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Objective: To perform a systematic review to assess the effectiveness and safety of Reduning Injection versus neuraminidase inhibitors in treatment of influenza. Methods: The MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Bio-medical Literature and Retrieval System (Sinomed), China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP), Wanfang Data Knowledge Service Platform and ClinicalTrails.gov were systematically searched from inception dates to May 2021 for randomized controlled trials (RCTs) exploring Reduning Injection alone or in combination with neuraminidase inhibitors in patients with influenza. Statistical analysis was performed using RevMan 5.4 and Stata 15.1. The qualities of the involved studies were assessed by the risk of bias according to the Cochrane handbook. The evidence quality of each outcome was evaluated by GRADEpro GDT. Results: Twelve trials with 1,460 patients were included. The included studies had a certain unclear or high risk of bias. Reduning Injection appeared to be more effective in shortening the fever clearance time (MD: −16.20 h, 95% CI: −19.40 to −12.99, 7 trials, 814 patients, I2=94%, very low certainty), fever alleviation time (MD: −4.09 h, 95% CI: −4.22 to −3.96, 3 trials, 366 patients, I2=0%, low certainty), cough alleviation time (MD: −21.34 h, 95% CI: −41.56 to −1.11, 2 trials, 228 patients, I2=89%, very low certainty), fatigue alleviation time (MD: −31.83 h, 95% CI: −36.88 to −26.77, 2 trials, 270 patients, I2=0%, low certainty), sore throat alleviation time (MD: −28.66 h, 95% CI: −32.23 to −25.10, 1 trial, 150 patients, low certainty), and improving the total effective rate (RR: 1.15, 95% CI: 1.06 to 1.25, 10 trials, 1,074 patients, I2=76%, very low certainty). Besides, Reduning Injection seemed generally safe. Conclusions: This study provided low or very low evidence indicating Reduning Injection may be effective in the treatment of influenza and might be safe. Further rigorously designed studies are needed to confirm the effectiveness and safety of Reduning Injection and support it as a recommendation for influenza. [ABSTRACT FROM AUTHOR]

Objective: To systematically evaluate the efficacy and safety of Tanreqing Injection (痰热清注射液, TRQI) combined with conventional treatment on clinical outcomes in the treatment of patients with influenza. Methods: The electronic databases searched were Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), MEDLINE (PubMed), EMbase (OvidSP), Chinese Bio-medical Literature and Retrieval System (Sinomed), China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP) and WanFang Data Knowledge Service Platform, and we checked the reference sections of the retrieved articles as well. The search was performed in October 2018, and we used the randomized controlled trials (RCTs) that corresponded to the new diagnostic criteria for influenza. Two review authors independently screened the internalized articles in accordance with the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement checklist. We evaluated the quality of the articles and extracted the data from the studies using the Revmen5.3 software. Results: We included 12 RCTs of over 882 cases in this meta-analysis. Compared to conventional treatment, TRQI combined with conventional treatment could increase the total effective rate [9 RCTs, n=648, odds ratio (OR): 4.92, 95% confidence interval (CI): 2.94, 8.24, P<0.0001, random effects model], decrease the average time for fever clearance [7 RCTs, n=564, mean difference (MD): −1.08, 95% CI: −1.68, −0.48, P=0.0004, random effects model] and decrease the time for resolution of cough (5 RCTs, n=362, MD: −1.76, 95% CI: −2.63, −0.90, P<0.0001, random effects model). Conclusion: Based on this meta-analysis of RCTs, TRQI combined with conventional treatment had a statistically significant benefit in increasing the total effective treatment rate and reducing the time for fever clearance as well as time for resolution of cough. [ABSTRACT FROM AUTHOR]

Coronavirus and influenza virus infection seriously threaten human health. Cangma Huadu Granules (CMHD) is an in-hospital preparation composed of eight traditional Chinese medicines (TCM), which has been clinically used against COVID-19 in China and may be a promising candidate for the treatment of influenza. However, the role of its treatment urgently needs to be studied. Aim of the study : To evaluate the therapeutic effects of CMHD on pneumonia induced by coronavirus (HCoV-229E) and influenza A virus (H1N1/FM1) in mice and explore its mechanism of anti-infection. Mice were infected with HCoV-229E or H1N1/FM1 virus through the nasal cavity. CMHD (12.1, 6.05 and 3.03 g/kg/d) or the positive control drugs were administered intragastrically. The lung index and histopathological changes were used to evaluate the therapeutic effect of CMHD. The expression of TNF-α, IL-1β, IL-6 and IL-4 in Serum and the proportion of CD4+ and CD8+ T lymphocytes in peripheral blood were detected to evaluate the anti-inflammatory and immune regulation effects of CMHD, respectively. Furthermore, the levels of p–NF–κBp65/ NF-κB p65, which was the key targets of the NF-κB pathway was analyzed. In HCoV-229E-induced pneumonia, the lung index was markedly reduced, and lung pathology was improved in mice that treated with CMHD (12.1, 6.05 g/kg/d). Meanwhile, the expression of TNF-α, IL-6 were obviously inhibited, but the expression of IL-4 was significantly increased in CMHD groups. Compared with the model group, CMHD could also markedly upregulate the level of CD4+ and CD8+. Furthermore, CMHD has a markedly effect on inhibit the expression of p–NF–κB p65/NF-κB p65 in the lung. In H1N1-induced pneumonia, the lung index of mice in the CMHD (12.1 g/kg/d) treatment group was lower than that in the model group, and less inflammatory infiltration could be seen in the lung pathological. Moreover, CMHD could also obviously decrease the expression of TNF-α, IL-1β, IL-6, but significantly increase the expression of IL-4. Except for that, CMHD could also markedly downregulate the level of CD4+ and upregulate the level of CD8+ compared with the model group. In addition, CMHD has a markedly effect on inhibit the expression of p–NF–κB p65/NF-κB p65 in the lung. CMHD can significantly combats viral infections caused by HCoV-229E and H1N1, and the mechanism may be related to its multiple functions of anti-inflammatory, immunity regulating and inhibiting NF-κB signal transduction pathway. [Display omitted] [ABSTRACT FROM AUTHOR]