A Five-Dimensional Network Meta-Analysis of Chinese Herbal Injections for Treating Acute Tonsillitis Combined With Western Medicine

Abstract

Background: Acute tonsillitis has high morbidity. Chinese herbal injections (CHIs) were reported to be useful in treating acute tonsillitis and might reduce the probability of antibiotic resistance. Nevertheless, the optimal strategy for combining CHIs with western medicine (WM) to treat acute tonsillitis remains unclear.Methods: We retrieved data from the following databases with retrieval time from inception to 11 January 2022: PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, Weipu Journal Database, and Chinese Biomedical Literature Database. Version 2 of the Cochrane risk-of-bias tool (ROB2) was used for evaluating the quality of the included studies. R 4.1.2, STATA 14.0, and Python 3.10.4 were employed for network meta-analysis, with 5-dimensional K-means cluster analysis, meta-regression analyses, sensitivity analyses, and subgroup analyses.Results: A total of 110 randomized controlled trials including 12,152 patients were included. All the studies were rated as “high risk” and “some concerns”. In terms of improving clinical effectiveness rate, Qingkailing injection + WM ranked ahead of other interventions (89.51%). Regarding reducing antipyretic time, Reduning injection + WM had the highest-ranking probability (68.48%). As for shortening sore throat relief time, Shuanghuanglian injection + WM ranked first (76.82%). Concerning shortening red and swollen tonsils relief time, Yanhuning injection + WM possessed the highest-ranking probability (89.17%). In terms of reducing tonsillar exudate relief time, Xuebijing injection + WM ranked ahead of the other interventions (94.82%). Additionally, the results of the cluster analysis suggested that Xuebijing injection + WM, Reduning injection + WM, and Yanhuning injection + WM were probably the best interventions. Furthermore, adverse drug reactions rate of Xuebijing injection + WM, Reduning injection + WM, Yanhuning injection + WM, Qingkailing injection + WM, and Shuanghuanglian injection + WM were individually 0.00%, 3.11%, 3.08%, 4.29%, and 4.62%.Conclusions: CHIs + WM have a better impact on patients with acute tonsillitis than WM alone. Xuebijing injection, Reduning injection, and Yanhuning injection might have potential advantages in treating the disease. Concerning adverse drug reactions, Xuebijing injection is presumably the optimal CHI. More high-quality studies are needed to further confirm our findings.Systematic Review Registration: CRD42022303243; URL= https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=303243

Unraveling the Mechanism of Xiaochaihu Granules in Alleviating Yeast-Induced Fever Based on Network Analysis and Experimental Validation

“…Zingiber officinale Roscoe Immunomodulatory, antitumorigenic, anti-inflammatory, anti-apoptotic, anti-hyperglycemic, anti-lipidemic and anti-emetic actions [33] Gingerols { [4]-, [6]-, [7]-, [8]-, and [10]-gingerol, 6-gingerol, 6-shogaol, [4]-, [6]-, [8]-, [10]-and [12]-shogaol}, volatile oil (curcumene, terpineol, borneol) [33] Glycyrrhiza uralensis Fisch. ex DC.…”

“…At 8 h post yeast injection, the XCHG group received XCHG extracts through gavage administration at a dose of 0.39 g/kg, whereas the APAP group received an dose of APAP (80 mg/kg) by gavage. The T core was recorded at 14 time points (1,2,4,6,8,9,10,12,14,16,18,20,22, and 24 h) after the yeast injection. Mice exhibiting a temperature increase exceeding 0.8 • C were classified as having a fever [112,113].…”

“…Additionally, it causes adverse effects, such as skin rash, urticaria, and thrombocytopenia [ 6 , 7 ]. Traditional Chinese medicine (TCM), offering a comprehensive treatment strategy that addresses the disease’s symptoms and underlying causes, has been employed in fever treatment for centuries [ 8 , 9 , 10 ]. TCM leverages multi-component approaches to target multiple nodes, thereby regulating the disease network and enhancing synergistic effects [ 11 ].…”