不同分为对照组(182例)和观察组(188例)。对照组患者给予磷酸奥司他韦颗粒进行治疗,观察组患者给予连花清瘟颗粒进行治疗。比较两组患者的临床疗效、不良反应发生率及症状恢复时间。结果 观察组(90.43%)的临床总有效率明显高于对照组(80.77%),差异有统计学意义(P<0.05)。观察组(6.38%)和对照组(5.49%)的不良反应发生率差异不显著(P>0.05)。观察组的体温恢复正常时间(3.51±0.69)d、鼻塞消失时间(3.40±0.66)d、咳嗽消失时间(3.31±0.65)d、乏力恢复正常时间(3.47±0.68)d明显比对照组的(3.72±0.71)、(3.57±0.68)、(3.45±0.66)、(3.69±0.70)d短,差异有统计学意义(P<0.05)。结论 连花清瘟颗粒治疗流行性感冒患者效果显著,可明显缩短患者临床症状恢复时间,且用药安全,值得推荐。

连花清瘟颗粒联合磷酸奥司他韦颗粒治疗小儿甲型流行性感冒的临床研究

目的 研究连花清瘟颗粒辅助治疗甲型流行性感冒的疗效。方法 以2022年至2023年徐州矿务集团第一医院确诊的50例甲型流行性感冒患儿作为研究对象,将其分为对照组和观察组,各25例。除给予退热等基础治疗外,对照组给予磷酸奥司他韦颗粒治疗,观察组给予连花清瘟颗粒联合奥司他韦颗粒治疗,两组患者均连续治疗5 d,比较临床疗效差异。结果 观察组患者经连花清瘟颗粒联合磷酸奥司他韦颗粒治疗,发热改善时间、咽痛改善时间、鼻塞改善时间、咳嗽改善时间均明显短于对照组(P <0.05)。对照组25例患者,经磷酸奥司他韦颗粒治疗,临床总有效率为82.00%;观察组25例患者经连花清瘟颗粒联合磷酸奥司他韦颗粒治疗,临床总有效率为96.00%,明显高于对照组(P <0.05)。结论 对小儿甲型流行性感冒患者而言,在采用磷酸奥司他韦颗粒治疗基础上,联合应用连花清瘟颗粒,不仅可以有效缩短临床症状的改善时间,还可以提高临床疗效。

连花清瘟颗粒与阿奇霉素序贯疗法在肺炎支原体肺炎患儿中的应用研究

目的分析肺炎支原体(MP)肺炎患儿采用连花清瘟颗粒与阿奇霉素序贯疗法联合治疗的效果。方法98例MP肺炎患儿,使用随机数字表法分为研究组与对照组,各49例。对照组患儿采用阿奇霉素序贯疗法治疗,研究组在对照组基础上联合连花清瘟颗粒治疗。比较两组疗效、症状与体征恢复时间、肺功能[用力肺活量(FVC)、呼气峰流速(PEF)]、临床肺部感染量表(CPIS)评分、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]、生活质量评分、不良反应发生情况。结果研究组治疗总有效率95.92%高于对照组的81.63%,差异有统计学意义(P<0.05)。研究组退热、咳嗽缓解、啰音消失时间分别为(3.02±1.02)、(4.68±1.69)、(4.04±0.70)d,短于对照组的(4.41±1.42)、(6.02±2.02)、(5.05±0.75)d,差异有统计学意义(P<0.05)。治疗后,研究组FVC(2.30±0.24)L、PEF(192.60±17.08)L/min高于对照组的(1.85±0.23)L、(169.55±18.20)L/min,CPIS评分(1.45±0.55)分低于对照组的(1.87±0.42)分,差异有统计学意义(P<0.05)。治疗后,研究组IL-6、TNF-α、CRP分别为(30.12±5.88)pg/ml、(30.45±4.85)pg/ml、(10.75±3.82)mg/L,低于对照组的(35.24±7.08)pg/ml、(40.56±5.02)pg/ml、(14.28±3.70)mg/L,差异有统计学意义(P<0.05)。治疗后,研究组生活质量评分(88.85±5.45)分高于对照组的(82.65±6.02)分,差异有统计学意义(P<0.05)。两组不良反应发生率比较,结果无差异性(P>0.05)。结论MP肺炎患儿采用连花清瘟颗粒与阿奇霉素序贯疗法联合治疗效果确切,能够促进症状与体征恢复,改善肺功能、肺部感染情况与炎症因子水平,保障生活质量,安全性较为理想,适于临床推广。

