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.

Effects of Lianhua Qingwen on Pulmonary Oxidative Lesions Induced by Fine Particulates(PM2.5) in Rats

Objective To investigate the antagonistic effects of different doses of Lianhua Qingwen on pulmonary injury induced by fine particulates PM2.5 in rats. Methods Fine particulates suspended in the environment were collected. Forty-eight healthy adult wistar rats were randomly divided into 6 groups with 8 rats in each group. Four groups of rats were exposed to PM2.5 by intratracheally dripping suspensions of fine particulates PM2.5(7.5 mg/kg) as dust-exposed model rats. Among them 24 rats in three groups received Lianhua Qingwen treatment(crude drug) at a dose of 2 g/kg, 4 g/kg, 8 g/kg per day for 3 days before dust exposure and were defined as low-dose, middle-dose and high-dose Lianhua Qingwen treatment groups respectively. The other dust-exposed model rats without treatment were assigned as PM2.5 control group. The un-exposed rats were set as saline control group(1.5 ml/kg saline) and blank control group. All rats were killed after 24 hours of the exposure. Lung tissue, serum and bronchoalveolar lavage fluid(BALF) were collected. The levels of malonaldehyde(MDA), lactate dehydrogenase(LDH), and glutathione peroxidase(GSH-PX) in blood serum and BALF, and superoxide dismutase(SOD) in blood surum were measured using fluorescent quantitation PCR; Expression of NF-E2-related factor 2(NRF-2), heme oxygenase 1(HO-1) and quinone oxidoreductase 1(NQO1) in lung tissues were measured using Western blot. Pathological changes of lung tissues in each group were also examined. Results Pathology revealed thickened alveolar septum, congestion of capillary, interstitial edema and infiltration of lymphocyte and neutrophil surrounding bronchiole in the PM2.5 control group, which weresignificantly relieved in the Lianhua Qingwen treatment groups. Compared to the blank and saline control groups, the PM2.5 control group had significantly higher levels of LDH and MDA(p<0.01) and lower level of GSH-PS(p<0.01) in BALF, significantly higher levels of LDH and MDA(p<0.05) and lower level of GSH-PS(p<0.05) in rat serum. The levels of MDA in blood serum and BALF were significantly lower in each treatment group than that in PM2.5 control group(all P<0.05). In both middle-dose and high-dose treatment group the measurements of LDH in serum and BALF as well as GSH-PX in serum were significant difference from those of PM2.5 control group(all P<0.05). Expressions of NRF-2, HO-1 and NQO1 in lung tissues were significantly different among middle-dose and high-dose treatment group compared with those in PM2.5 control group(all P<0.05). Conclusion Fine particulates PM2.5 in environment may induce pulmonary oxidative lesions in rats. Middle-dose and high-dose Lianhua Qingwen has antagonist effece on the injuries induced by fine particulates.

Clinical applications and pharmacological research progress of Lianhua Qingwen capsules/granules

Lianhua Qingwen capsule/granule is an innovative Chinese medicine developed under the guidance of the traditional Chinese medicine(TCM)collateral disease theory.It has the effect of“clearing heat and removing toxin,ventilating the lungs and discharging heat”.In 2003,it was approved as a new drug by the China National Medical Products Administration,through expedited approval during severe acute respiratory syndrome,and now,it has become a representative proprietary Chinese medicine for the treatment of infectious diseases of the respiratory system.Pharmacodynamic studies have revealed that Lianhua Qingwen has broad-spectrum antiviral,antibacterial and anti-inflammatory,antipyretic,coughrelieving,and immunoregulation effects.Clinically it has been used in the treatment of communicable and infectious respiratory diseases such as Coronavirus Disease 2019,influenza,colds,pulmonary infections,etc.and has achieved remarkable curative effects,showing the important clinical guidance of the TCM collateral disease theory.

Determination of Berberine Hydrochloride Content in Qingwen Baidu Granule by HPLC

The paper was to establish a simple and sensitive HPLC method for determination of berbefine hydrochloride content in Qingwen Baidu granule. The HPLC system consisted of Stable Bond - C18 column （4.6 × 150 mm, 5um） and with a mobile phase of acetonitrile -0.05mol/L potassium dihydrogen phosphate solution （50：50,v：v） mixture. Berberine hydrochloride was detected at the wavelength of 345 nm, with a flow rate of 1.0 ml/min and a column temperature of 30 ℃. The excipients and solvents in the granule could be well separated from the drug under such a designated chromatogram condition and did not interfere with the assay. A good linear relationship was found between peak area and the concentration of berberine hydrochloride in the range of 16.0 -48.0 I^g/mL. The average recovery of berberine hydrochloride was 99.09%. The established approach was specific, accurate, reliable, prompt, sensitive and applicable, and could be used to control the quality of Qingwen Baidu granule.

