Skip to main content
Top
Published in: Trials 1/2016

Open Access 01-12-2016 | Study protocol

Efficacy and safety of Qi-Wei-Qing-Yan aerosol in treatment of acute pharyngitis (lung-stomach excess-heat syndrome): study protocol for a randomized controlled trial

Authors: Hong-li Jiang, Bin She, Wei Liu, Bing Mao, Ju-ying Zhang

Published in: Trials | Issue 1/2016

Login to get access

Abstract

Background

Acute pharyngitis accounts for an estimated 15 million patient visits in the United States. However, there is no proven effective and safe treatment. Although Chinese herbal medicine is widely used in the treatment of acute pharyngitis, there is a lack of evidence-based data. Despite several clinical trials conducted in this setting, no randomized placebo-controlled trial has been performed to date. This trial aims to investigate the efficacy and safety of Qi-Wei-Qing-Yan aerosol (QWQYA), a Chinese herbal prescription, compared with a placebo aerosol in the treatment of acute pharyngitis with lung-stomach excess-heat syndrome.

Methods/design

This is a prospective, multicenter, randomized, double-blinded, parallel-group, placebo-controlled trial. A total of 420 adult patients, of either sex, with acute pharyngitis will be enrolled from seven study sites across China. All patients will be randomly allocated to one of three parallel treatment groups: (1) QWQYA with the current propellant, (2) QWQYA with a previous propellant, and (3) the placebo aerosol with the current propellant. The study medication will be administered into the pharyngeal region in three sprays thrice daily for 5 consecutive days. The primary outcome measures are time to complete resolution of sore throat and relief rate of sore throat. Secondary outcome measures include resolution rate of sore throat, time to relief of sore throat, intensity of sore throat, and change of traditional Chinese medicine syndrome score and clinical signs score from baseline to post-treatment, as well as the occurrence of any adverse events.

Discussion

This will be the first clinical trial to investigate the efficacy and safety of QWQYA in the treatment of acute pharyngitis in an adult population in a multicenter, randomized, double-blinded, parallel-group, placebo-controlled manner. Not only might it establish the basis for the efficacy and safety of QWQYA in treating acute pharyngitis, but it might also provide evidence to support the use of Chinese herbal medicine in treating acute pharyngitis and thus support an alternative treatment option for management of acute pharyngitis.

