Abstract
Objective
To evaluate the efficacy and safety of Qingkailing Injection (清开灵注射液, QKL) for treatment of children pneumonia caused by respiratory syncytial virus (RSV).
Methods
Randomized clinical trials (RCTs) comparing QKL with ribavirin injection in the treatment of children pneumonia induced by RSV were searched in PubMed, Science Direct, Cochrane Library, Chinese VIP database, CNKI and Wanfang databases from their inception to March 2014. Meta-analyses were performed using RevMan 5.2 software. The methodological quality of the selected RCTs was evaluated by the Modified Jadad Score. The primary outcome measures were effective rate and the secondary outcomes were relief time of fever and cough.
Results
Seven RCTs with 992 cases published from 2008 to 2013 were identified. The meta-analysis results indicated that QKL was more effective in cure rate [risk ratios (RR)=1.32, 95% CI (1.17, 1.50), P<0.01], total effective rate [RR=1.07, 95% CI (1.02, 1.13), P=0.009] and less fever clearance time [mean difference=–0.73, 95% CI (–1.22,–0.23), P=0.004], compared with ribavirin injection in the treatment of RSV-induced children pneumonia. No dead case was reported in all trials. There were 3 trials mentioned adverse events, 2 reported no obvious adverse event occurred while 1 reported adverse events described as skin hypersensitivity, elevation of ALT, a mild abnormal of hepatic and renal function in both QKL and ribavirin group.
Conclusions
QKL was an effective and relatively safe option for the treatment of RSV-induced children pneumonia. These therapeutic effects were promising but need to be interpreted with caution due to variations in the treatment and methodological weakness in the studies.
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References
Hall CB, Weinberg GA, Iwane MK, Blumkin AK, Edwards KM, Staat MA, et al. The burden of respiratory syncytial virus infection in young children. N Engl J Med 2009;360:588–598.
Kim JY, Chang J. Need for a safe vaccine against respiratory syncytial virus infection. Kor J Pediatr 2012;55:309–315.
Beeler JA, Eichelberger MC. Influenza and respiratory syncytial virus (RSV) vaccines for infants: safety, immunogenicity, and efficacy. Microb Pathol 2013;55:9–15.
Haynes LM. Progress and challenges in RSV prophylaxis and vaccine development. J Infect Dis 2013;208 (Suppl 3):S177–S183.
American Academy of Pediatrics Committee on Infectious Diseases. Use of ribavirin in the treatment of respiratory syncytial virus infection. Pediatrics 1993;92:501–504.
The State Pharmacopoeia Committee of the People’s Republic of China. Pharmacopoeia of the People’s Republic of China. Beijing: Chinese Medical Science and Technology Press; 2010:1110–1111.
Qi ZJ, Qian JJ, Qiao TX, Hou WH. A preliminary biochemical study on the protective effects of Qingkailing injection on liver injury. J Tradit Chin Med (Chin) 1983;3:27–31.
Li C, Wang X, Chen S. Clinical study on acute upper respiratory tract infection treated with Qingkailing Injection. Chin J Integr Tradit West Med (Chin) 1999;19:212–214.
Yan SK, Xin WF, Luo GA, Wang YM, Cheng YY. An approach to develop two-dimensional fingerprint for the quality control of Qingkailing Injection by high-performance liquid chromatography with diode array detection. J Chromatogr 2005;1090:90–97.
Zhang HY, Hu P, Luo GA, Liang QL, Wang YL, Yan SK, et al. Screening and identification of multi-component in Qingkailing injection using combination of liquid chromatography/time-offlight mass spectrometry and liquid chromatography/ion trap mass spectrometry. Anal Chem Acta 2006;577:190–200.
Lee KH, Wang HK, Itokawa H, Morris-Natschke SL. Current perspectives on Chinese medicines and dietary supplements in China, Japan and the United States. J Food Drug Anal 2000;8:219–228.
Chen X, Howard OM, Yang X, Wang L, Oppenheim JJ, Krakauer T. Effects of Shuanghuanglian and Qingkailing, two multi-components of traditional Chinese medicinal preparations, on human leukocyte function. Life Sci 2002;70:2897–2913.
Yue S, Li Q, Liu S, Luo Z, Tang F, Feng D, et al. Mechanism of neuroprotective effect induced by Qingkailing as an adjuvant drug in rabbits with E. coli bacterial meningitis. Acta Neurochir Suppl 2006;96:413–418.
Hua Q, Zhu X, Li P, Tang H, Cai D, Xu Y, et al. Refined Qing Kai Ling, traditional Chinese medicinal preparation, reduces ischemic stroke-induced infarct size and neurological deficits and increases expression of endothelial nitric oxide synthase. Biol Pharm Bull 2008;31:633–637.
Lv L, Liu Y, Shi HF, Dong Q. Qingkailing Injection attenuates apoptosis and neurologic deficits in a rat model of intracerebral hemorrhage. J Ethnopharmacol 2009;125:269–273.