Meta-analysis of the efficacy and safety of Lianhua Qingwen combined with western medicine in the treatment of common patients with new coronary pneumonia

Objective:To evaluate the clinical efficacy of Lianhua Qingwen combined with Western medicine in the treatment of common patients with new coronary pneumonia by Meta analysis system.Methods:Computer retrieval of Chinese Journal Full-text Database,Weipu Chinese Scientific and Technical Periodical Full-text Database,Wanfang Data Knowledge Service Platform,Chinese Biomedical Literature Database,PubMed Database and manual retrieval of relevant literature.The search period is from database establishment to April 2020 Two researchers independently searched,screened the literature,and performed data extraction and quality evaluation on the included literature according to the Cochrane systematic review methodology.RevMan5.3 software was used for Meta analysis.Results:A total of 5 RCT literatures were included in this study,and the total effect value was combined using a fixed-effect model.As a result,3 literatures were used for clinical efficacy statistics RR=2.59,95%CI(1.68,3.98),Z=4.32,P<0.05,statistically significant;there are 3 literatures on the disappearance rate of the main symptoms,including the disappearance of fever,cough and fatigue,subgroup study,no heterogeneity between the three groups(I2=0%,P=0.88),combined with RR=3.27,95%CI(2.18,4.91),Z=5.75,P<0.05,with statistical significance;there are 3 articles with statistics on the disappearance rate of comorbidities RR=13.68,95%CI(2.80,66.79),Z=3.23,P<0.05,which is statistically significant;there are 2 literatures that count the fever remission time MD=-1.07,95%CI(-1.77,-0.37),Z=2.99,P<0.05,Statistically significant;2 literatures reported aggravating conditions in the treatment group,RR=0.33,95%CI(0.13,0.81),Z=2.41,P<0.05,statistically significance.Conclusion:Lianhua Qingwen combined with Western medicine is effective in the treatment of common patients with new coronary pneumonia,and there are few adverse reactions.However,due to the limitations of the included literature,the Meta analysis results also have corresponding limitations,so more high-quality RCT is needed to further In-depth study.

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.

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.

Identification of Gardenoside and Sarsasapogenin from Qingwen Baidu Granules by TLC

[ Objective ] We aimed to establish the identification method of gardenoside and sarsasapogenin in Qingwen baidu granules. [ Method] With ethyl ace- tate-acetone-formic acid-water （10：7：2：0.5） as the developer and 10% sulfuric acid ethanol solution as the chromogenic reagent, the samples were heated at 100 ~C until the spots were clearly visible, and the existence of gardenoside was checked under natural light. With toluene-acetone（9：l ） as the developer and 5% vanillin sulfuric acid solution as the chromogenic reagent, the samples were heated at 105 ~C until the spots were clearly visible, and the existence of sarsasapogenin was checked under natural light. [Result] Qingwen baidu granules had the same spots with gardenoside and sarsasapogenin at the same Rfvalue under natural light. [ Conclusion] A TLC method detecting gardenoside and sarsasapogenin in Qingwen baidu granules was established, which had good specificity and repeatability, suitable for rapid detection of gardenoside and sarsasapogenin.

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。

Identification of Coptis chinensis and Forsythia sus-pensa from Qingwen Baidu Granules by TLC

[ Objective] The paper was to establish the identification method of Coptis chinensis and Forsythia suspensa in Qingwen baidu granules. [ Method ] With benzene-ethyl acetate-methanol-isopropanol-cancentrated ammonium liquid （ 12：6：3：3：1 ） as the developer, the samples were outspread in the cylinder with sat- urated ammonia steam by thin layer chromatography （TLC）, and the existence of C. chinensis and berberine hydrochloride was checked under UV lamp. With tri- chloromethane-methanol （5：1） as the developer and 10% sulfuric acid ethanol solution as the chromogenic reagent, the samples were heated at 105 ℃ for 5 min to check the existence of F. suspense under natural light. [Result] Qingwen baidu granules had the same spots with C. chinensis control and berberine hydrochloride at the same Rf value under 365 nm UV lamp; Qingweu baidu granules had the same spots with F. suspensa control at the same Rfvalue under natural light. [ Condusion] A TLC method detecting C. chinensis and F. suspensa in Qingwen baidu granules was established, which had good specificity and repeatability, suitable for rapid detection of C. chinensis and F. suspensa. It could be well applied to control the quality of Qingwen baidu granule.