以连花清瘟胶囊简介英译现状为例探讨中医药文化国际传播困局与策略

中医药文化是中国最具代表性的传统文化之一。随着新型冠状病毒肺炎疫情的暴发,中医药越发彰显出其优势和特色。连花清瘟胶囊作为抗击疫情的有力武器,为促进中医药文化的国际传播铺垫了良好基础。此文以连花清瘟胶囊简介英译现状为例,深入探讨当前中医药文化国际传播中面临的传而不正、传而不通、传而不一等困局,并针对性地提出深度学习中医药文化、引导文化适应、规范中医术语英译标准、培养中医药文化传播人才等策略,以求中医药文化传而达正、传而达通、传而达一、传而达精,希冀切实促进疫情之下中医药文化走向世界。

连花清瘟颗粒联合丙酸氟替卡松鼻喷雾剂在儿童哮喘共患鼻窦炎中的临床疗效及对肺功能、炎症因子的影响

目的探讨连花清瘟颗粒联合丙酸氟替卡松鼻喷雾剂对儿童哮喘共患鼻窦炎的临床疗效,以及对肺功能、炎症因子的影响。方法方便选取2021年1月—2023年9月龙岩市第二医院收治的66例哮喘共患鼻窦炎患儿为研究对象,采用随机数表法分为对照组(采用丙酸氟替卡松鼻喷雾剂治疗)和研究组(在对照组基础上增加连花清瘟颗粒治疗),每组33例。比较两组患儿治疗效果、治疗前后肺功能及血清炎症因子水平。结果研究组治疗总有效率(93.94%)显著高于对照组(75.76%),差异有统计学意义(χ^(2)=4.243,P<0.05);研究组咳嗽、呼吸困难、鼻塞、流涕症状改善时间均短于对照组,差异有统计学意义(P均<0.05)。研究组治疗后第1秒用力呼气量(Forced Expiratory Volume,FEV1)(1.72±0.24)L、用力肺活量(Forced Vital Capacity,FVC)(2.12±0.34)L、呼气峰流速(Peak Expiratory Flow,PEF)(3.24±0.46)L/s均高于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组白细胞介素4(Interleukin-4,IL-4)、白细胞介素-6(Interleukin-6,IL-6)及肿瘤坏死因子(Tumor necrosis Factor,TNF-α)均低于对照组,差异有统计学意义(P均<0.05)。结论连花清瘟与丙酸氟替卡松鼻喷雾剂联合治疗儿童哮喘共患鼻窦炎疗效显著,可快速消除换患儿的临床症状、改善其肺功能,降低其炎症反应水平。

轻型方治疗新型冠状病毒奥密克戎变异株感染轻型患者临床研究

目的:比较轻型方与痰热清胶囊、连花清瘟胶囊治疗新型冠状病毒奥密克戎变异株感染轻型患者临床疗效。方法:纳入新型冠状病毒奥密克戎变异株感染轻型患者150例,根据倾向性评分法以1∶1∶1匹配,分为轻型方组、痰热清组、连花清瘟组各50例。通过问卷星进行中医临床症状的收集,对比分析3组患者的中医证候评分及临床疗效,比较3组患者的转阴时间及转阴率。结果:治疗后3组患者乏力、鼻塞流涕、咽痛、咳嗽证候评分均较治疗前降低,差异有统计学意义(P<0.01或P<0.05)。治疗后轻型方组、痰热清组气喘评分较治疗前降低,差异有统计学意义(P<0.01);连花清瘟组气喘评分与治疗前比较,差异无统计学意义(P>0.05)。治疗后轻型方组咽痛评分低于痰热清组,差异有统计学意义(P<0.05)。3组治疗后中医证候评分总分均较本组治疗前降低,差异有统计学意义(P<0.01);3组治疗后中医证候评分总分比较,差异无统计学意义(P>0.05)。轻型方组转阴天数最短,其次为痰热清组,连花清瘟组转阴天数最长;轻型方组转阴天数与连花清瘟组比较,差异有统计学意义(P<0.05)。轻型方组14 d阴转率94%,高于痰热清组88%与连花清瘟组56%,差异有统计学意义(P<0.001)。轻型方组、痰热清组和连花清瘟组治疗有效率分别为90%、86%和80%,3组比较差异无统计学意义(P>0.05)。结论:与痰热清胶囊、连花清瘟胶囊比较,轻型方能提高新型冠状病毒奥密克戎变异株感染轻型患者的转阴率,缩短转阴天数,可阻止病情进一步加重,从而降低死亡风险。

