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芩香清解口服液治疗儿童流感的有效性和安全性:一项随机、双盲、多中心临床试验

Efficacy and safety of Qinxiang Qingjie oral solution for the treatment of influenza in children: a randomized, double-blind, multicenter clinical trial.

作者信息

Hu Siyuan, Ma Rong, Shen Kunling, Xin Deli, Li Xinmin, Xu Baoping, Zhao Xiaobing, Feng Ziwei, Yan Yongbin, Xue Zheng, Zhang Baoqing, Li Xueming, Zheng Yanmei, Zhou Hongxia, Wu Liqun, Yang Lili, Xu Hua, Shao Rongchang, Yin Yong, Zhong Chengliang, Li Han, Cai Qiuhan, Xu Yaqian

机构信息

Department of Pediatrics, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.

Department of Clinical Trial Center, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.

出版信息

Transl Pediatr. 2022 Jun;11(6):987-1000. doi: 10.21037/tp-22-201.

Abstract

BACKGROUND

Qinxiang Qingjie (QXQJ), an oral solution containing various Chinese herbs, is indicated for pediatric upper respiratory tract infections. The treatment of influenza also shows potential advantages in shortening the duration of illness and improving symptoms. However, there is still a lack of high-quality clinical evidence to support this. The trial was to explore the efficacy and safety of QXQJ for treating pediatric influenza and provide an evidence-based basis for expanding its applicability.

METHODS

A randomized, double-blind, double-dummy, positive-controlled, multicenter clinical trial was conducted in 14 hospitals in China. Children aged 1-13 years with influenza and "exterior and interior heat syndromes" as defined by traditional Chinese medicine (TCM) were randomly assigned to two groups with 1:1 radio. Children in the test group received QXQJ oral solution and oseltamivir simulant, while the control group received oseltamivir phosphate granules and QXQJ simulant. The duration of treatment was five days, followed by a two-day follow-up period. The primary endpoint was the clinical recovery time. Secondary endpoints included the time to defervescence, incidences of complications and severe or critical influenza, negative conversion rate, improvement of TCM syndromes, and safety profiles of the therapeutics, which mainly contained the adverse clinical events and adverse drug reactions.

RESULTS

A total of 231 children were randomized to either the QXQJ (n=117) or oseltamivir (n=114) group. The FAS and PPS results showed that both groups experienced a median clinical recovery time of three days (P>0.05). The median time to defervescence of both groups were 36 hours in FAS and PPS (P>0.05), and two groups did not differ in terms of the other secondary endpoints (P>0.05). 14 patients (12.39%) in the QXQJ group and 14 patients (12.50%) in the oseltamivir group reported at least one adverse event, respectively. One serious adverse event occurred in the QXQJ group. There was no significant difference in the incidence of adverse events or adverse drug reactions between the groups.

CONCLUSIONS

The efficacy of QXQJ oral solution was comparable to that of oseltamivir for treating influenza in children, with an acceptable safety profile.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR1900021060.

摘要

背景

芩香清解口服液(QXQJ)是一种含有多种中药的口服溶液,适用于小儿上呼吸道感染。在治疗流感方面,它在缩短病程和改善症状方面也显示出潜在优势。然而,仍缺乏高质量的临床证据支持这一点。本试验旨在探讨QXQJ治疗小儿流感的疗效和安全性,并为扩大其适用范围提供循证依据。

方法

在中国的14家医院进行了一项随机、双盲、双模拟、阳性对照、多中心临床试验。将年龄在1至13岁、患有流感且符合中医“表里俱热证”的儿童按1:1比例随机分为两组。试验组儿童服用QXQJ口服液和奥司他韦模拟剂,对照组儿童服用磷酸奥司他韦颗粒和QXQJ模拟剂。治疗疗程为5天,随后有2天的随访期。主要终点是临床恢复时间。次要终点包括退热时间、并发症和重症或危重症流感的发生率、病毒转阴率、中医证候改善情况以及治疗药物的安全性,主要包括临床不良事件和药物不良反应。

结果

共有231名儿童被随机分为QXQJ组(n = 117)或奥司他韦组(n = 114)。全分析集(FAS)和符合方案集(PPS)结果显示,两组的临床恢复时间中位数均为3天(P>0.05)。FAS和PPS中两组的退热时间中位数均为36小时(P>0.05),两组在其他次要终点方面也无差异(P>0.05)。QXQJ组有14名患者(12.39%)、奥司他韦组有14名患者(12.50%)分别报告了至少1次不良事件。QXQJ组发生1例严重不良事件。两组不良事件和药物不良反应的发生率无显著差异。

结论

QXQJ口服液治疗儿童流感的疗效与奥司他韦相当,安全性可接受。

试验注册号

中国临床试验注册中心ChiCTR1900021060

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d62/9253950/c30a8b68e4aa/tp-11-06-987-f1.jpg

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