Effects of Qingwen Baidu decoction on coagulation and multiple organ injury in rat models of sepsis

Background:Sepsis-induced coagulopathy and multiple organ dysfunction syndromes are the leading causes of death in patients with sepsis.Qingwen Baidu decoction(QWBD)can effectively improve the clinical manifestations of sepsis and ease inflammation,but its effects on coagulation functions and multiple organ injuries remain unclear.Methods:100 healthy,male Sprague-Dawley rats were randomly divided into the sham group,the cecal ligation and puncture(CLP)group,the low-dose QWBD group,and the high-dose QWBD group,with 25 rats in each group.The sepsis model was established using CLP.Blood was collected to measure platelet count,serum creatinine(Cr),blood urea nitrogen(BUN),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)levels,as well as coagulation function.The total protein in bronchoalveolar lavage fluid(BALF)was determined in each group of rats.The lung,liver,and kidney tissues were harvested,and statistics were calculated on the wet-to-dry(W/D)weight ratio.Changes in histopathology and thrombin level were evaluated in each group.The remaining ten rats in each group were observed daily to record the number of surviving rats.Such observation was made consecutively for 7 days to calculate survival rates.Results:After model establishment,ALT,AST,Cr,and BUN levels were significantly elevated(P<0.01).The BALF protein content and lung W/D weight ratio were significantly increased(P<0.01).Furthermore,the survival rate of rats was significantly reduced in the CLP group compared with the sham group.After the treatment,rats in the high-dose QWBD group had lower ALT(P<0.05),AST(P<0.01),Cr(P<0.05),BUN(P<0.01)levels,lower BALF protein content(P<0.05)and lower lung W/D weight ratio(P<0.01)than the CLP group.However,rats in the high-dose QWBD group had significantly better pathological changes in the lung,liver,and kidney compared to the sham group.After the treatment,the platelet level in the peripheral blood was elevated(P<0.05)and both activated partial thromboplastin time and prothrombin time were significantly shortened(P<0.01).The fibrinogen level was significantly increased(P<0.01).Finally,thrombin positive expression areas in the lung,liver,and kidney were significantly decreased in the high-dose QWBD group.Conclusion:QWBD can improve coagulation disorders caused by sepsis and has a protective effect on multiple organ injuries in rats.

An umbrella review of Lianhua Qingwen combined with Western medicine for the treatment of coronavirus disease 2019

Objective:Lianhua Qingwen combined with Western medicine(LHQW+WM)has been proposed as a viable treatment for coronavirus disease 2019(COVID-19).Interestingly,umbrella reviews of systematic reviews(SRs),which provide the most comprehensive evidence,are the best evidence in evidence-based medicine.Therefore,an umbrella review of SRs that summarizes and evaluates the efficacy of LHQW+WM for COVID-19 is urgently required.Methods:Overall,6 databases were used to conduct a comprehensive literature search from inception to January 22,2022.The corrected covered area(CCA)was used to analyze the overlapping between SRs.Meta-analysis was conducted when that of the included SRs was inappropriate.A MeaSurement Tool to Assess Systematic Reviews(AMSTAR-2)was also employed to assess the quality of the included SRs.Results:In total,12 SRs were identified,which included 12 unique primary studies.The included SRs ranged in quality from moderate to critically low and had an extremely high CCA(36.4%).Compared to conventional treatment,LHQW+WM showed efficacy concerning fatigue recovery[risk ratio(RR)=1.69,95%confidence interval(CI):1.04-2.73,n=2,I2=0%],cough recovery(RR=1.65,95%CI:1.09-2.51,n=3,I2=39.1%),and overall effective rates(RR=1.17,95%CI:1.07-1.28,n=3,I2=17.5%).Conclusion:LHQW+WM may improve the clinical symptoms of patients with COVID-19;however,the results should be interpreted cautiously because of the rigorous processes in the included SRs.