UPLC-MS/MS法同时测定连花清瘟胶囊中11种成分

目的建立UPLC-MS/MS法同时测定连花清瘟胶囊中红景天苷、绿原酸、连翘酯苷A、连翘苷、槲皮素、木犀草素、山柰酚、大黄酸、甘草酸、大黄素、大黄素甲醚的含量。方法该药物75%甲醇提取液的分析采用XB-C 18色谱柱(100 mm×3 mm,2.6μm);流动相乙腈-甲醇-水(含10 mmo/L乙酸铵和0.1%甲酸),梯度洗脱;体积流量0.5 mL/min;柱温40℃;电喷雾离子源;正负离子检测;多反应监测模式。结果11种成分在各自范围内线性关系良好(r≥0.9946),平均加样回收率85.5%~110.3%,RSD 1.2%~3.9%。结论该方法准确快速,重复性好,可用于连花清瘟胶囊的质量控制。

UPLC-QTRAP-MS/MS法同时测定连花清瘟胶囊(颗粒)中18种成分及山银花中灰毡毛忍冬皂苷乙

目的建立UPLC-QTRAP-MS/MS法同时测定连花清瘟胶囊(颗粒)中连翘苷、连翘酯苷A、绿原酸、3,5-O-二咖啡酰奎宁酸、4,5-O-二咖啡酰奎宁酸、木犀草苷、盐酸麻黄碱、盐酸伪麻黄碱、苦杏仁苷、(R,S)-告依春、芦荟大黄素、大黄素、大黄酚、大黄素甲醚、大黄酸、红景天苷、甘草苷、甘草酸铵,以及山银花中灰毡毛忍冬皂苷乙的含量。方法该药物40%甲醇提取液的分析采用Waters ACQUITY UPLC HSS T3色谱柱(2.1 mm×100 mm,1.8μm);流动相(5 mmol/L乙酸铵+0.1%甲酸)-甲醇,梯度洗脱;体积流量0.3 mL/min;柱温35℃;电喷雾离子源;正负离子模式扫描;多反应监测模式。结果19种成分在各自范围内线性关系良好(r>0.9990),平均加样回收率89.37%~102.19%,RSD 2.03%~3.75%。各批样品均未检出灰毡毛忍冬皂苷乙。结论该方法简便、准确、高效,可用于连花清瘟胶囊(颗粒)的质量控制及山银花的掺伪鉴别。

连花清瘟颗粒辅治儿童咳嗽变异性哮喘合并肺炎支原体感染的临床效果

目的观察连花清瘟颗粒辅治儿童咳嗽变异性哮喘合并肺炎支原体感染的临床效果。方法选取2018年1月—2020年1月宜春学院第二附属医院收治的咳嗽变异性哮喘合并肺炎支原体感染患儿88例,采用随机数字表法分为观察组与对照组,各44例。对照组患儿入院后予常规方案治疗,观察组在对照组基础上加用连花清瘟颗粒治疗,2组均连续治疗4周。比较2组治疗效果,临床症状(高热、咳嗽、喘息、肺部啰音)改善情况,治疗前后肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))及呼气流量峰值(PEF)]、相关炎性指标[血清Clara细胞分泌蛋白(CCSP)、干扰素-γ(IFN-γ)和白介素-17(IL-17)]、免疫因子[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平变化及不良反应(恶心呕吐、皮疹、腹泻、头痛)发生情况。结果观察组与对照组治疗总有效率(95.46%vs.86.36%)比较差异无统计学意义(χ^(2)=2.200,P=0.138);观察组各项症状改善时间均短于对照组(P<0.01)。治疗4周后,2组FVC、FEV_(1)及PEF均较治疗前增加,且观察组增加的程度大于对照组(P<0.05或P<0.01);2组CCSP、IFN-γ水平均较治疗前升高,IL-17水平降低,且观察组升高或降低的程度大于对照组(P均<0.01);2组IgA水平、CD4^(+)、CD8^(+)均较治疗前升高,CD4^(+)/CD8^(+)降低,且观察组升高或降低的程度大于对照组(P<0.05或P<0.01);IgM水平升高,但观察组升高幅度小于对照组,差异有统计学意义(P<0.01);2组IgG水平均高于治疗前,但2组比较差异无统计学意义(P>0.05)。观察组与对照组不良反应总发生率(18.18%vs.11.36%)比较差异无统计学意义(χ^(2)=0.812,P=0.367)。结论连花清瘟颗粒辅治儿童咳嗽变异性哮喘合并肺炎支原体感染的临床效果显著,可缓解患儿症状,缩短康复时间,促进肺通气功能的恢复以及炎性指标和免疫指标改善,且不良反应症状较轻,值得临床推广应用。