Trial registration

Chinese Clinical Trial Registry ChiCTR-IPR-15005991.
Literature
1.
go back to reference Hing E, Hall MJ, Xu J. National Hospital Ambulatory Medical Care Survey: 2006 outpatient department summary. Natl Health Stat Report. 2008; 1–31. Hing E, Hall MJ, Xu J. National Hospital Ambulatory Medical Care Survey: 2006 outpatient department summary. Natl Health Stat Report. 2008; 1–31.
2.
go back to reference Wei JL, Kasperbauer JL, Weaver AL, Boggust AJ. Efficacy of single-dose dexamethasone as adjuvant therapy for acute pharyngitis. Laryngoscope. 2002;112:87–93.CrossRefPubMed Wei JL, Kasperbauer JL, Weaver AL, Boggust AJ. Efficacy of single-dose dexamethasone as adjuvant therapy for acute pharyngitis. Laryngoscope. 2002;112:87–93.CrossRefPubMed
4.
go back to reference Centor RM, Atkinson TP, Ratliff AE, Xiao L, Crabb DM, Estrada CA, et al. The clinical presentation of fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study. Ann Intern Med. 2015;162:241–7.CrossRefPubMed Centor RM, Atkinson TP, Ratliff AE, Xiao L, Crabb DM, Estrada CA, et al. The clinical presentation of fusobacterium-positive and streptococcal-positive pharyngitis in a university health clinic: a cross-sectional study. Ann Intern Med. 2015;162:241–7.CrossRefPubMed
5.
go back to reference Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013;11:CD000023.PubMed Spinks A, Glasziou PP, Del Mar CB. Antibiotics for sore throat. Cochrane Database Syst Rev. 2013;11:CD000023.PubMed
6.
7.
go back to reference Gulliford MC, Dregan A, Moore MV, Ashworth M, Staa T, McCann G, et al. Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices. BMJ Open. 2014;4:e006245.PubMedCentralCrossRefPubMed Gulliford MC, Dregan A, Moore MV, Ashworth M, Staa T, McCann G, et al. Continued high rates of antibiotic prescribing to adults with respiratory tract infection: survey of 568 UK general practices. BMJ Open. 2014;4:e006245.PubMedCentralCrossRefPubMed
8.
go back to reference Korb K, Scherer M, Chenot JF. Steroids as adjuvant therapy for acute pharyngitis in ambulatory patients: a systematic review. Ann Fam Med. 2010;8:58–63.PubMedCentralCrossRefPubMed Korb K, Scherer M, Chenot JF. Steroids as adjuvant therapy for acute pharyngitis in ambulatory patients: a systematic review. Ann Fam Med. 2010;8:58–63.PubMedCentralCrossRefPubMed
9.
go back to reference Wing A, Villa-Roel C, Yeh B, Eskin B, Buckingham J, Rowe BH. Effectiveness of corticosteroid treatment in acute pharyngitis: a systematic review of the literature. Acad Emerg Med. 2010;17:476–83.CrossRefPubMed Wing A, Villa-Roel C, Yeh B, Eskin B, Buckingham J, Rowe BH. Effectiveness of corticosteroid treatment in acute pharyngitis: a systematic review of the literature. Acad Emerg Med. 2010;17:476–83.CrossRefPubMed
10.
go back to reference Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. BMJ. 2009;339:b2976.PubMedCentralCrossRefPubMed Hayward G, Thompson M, Heneghan C, Perera R, Del Mar C, Glasziou P. Corticosteroids for pain relief in sore throat: systematic review and meta-analysis. BMJ. 2009;339:b2976.PubMedCentralCrossRefPubMed
11.
go back to reference Moore N, Charlesworth A, Van Ganse E, LeParc JM, Jones JK, Wall R, et al. Risk factors for adverse events in analgesic drug users: results from the PAIN study. Pharmacoepidemiol Drug Saf. 2003;12:601–10.CrossRefPubMed Moore N, Charlesworth A, Van Ganse E, LeParc JM, Jones JK, Wall R, et al. Risk factors for adverse events in analgesic drug users: results from the PAIN study. Pharmacoepidemiol Drug Saf. 2003;12:601–10.CrossRefPubMed
13.
go back to reference Hubbert M, Sievers H, Lehnfeld R, Kehrl W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis – a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur J Med Res. 2006;11:20–6.PubMed Hubbert M, Sievers H, Lehnfeld R, Kehrl W. Efficacy and tolerability of a spray with Salvia officinalis in the treatment of acute pharyngitis – a randomised, double-blind, placebo-controlled study with adaptive design and interim analysis. Eur J Med Res. 2006;11:20–6.PubMed
14.
go back to reference Saxena RC, Singh R, Kumar P, Yadav SC, Negi MP, Saxena VS, et al. A randomized double blind placebo controlled clinical evaluation of extract of Andrographis paniculata (KalmCold) in patients with uncomplicated upper respiratory tract infection. Phytomedicine. 2010;17:178–85.CrossRefPubMed Saxena RC, Singh R, Kumar P, Yadav SC, Negi MP, Saxena VS, et al. A randomized double blind placebo controlled clinical evaluation of extract of Andrographis paniculata (KalmCold) in patients with uncomplicated upper respiratory tract infection. Phytomedicine. 2010;17:178–85.CrossRefPubMed
15.
go back to reference Brinckmann J, Sigwart H, van Houten Taylor L. Safety and efficacy of a traditional herbal medicine (Throat Coat) in symptomatic temporary relief of pain in patients with acute pharyngitis: a multicenter, prospective, randomized, double-blinded, placebo-controlled study. J Altern Complement Med. 2003;9:285–98.CrossRefPubMed Brinckmann J, Sigwart H, van Houten Taylor L. Safety and efficacy of a traditional herbal medicine (Throat Coat) in symptomatic temporary relief of pain in patients with acute pharyngitis: a multicenter, prospective, randomized, double-blinded, placebo-controlled study. J Altern Complement Med. 2003;9:285–98.CrossRefPubMed
16.
go back to reference Huang Y, Wu T, Zeng L, Li S. Chinese medicinal herbs for sore throat. Cochrane Database Syst Rev. 2012;3:CD004877.PubMed Huang Y, Wu T, Zeng L, Li S. Chinese medicinal herbs for sore throat. Cochrane Database Syst Rev. 2012;3:CD004877.PubMed
18.