Meta-analysis on the effect of combining Lianhua Qingwen with Western medicine to treat coronavirus disease 2019

Background: Coronavirus disease 2019(COVID-19) has become a worldwide life-threatening pandemic.Lianhua Qingwen is believed to possess the ability to treat or significantly improve the symptoms of COVID-19. These claims make it important to systematically evaluate the effects of using Lianhua Qingwen with Western medicine to treat COVID-19.Objective: To evaluate the safety and efficacy of combination therapy, employing Lianhua Qingwen with Western medicine, to treat COVID-19, using a meta-analysis approach.Search strategy: China National Knowledge Infrastructure, Wanfang Database, VIP Database, Pub Med,Embase, and Cochrane Library databases were searched for studies evaluating the effect of Lianhua Qingwen-Western medicine combination therapy in the treatment of COVID-19.Inclusion criteria:(1) Research object: hospitalized patients meeting the diagnostic criteria of COVID-19 were included.(2) Intervention measures: patients in the treatment group received Lianhua Qingwen treatment combined with Western medicine, while the control group received either Western medicine or Chinese medicine treatment.(3) Research type: randomized controlled trials and retrospective study were included.Data extraction and analysis: Two researchers extracted the first author, the proportion of males and females, age, body temperature, course of treatment, rate of disappearance of main symptoms, duration of fever, adverse reactions, and total effectiveness from the literature. Odds ratio(OR) and 95% confidence interval(CI) were used as the effect value for count data, and mean difference(MD) and 95% CI were used as the effect value for measurement data.Results: Six articles met the inclusion criteria, including a total of 856 COVID-19 patients. The meta-analysis showed that Lianhua Qingwen combination therapy achieved higher rates of fever reduction(OR = 3.43, 95% CI [1.78, 6.59], P = 0.0002), cough reduction(OR = 3.39, 95% CI [1.85, 6.23],P < 0.0001), recovery from shortness of breath(OR = 10.62, 95% CI [3.71, 30.40], P < 0.0001) and recovery from fatigue(OR = 2.82, 95% CI [1.44, 5.53], P = 0.003), higher total effectiveness rate(OR = 2.51, 95% CI[1.73, 3.64], P < 0.00001), and shorter time to recovery from fever(MD = à1.00, 95% CI [à1.04, 0.96],P < 0.00001), and did not increase the adverse reaction rate(OR = 0.65, 95% CI [0.42, 1.01], P = 0.06), compared to the single medication control.Conclusion: The Lianhua Qingwen and Western medicine combination therapy is highly effective for COVID-19 patients and has good clinical safety. As only a small number of studies and patients were included in this review, more high-quality, multicenter, large-sample-size, randomized, double-blind,controlled trials are still needed for verification.

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.

Efficacy and Safety of Lianhua Qingwen for Patients with COVID-19: A Systematic Review and Meta-Analysis

Background: Corona virus disease 2019(COVID-19) has spread around the world since its outbreak, and there is no ascertained effective drug up to now. Lianhua Qingwen(LHQW) has been widely used in China and overseas Chinese, which had some advantages in the treatment of COVID-19. Objective: To evaluate the efficacy and safety of LHQW for COVID-19 by conducting a systematic review with meta-analysis. Methods: A comprehensive literature search was conducted in 12 electronic databases from their establishment to October 30, 2021. Note Express 3.2.0 was used for screening of trials, and the data was independently extracted in duplicate by 2 researchers. The risk of bias of randomized controlled trials(RCTs) and retrospective studies were assessed by using the Cochrane collaboration tool and Newcastle Ottawa Scale, respectively, followed by data analysis using RevMan 5.3. The RCTs or retrospective studies to treat COVID-19 using LHQW were included. The intervention measures in the experimental group were LHQW alone or combined with chemical drugs(LCWC), and that in the control group were chemical drugs(CDs). Outcome measures included computed tomography(CT) recovery rate, disappearance rates of primary(fever, cough, fatigue), respiratory, gastrointestinal and other symptoms, exacerbation rate and adverse reaction. Subgroup analysis was conducted according to whether LHQW was combined with CDs and the different treatment methods in the control group. Results: Nine trials with 1,152 participants with COVID-19 were included. The CT recovery rates of LHQW and LCWC were 1.36 and 1.32 times of CDs, respectively(P<0.05). Compared with CDs, LCWC remarkably increased the disappearance rates of fever, cough, fatigue, expectoration, shortness of breath, and muscle soreness(P<0.05). LHQW also obviously decreased the exacerbation rate, which was 0.45 times of CDs alone(P<0.05). There was no obvious difference between LCWC and CDs in adverse reaction(P>0.05). Conclusions: LHQW was more suitable for treating COVID-19 patients with obvious expectoration, shortness of breath and muscle soreness. LHQW had advantages in treating COVID-19 with no obvious exacerbation.(PROSPERO No. CRD42021235937)

