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一项基于计算的针对儿童支原体肺炎的三臂随机对照试验新治疗策略。

A computational-based new treatment strategy with three-armed RCT on Mycoplasma pneumoniae pneumonia in children.

作者信息

Zhong Chengliang, Liu Qingyuan, Guo Shengxuan, Sun Deyang, Wang Boyang, Hu Siyuan, Li Xinmin, Zhao Weibo, Ding Ying, Yuan Bin, Liu Jing, Xiang Long, Li Nan, Xue Zheng, Li Yan, Teng Yiqun, Yi Rongsong, Li Shao, Ma Rong

机构信息

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

Institute for TCM-X, Department of Automation, Tsinghua University, Beijing, 100084, China.

出版信息

Chin Med. 2025 Jul 1;20(1):97. doi: 10.1186/s13020-025-01149-3.

Abstract

Mycoplasma pneumoniae pneumonia (MPP) is a common type of pneumonia among school-aged children and adolescents. Jinzhen Oral Liquid (JZOL) and Azithromycin (AZ) are commonly used treatments in traditional Chinese medicine (TCM) and Western medicine, respectively. There are several clinical and basic research reports on their solo effect against MPP, enabling their combined treatment to become possible. However, the mechanisms and specific pharmacodynamics of their combined therapy remain unclear. In this study, we conducted a mechanistic analysis of the combination of JZOL and AZ based on network target, elucidating their modular network regulatory mechanisms. The modular mechanisms involve four modules, including hormone response, cell differentiation and migration, signal transduction, oxygen and hypoxia response, centered by TNF signaling pathway-mediated regulation. Under the instruction of computational analysis, we conducted a randomized, double-blind, three-armed, parallel-controlled, multicenter clinical study of different doses of JZOL combined with AZ for the treatment of MPP in children. The objective of clinical research is to evaluate the synergistic effect of different doses of JZOL combined with AZ in the treatment of children with MPP, shortening the course of disease and improving prognosis, while observing the safety of clinical application. At the study endpoint, the median time to clinical recovery showed statistically significant differences (The double-dose group lasts for 5 days, the regular-dose group lasts for 6 days, and the placebo group lasts for 8 days), which were also observed between groups for time to complete fever remission, time to relief of cough/phlegm, effective rate of chest X-ray improvement, and rate of healing of TCM symptoms. Different doses of JZOL combined with AZ have shown the effects of shortening the course of the disease, relieving the symptoms, and improving the prognosis. The research program composed of computational prediction and clinical trials can significantly accelerate the research and development process and identify more effective treatment with good safety, which is worthy of clinical promotion. Chinese Clinical Trial Registry ChiCTR1800019007.

摘要

支原体肺炎(MPP)是学龄儿童和青少年中常见的肺炎类型。金振口服液(JZOL)和阿奇霉素(AZ)分别是中医和西医常用的治疗药物。关于它们单独治疗MPP的临床和基础研究报告有不少,这使得它们的联合治疗成为可能。然而,其联合治疗的机制和具体药效学仍不清楚。在本研究中,我们基于网络靶点对JZOL和AZ的联合进行了机制分析,阐明了它们的模块化网络调节机制。模块化机制涉及四个模块,包括以肿瘤坏死因子信号通路介导的调节为中心的激素反应、细胞分化和迁移、信号转导、氧和缺氧反应。在计算分析的指导下,我们对不同剂量的JZOL联合AZ治疗儿童MPP进行了一项随机、双盲、三臂、平行对照、多中心临床研究。临床研究的目的是评估不同剂量的JZOL联合AZ治疗儿童MPP的协同效果,缩短病程并改善预后,同时观察临床应用的安全性。在研究终点,临床恢复的中位时间显示出统计学上的显著差异(双剂量组持续5天,常规剂量组持续6天,安慰剂组持续8天),在完全退热时间、咳嗽/咳痰缓解时间、胸部X线改善有效率和中医症状愈合率方面组间也观察到差异。不同剂量的JZOL联合AZ已显示出缩短病程、缓解症状和改善预后的效果。由计算预测和临床试验组成的研究方案可显著加速研发进程,并确定更安全有效的治疗方法,值得临床推广。中国临床试验注册中心ChiCTR1800019007。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ec6b/12210776/38ad72899b67/13020_2025_1149_Fig1_HTML.jpg

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