《新型冠状病毒肺炎诊疗方案(试行第九版)》中医治疗更新解读

2022年3月14日《新型冠状病毒肺炎诊疗方案(试行第九版)》发布,其中中医诊疗方案也进行了更新。本中医诊疗方案体现了“抗疫三方”的转化成果;扩大了金花清感颗粒、连花清瘟颗粒(胶囊)的使用范围,即从第八版的医学观察期扩大到医学观察期、轻型中的湿热蕴肺证和普通型的疫毒夹燥证;普通型增加了疫毒夹燥证,治以宣肺润燥解毒方;增加了针灸治疗部分,无论轻型、普通型、重型均可采取针灸治疗;对中药治疗儿童感染者提出了指导意见,使本方案的适用人群更加广泛;对部分药物的用法、名称等进行了规范。本版中医诊疗方案体现了当前有关中医药防治新型冠状病毒肺炎研究的最新进展,丰富了中医治疗的内容。

真实世界连花清瘟胶囊(颗粒)适应证人群临床特征及联合用药分析

目的探索真实世界中连花清瘟胶囊(颗粒)适应证人群的临床特征及联合用药情况,为该药临床用药提供参考和借鉴。方法基于医院信息管理系统(HIS),对数据库中18家医院2002年5月20日至2019年3月20日使用连花清瘟胶囊(颗粒)的5902例患者进行一般用药人群临床用药特征描述分析,运用关联规则,对连花清瘟胶囊(颗粒)的联合用药一并分析。结果连花清瘟胶囊(颗粒)的使用人群主要以45~65岁男性患者为主,住院天数多为15~28 d,西医诊断频次肺部感染最多,治疗结局以好转或治愈出院为主。临床上常与西药乙酰水杨酸、氨溴索、左氧氟沙星以及中药丹红注射液、痰热清注射液、喜炎平注射液等联合应用的患者。结论连花清瘟胶囊(颗粒)临床使用基本符合药品说明书,单次用药剂量大于说明书中剂量范围,体现了连花清瘟胶囊(颗粒)的用药现状;通过对合并用药分析,发现了临床常用合并治疗方案,为临床合理用药提供参考。

防治病毒性肺炎中连花清瘟胶囊重要靶点DPP4的生物信息学分析

目的通过生物信息学的方法对DPP4基因与蛋白进行系统的分析,为DPP4在病毒侵入宿主细胞和连花清瘟胶囊等药物防治等方面的研究打下生物信息学基础。方法首先分析DPP4蛋白的亲疏水性、信号肽结构、跨膜结构等基本性质,再通过SOPMA、SWISS-MODEL、STRING、MEGA-X等软件分析蛋白质的结构、相互作用关系、进化关系等高级属性进行分析,并通过其性质和属性分析DPP4在病毒侵入和药物治疗原理方面的作用。结果DPP4是一个亲水性非经典分泌蛋白,具有一个跨膜结构,并在小肠中表达较为丰富,在细胞中主要分布在内质网。DPP4的翻译后修饰位点较多,三级结构呈较为特殊的哑铃形,蛋白主要涉及糖代谢调控、炎性反应以及病毒侵入宿主细胞等生物过程。人类DPP4蛋白与啮齿类动物DPP4蛋白的亲缘性较差。结论连花清瘟胶囊对DPP4具有明确的靶向作用,并且DPP4蛋白与病毒侵入人体密切相关,因此其对病毒性肺炎的防治效果是可靠且明确的。