Anti-Inflammatory Effect of Qingwen Baidu Decoction (清瘟败毒饮) in Sepsis Rats

Objective：To explore the pharmacological anti-inflammatory mechanism of Chinese formula Qingwen Baidu Decoction（清瘟败毒饮,QBD） from the view of holistic biology.Methods：The rats were randomly divided into a normal conrol group,a lipopolysaccharide（LPS） group,the low- and high-dose QBD groups,and a dexamethasone（DXM） group.NR8383 cells were treated with culture fluid containing 6%serum from rats of each group respectively.Inflammatory mediators were detected by reverse transcription polymerase chain reaction（RT-PCR）,Western blotting hybridization,enzyme linked immunosorbent assay（ELISA）,polymerase chain reaction（PCR） gene array and antibody array.Results：It is showed that the levels of interleukin（IL）-1 α,IL-4 and IL-12 were enhanced in the low-dose QBD group;levels of IL-1 α,IL-12 and IL-18 were augmented in the high-dose QBD group,compared with the LPS group after ELISA detection.Western blot showed that IL-1β and tumor necrosis factor（TNF）-α expression of the control group were lower than other groups.IL-1 βlevel of the low-dose and high-dose QBD groups detected by RT-PCR was higher in early stage but lower after24 h than that of the control group（P〈0.01）.Expression of 84 main inflammatory cytokines and receptors was detected by rat inflammatory cytokines and receptors PCR array.Up-regulation genes were 22 in both the LPS group and the low-dose QBD group,among which 16 up-regulating genes were the same.In these 16 genes,the up-regulating amplitude of 9 genes in the low-dose QBD group was less than that in the LPS group,4 were similar to and 3 were more.Twenty-nine main cytokines were inspected by rat cytokine antibody array.Intergroup gray value differences were found in 7 expressed cytokines.The levels of these 7 cytokines in the lowdose QBD group were all lower than those in the the LPS group.Conclusions：QBD has anti-inflammatory effect on sepsis by changing the level of inflammatory mediators.

清瘟败毒饮颗粒结合双嘧达莫治疗儿童川崎病临床疗效及安全性观察

目的分析清瘟败毒饮颗粒结合双嘧达莫治疗儿童川崎病临床疗效及安全性。方法研究纳入2019年1月—2022年10月小儿内科收治的82例儿童川崎病进行分组研究,分组方法为随机数字表法,将其分为西医组和中医组,各41例,西医组给予双嘧达莫治疗,中医组治疗方法同西医组,并结合清瘟败毒饮颗粒治疗,各组数据观察:临床治疗效果、治疗前后患儿中医证候(壮热不退、肌肤斑疹、唇赤干裂、咽红目赤、关节疼痛、手足硬肿等)积分变化、患儿冠脉损伤发生率、发热持续时间、淋巴结肿大消退时间及四肢肿胀消退时间、黏膜充血消退时间、住院时间、治疗前后患儿降钙素原(procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)、红细胞沉降率(erythrocyte sedimentation rate,ESR)等水平炎症因子水平变化、免疫球蛋白G(immunoglobulin G,IgG)及免疫球蛋白M(immunoglobulin M,IgM)、补体C_(3)(complement 3,C_(3))等免疫指标水平变化、不良反应发生情况。结果中医组患儿治疗总有效率比西医组高,P<0.05;中医组患儿冠脉损伤发生率低于西医组,P<0.05;中医组患儿发热持续时间、淋巴结肿大消退时间及四肢肿胀消退时间、黏膜充血消退时间、住院时间均比西医组短,均P<0.05;治疗前各组患儿中医证候(壮热不退、肌肤斑疹、唇赤干裂、咽红目赤、关节疼痛、手足硬肿等)积分、PCT及CRP、ESR、IgG、IgM、C_(3)等指标比较,P>0.05,治疗后各组患儿中医证候(壮热不退、肌肤斑疹、唇赤干裂、咽红目赤、关节疼痛、手足硬肿等)积分、PCT及CRP、ESR、IgG、IgM、C_(3)等指标均改善,中医组患儿治疗后中医证候(壮热不退、肌肤斑疹、唇赤干裂、咽红目赤、关节疼痛、手足硬肿等)积分、PCT及CRP、ESR、IgG、IgM、C_(3)等指标均优于西医组,均P<0.05;中医组与西医组患儿治疗不良反应率均较低,P>0.05。结论清瘟败毒饮颗粒结合双嘧达莫治疗儿童川崎病临床疗效显著,患儿症状改善,免疫功能提升,冠脉损伤发生率低,恢复快,治疗安全可靠,值得应用。

