BackgroundCough variant asthma (CVA) is one of the leading causes of chronic coughing. The main treatment is currently anti-inflammatory medication. However, the coughing may return or be aggravated and lung function may deteriorate once the anti-inflammatory treatment is stopped. The effect of Chinese herbal medicine (CHM) on chronic coughing is remarkable, but high-quality evidence supporting its effectiveness is still lacking. This trial aims to evaluate the safety and efficacy, especially the long-term efficacy, of CHM plus anti-inflammatory medications for the treatment of CVA.Methods/designA randomized placebo-controlled double-blind trial will be conducted. It will consist of a 3-month intervention followed by a 6-month follow-up period.The target sample size is 60 patients with CVA who are between 18 and 70 years old. The eligible subjects will be allocated randomly into the experimental or control group in a ratio of 1:1. Patients in the experimental group will take CHM granules (4.9 g twice daily), while patients in the control group will be given a matched placebo. An administration of salmeterol/fluticasone propionate combination for 12 weeks will be the basic therapy for the two groups. The primary outcome is the cough visual analog scales (CVAS). The secondary outcomes include quality of life, rate of symptom relapse, lung function, and blood tests. A safety assessment will also be performed during the trial.DiscussionThe evidence gathered by the trial will be a valuable addition to informing treatment options for patients with CVA.Trial registrationhttp://www.chictr.org.cn, ID: ChiCTR-IOR-16009148. Registered on 3 September 2016.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3073-x) contains supplementary material, which is available to authorized users.
Background: Radix Scutellariae (RS) has been used to treat influenza for thousands of years in China.However, its mechanisms of action remain unclear. The aim of the present study was to use a network pharmacology and molecular docking-based approach to explore active components and potential molecular mechanisms of RS for influenza A.Methods: Target genes of RS and influenza A were attained by accessing network databases. We then determined the intersection of both genes through bioinformatics using R and Perl language. The proteinprotein interaction (PPI) network was constructed by the STRING website (https://cn.string-db.org). The network analysis was done using Cytoscape software. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) were applied for the above genes. Effective components as core targets were screened out based on the condition that the interaction must come first. These core targets were combined with 3D structures of main RNA coding proteins of influenza A virus. Molecular docking was used to visualize drug-target interaction via AutoDock Vina and PyMOL.Results: Twenty-eight active components and 40 target genes were acquired through the regulatory network of active components of RS and the PPI network. Seventy-one bioinformatics expressions were obtained through GO enrichment analysis (P<0.05). A total of 124 signaling pathways were screened by KEGG enrichment analysis (P<0.05). Acacetin, wogonin, baicalein, oroxylin A, and beta-sitosterol, which are rich in RS, are closely related to hemagglutinin (HA), NeurAminidase (NA), nucleoprotein (NP), polymerase basic protein 1 (PB1), polymerase basic protein 2 (PB2), polymerase acidic (PA), matrix protein 1 (M1), matrix protein 2 (M2), and non-structural protein (NS), which are the main RNA coding proteins of influenza A virus. The binding energies of these 8 proteins were less than -5 kJ/mol, indicating that the ligands had strong affinity with receptor proteins.Conclusions: RS is rich in core target compounds, and its mechanism of action is further expressed. It could have a good therapeutic effect for influenza A through multi-compound and multi-target regulation of these specific protein targets, and targets and pathways related to immunity and inflammation.
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