连花清瘟颗粒结合重组人干扰素α1b治疗小儿急性毛细支气管炎效果观察

目的观察连花清瘟颗粒结合重组人干扰素α1b治疗小儿急性毛细支气管炎效果。方法研究纳入小儿急性毛细支气管炎共计91例(2018年1月—2020年11月收治),将其以随机数字表法分成对照组与观察组,分别为45例、46例,对照组采取西医常规治疗,并雾化吸入布地奈德与复方异丙托溴铵溶液、重组人干扰素α1b治疗,观察组在对照组西医常规疗法基础上联合连花清瘟颗粒治疗,数据观察:临床疗效、治疗前后两组患儿中医证候积分变化、治疗后两组患儿咳嗽消失时间及喘息消失时间、三凹征消失时间及发热消失时间、肺部罗音消失时间等、治疗前后患儿血气指标变化及肺功能指标变化、T细胞亚群指标变化、患儿不良反应情况。结果两组患儿治疗总有效率无差异,对照组为93.33%(42/45),观察组为97.83%(45/46)(P>0.05),而观察组患儿治疗后显效率(85.78%)显著高于对照组患儿(57.78%)(P<0.05);治疗前,两组患儿中医证候积分、氧分压(partialpressureofoxygen,SpO_(2))及二氧化碳分压(carbon dioxide partial pressure,PaCO_(2))、动脉血酸碱度(arterial blood,pH值)等血气指标、肺功能各项指标(达峰时间比、达峰容积比、呼吸比及潮气等)、白介素-4(interleukin-4,IL-4)及白介素-6(interleukin-6,IL-6)、超敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)等炎性因子水平、T细胞亚群指标(CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8))比较,P>0.05,治疗后两组患儿中医证候积分、SpO_(2)及PaCO_(2)、肺功能指标(达峰时间比、达峰容积比、呼吸比及潮气等)、IL-4及IL-6、hs-CRP、TNF-α、T细胞亚群指标(CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8))等均改善,观察组患儿治疗后中医证候积分、SpO_(2)及PaCO_(2)、肺功能指标(达峰时间比、达峰容积比、呼吸比及潮气等)、IL-4及IL-6、hs-CRP、TNF-α、T细胞亚群指标(CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(8))等优于对照组患儿(P<0.05);与对照组患儿相比,观察组咳嗽消失时间与喘息消失时间、发热消失时间、三凹征消失时间、肺部罗音消失时间等指标均更短(P<0.05);观察组不良反应率为4.35%(2/46),对照组不良反应率为4.44%(2/45)。结论连花清瘟颗粒结合重组人干扰素α1b治疗小儿急性毛细支气管炎效果显著,治疗不良反应少,安全可靠,患儿恢复佳,值得应用。

连花清瘟胶囊治疗流行性上呼吸道感染的效果研究

目的 观察连花清瘟胶囊治疗流行性上呼吸道感染的效果。方法 240例流行性上呼吸道感染患者,按照不同治疗方式将患者分为对照组和观察组,各120例。对照组接受常规抗病毒口服液治疗,观察组在对照组基础上接受连花清瘟胶囊治疗。比较两组患者临床疗效、不良反应发生情况及治疗后1、2 h体温情况。结果 观察组显效47例(39.17%),有效64例(53.33%),无效9例(7.50%),治疗总有效率为92.50%(111/120);对照组显效42例(35.00%),有效56例(46.67%),无效22例(18.33%),治疗总有效率为81.67%(98/120)。观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,但差异无统计学意义(P>0.05)。观察组治疗后1 h体温为(37.28±0.12)℃,治疗后2 h体温为(36.91±0.10)℃;对照组治疗后1 h体温为(37.89±0.97)℃,治疗后2 h体温为(37.45±0.22)℃。观察组治疗后1、2 h体温均低于对照组,差异有统计学意义(P<0.05)。结论 流行性上呼吸道感染患者接受连花清瘟胶囊治疗可以提升其治疗效果,安全性更好,能改善患者临床症状,降低体温。