清瘟败毒饮加减对小儿川崎病(气血两燔证)的临床改善及对患儿血清炎症和免疫功能的影响

目的观察清瘟败毒饮加减联合丙种球蛋白治疗小儿川崎病(气血两燔证)的临床疗效及其对患儿血清炎症和免疫功能的影响。方法选择2020年1月—2023年12月于医院心内科治疗的220例小儿川崎病患儿并随机分为两组,每组110例,其中对照组患儿予以阿司匹林联合丙球蛋白治疗,观察组在对照组基础上联合清瘟败毒饮加减治疗。比较两组患儿的临床疗效、症状消失时间,以及治疗前后血清炎症因子水平、免疫功能、心功能变化。结果对照组患儿的有效率为90.91%(100/110),观察组患儿的有效率为98.18%(108/110),与对照组比较,观察组的有效率显著升高(P<0.05)。与对照组比较,观察组患儿的发热等典型临床症状消失时间明显缩短(P<0.01)。干预完成后,观察组患儿白介素-6(interleukin-6,IL-6)、C-反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)等血清炎症因子水平相较于对照组均明显降低(P<0.01)。干预前两组患儿的免疫功能指标水平无明显差异(P>0.05);干预完成后,观察组患儿CD_(4)^(+)和CD_(4)^(+)/CD_(8)^(+)水平相较于对照组明显升高,而CD_(8)^(+)水平明显下降,差异具有统计学意义(P<0.01,P<0.05);CD_(3)^(+)水平有上调趋势,但差异无统计学意义(P>0.05)。干预前两组患儿的心功能无明显差异(P>0.05);干预完成后,观察组患儿血清中心脏型脂肪酸结合蛋白(Heart-type fatty acid binding protein,h-FABP)及B型钠尿肽(B-type natriuretic peptide,BNP)水平相较于对照组均明显下降(P<0.01)。干预过程中所有患儿的主要不良反应有恶心呕吐、食欲不振、腹痛腹泻等,症状轻微,两组患儿的不良反应发生率无明显差异(P>0.05)。结论清瘟败毒饮加减联合丙球蛋白治疗小儿川崎病干预效果较好,对改善患儿临床症状、抑制炎症反应、保护心脏功能、调节免疫功能、不良反应有较好干预效果。

基于气化理论探讨清瘟败毒饮方证核心病机与组方思路

气化理论是中医学认识人体生命活动规律、了解疾病发生发展规律的指导思想。基于气化理论,通过考证著作、整理文献、逻辑分析,认为清瘟败毒饮方证的核心病机为火气独胜,胃虚受毒,气失枢转,五脏气化失常,燔灼十二经。其组方思路为清胃气以斡旋枢机、降逆火以平衡升降、滋肾水以生津化源。因此,清瘟败毒饮虽为治疗热疫的名方,但其应用范围不应局限于热疫以及疾病的毒炽气血阶段,而应推而广之,凡是存在火气独胜之证,均可依据本方思路施治。

清瘟护肺颗粒化学成分研究

目的研究清瘟护肺颗粒的化学成分。方法查阅中国知网、PubMed、Web of Science等数据库,检索该制剂组方药材化学成分的相关文献,结合文献报道和ChemicalBook数据库信息,建立化学成分数据库。采用超高效液相色谱-四极杆/静电场轨道阱高分辨质谱(UHPLC-Q Exactive Focus MS/MS)法分析制剂的图谱数据,并以Xcalibur 4.0软件拟合分子式,与自建数据库信息进行匹配,初步推测分子式信息,与ChemicalBook或ChemSpider数据库比对,推测化学成分结构。结果共鉴定出158个化学成分,包括苷类36个,黄酮类29个,苯丙素类28个,有机酸类18个,萜类17个,色原酮类8个,其他类22个。结论所建立的方法可系统、准确、快速地定性分析清瘟护肺颗粒中的化学成分。