Yun Y, Wang CZ, Gui L, Li ZX. Baicalin inhibits TLR4 signaling pathway in RAW 264.7 cells following respiratory syncytial virus infection. Chin Tradit Pat Med (Chin) 2013;35:1117–1121.
He WY, Gao RM, Li XQ, Jiang JD, Li YH. In vitro antiinfluenza virus activity of 10 traditional Chinese medicines. Acta Pharm Sin (Chin) 2010;45:395–398.
Zu M, Zhou D, Gao L, Liu AL, Du GH. Evaluation of Chinese traditional patent medicines against influenza virus in vitro. Acta Pharm Sin (Chin) 2010;45:408–412.
Yang JG, Shen YH, Hong Y, Jin FH, Zhao SH, Wang MC, et al. Stir-baked Fructus gardeniae (L.) extracts inhibit matrix metalloproteinases and alter cell morphology. J Ethnopharmacol 2008;117:285–289.
Zhao LZ, Zeng YY, Huang XY, Zeng XF, Hou HN, Yin LL. Influence of Qingkailing injection on behaviors of T lymphocytes and DTH of mouse. J Sun Yat-sen Univ (Med Sci, Chin) 2008;129:407–411.
Xu F, Wang FJ, Ni CJ. The effect of Qingkailing versus ribovirin for children respiratory syncytial virus pneumonia. China Modern Doctor (Chin) 2011;49:34–35.
Ji H. Effect analysis of Qingkailing injection on pediatric respiratory syncytial virus pneumonia. Jilin Med (Chin) 2013;34:5382–5383.
Ju HX. The curative effect of Qingfei Oral Liquid combined with Qingkailing on pediatric respiratory syncytial virus pneumonia. Chin J Clin Res (Chin) 2013;26:602–603.
Ding JF. Effect of Qingkailing injections for 30 cases of children with respiratory syncytial virus pneumonia. Shaanxi J Tradit Chin Med (Chin) 2009;30:801.
Wang SC, Zhao X, Ren XZ, Yan Y, Ai J, Li RL, et al. Effective evaluation method of evaluating traditional Chinese medicine in the treatment of virus pneumonia based on dynamic changes of syndrome. World Sci Technol (Chin) 2008;10:10–15.
Wang YQ. Curative effect of Shenwei Qingkailing injections on treating 100 cases of patients with pediatric respiratory syncytial virus pneumonia. Chin Comm Doct (Chin) 2012;28:13.
Yang YN, Yang GL. Curative effect of Qingkailing injections on treating 40 cases of patients with pediatric respiratory syncytial virus pneumonia. China Med Pharm (Chin) 2013;3:76–77.
Ministry of Health PRC. Scheme for children’s pneumonia prevention and treatment. Scheme for prevention and treatment of children’s four diseases. Chin J Pediatr (Chin) 1987;25:47–49.
State Administration of Traditional Chinese Medicine. Standard for diagnosis and efficacy evaluation of traditional Chinese medicine diseases and syndromes: pediatric diseases. Nanjing: Nanjing University Press; 1995:78.
Banares R, Albillos A, Rincon D, Alonso S, Gonzalez M, Ruiz-del-Arbol L, et al. Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding: a meta-analysis. Hepatology 2002;35:609–615.
Liang JW, Yan HM, Yang Y, Ren XZ, Yuan B, Wang SC. Qingkailing versus ribovirin for children respiratory syncytial virus pneumonia: A single blinded, randomized, parallel control experiment. J Clin Rehabilitative Tissue Engin Res (Chin) 2007;11:4123–4125.
Yang Y, Wang SC, Bai WJ, Li RL, Ai J. Evaluation by survival analysis on effect of traditional Chinese medicine in treating children with respiratory syncytial viral pneumonia of phlegm-heat blocking Fei syndrome. Chin J Integr Med 2009;15:95–100.
Yang Y, Wang SC, Li RL. Effect of Qingkailing Injection on children with respiratory syncytial virus pneumonia of phlegmheat obstructing Fei syndrome pattern at different time-points. Chin J Integr Tradit West Med (Chin) 2010;30:908–911.
Hao Y, Kong X, Wu T. Assessment of the safety of Qin Kai Ling injection: a systematic review. J Evid Based Med (Chin) 2010;3:105–116.
Wu JR, Zhang B. Datamining study of adverse reaction caused by Qingkailing Injection. Chin J Pharmacoepidemiol (Chin) 2009;18:77–81.
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He, S., Li, Ws., Luo, Yj. et al. Qingkailing Injection (清开灵注射液) for Treatment of Children Pneumonia Induced by Respiratory Syncytial Virus: A Meta-Analysis of Randomized Controlled Trials. Chin. J. Integr. Med. 24, 288–295 (2018). https://doi.org/10.1007/s11655-017-2763-7
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DOI: https://doi.org/10.1007/s11655-017-2763-7