go back to reference Ravishankara AR, Turnipseed AA, Jensen NR, Barone S, Mills M, Howard CJ, et al. Do hydrofluorocarbons destroy stratospheric ozone? Science. 1994;263:71–5.CrossRefPubMed Ravishankara AR, Turnipseed AA, Jensen NR, Barone S, Mills M, Howard CJ, et al. Do hydrofluorocarbons destroy stratospheric ozone? Science. 1994;263:71–5.CrossRefPubMed
19.
go back to reference Tian YQ. Otolaryngology head and neck surgery. 8th ed. Beijing: People’s Health Publishing House; 2013. Tian YQ. Otolaryngology head and neck surgery. 8th ed. Beijing: People’s Health Publishing House; 2013.
20.
go back to reference Zheng XY. Guiding principle of clinical research on new drugs of traditional Chinese medicine (trial implementation). Beijing: Chinese Medical Science and Technology Press; 2002. Zheng XY. Guiding principle of clinical research on new drugs of traditional Chinese medicine (trial implementation). Beijing: Chinese Medical Science and Technology Press; 2002.
21.
go back to reference Lindbaek M, Francis N, Cannings-John R, Butler CC, Hjortdahl P. Clinical course of suspected viral sore throat in young adults: cohort study. Scand J Prim Health Care. 2006;24:93–7.CrossRefPubMed Lindbaek M, Francis N, Cannings-John R, Butler CC, Hjortdahl P. Clinical course of suspected viral sore throat in young adults: cohort study. Scand J Prim Health Care. 2006;24:93–7.CrossRefPubMed
22.
go back to reference Leelarasamee A, Leowattana W, Tobunluepop P, Chub-upakarn S, Artavetakun W, Jarupoonphol V, et al. Amoxicillin for fever and sore throat due to non-exudative pharyngotonsillitis: beneficial or harmful? Int J Infect Dis. 2000;4:70–4.CrossRefPubMed Leelarasamee A, Leowattana W, Tobunluepop P, Chub-upakarn S, Artavetakun W, Jarupoonphol V, et al. Amoxicillin for fever and sore throat due to non-exudative pharyngotonsillitis: beneficial or harmful? Int J Infect Dis. 2000;4:70–4.CrossRefPubMed
23.
go back to reference Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200–7.CrossRefPubMed Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158:200–7.CrossRefPubMed
24.
go back to reference Biao W. Effect of QiWeiQingYan aerosol on infantile herpangina of 70 cases. Henan Med Res. 2011;2:34–5. Biao W. Effect of QiWeiQingYan aerosol on infantile herpangina of 70 cases. Henan Med Res. 2011;2:34–5.
25.
go back to reference Zhang MR, Bi SK, Zhang MY. QiWeiQingYan aerosol in the treatment of acute pharyngitis of 120 cases. External Treatment Tradit Chin Med. 2000;9:19–20. Zhang MR, Bi SK, Zhang MY. QiWeiQingYan aerosol in the treatment of acute pharyngitis of 120 cases. External Treatment Tradit Chin Med. 2000;9:19–20.
26.
go back to reference Liu QF, Sun HB, Quan WJ, Qu ZY. Clinical observation of Huangqin Jingye Jiedu capsule in the treatment of acute pharyngitis. Nei Mongol J Tradit Chin Med. 2013;32:13–4. Liu QF, Sun HB, Quan WJ, Qu ZY. Clinical observation of Huangqin Jingye Jiedu capsule in the treatment of acute pharyngitis. Nei Mongol J Tradit Chin Med. 2013;32:13–4.
27.
go back to reference Wang Y, Lin YP, Deng KB, Liu TX. Clinical study on compound Yejuhua lozenge in treating sore throat (wind-heat). Chin J Inform Tradit Chin Med. 2012;19:6–8. Wang Y, Lin YP, Deng KB, Liu TX. Clinical study on compound Yejuhua lozenge in treating sore throat (wind-heat). Chin J Inform Tradit Chin Med. 2012;19:6–8.
28.
go back to reference Zhu HX, Chai F, Cao B. Clinical Studies on Zhongsheng pills in treating acute pharyngitis (wind-heat syndrome). Strait Pharm J. 2014;6:68–70. Zhu HX, Chai F, Cao B. Clinical Studies on Zhongsheng pills in treating acute pharyngitis (wind-heat syndrome). Strait Pharm J. 2014;6:68–70.
29.
go back to reference Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, et al. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012;18 Suppl 1:1–28.CrossRefPubMed Pelucchi C, Grigoryan L, Galeone C, Esposito S, Huovinen P, Little P, et al. Guideline for the management of acute sore throat. Clin Microbiol Infect. 2012;18 Suppl 1:1–28.CrossRefPubMed
30.
go back to reference Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981;1:239–46.CrossRefPubMed Centor RM, Witherspoon JM, Dalton HP, Brody CE, Link K. The diagnosis of strep throat in adults in the emergency room. Med Decis Making. 1981;1:239–46.CrossRefPubMed
31.
go back to reference Aalbers J, O’Brien KK, Chan WS, Falk GA, Teljeur C, Dimitrov BD, et al. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC Med. 2011;9:67.PubMedCentralCrossRefPubMed Aalbers J, O’Brien KK, Chan WS, Falk GA, Teljeur C, Dimitrov BD, et al. Predicting streptococcal pharyngitis in adults in primary care: a systematic review of the diagnostic accuracy of symptoms and signs and validation of the Centor score. BMC Med. 2011;9:67.PubMedCentralCrossRefPubMed
32.
go back to reference Wu J. Placebo control and clinical trial of Chinese medicine. Zhong Xi Yi Jie He Xue Bao. 2010;8:906–10.CrossRefPubMed Wu J. Placebo control and clinical trial of Chinese medicine. Zhong Xi Yi Jie He Xue Bao. 2010;8:906–10.CrossRefPubMed
33.
go back to reference Tang XD, Bian LQ, Gao R. Exploration into the preparation of placebos used in Chinese medicinal clinical trial. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009;29:656–8.PubMed Tang XD, Bian LQ, Gao R. Exploration into the preparation of placebos used in Chinese medicinal clinical trial. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2009;29:656–8.PubMed
Metadata
Title
Efficacy and safety of Qi-Wei-Qing-Yan aerosol in treatment of acute pharyngitis (lung-stomach excess-heat syndrome): study protocol for a randomized controlled trial
Authors
Hong-li Jiang
Bin She
Wei Liu
Bing Mao
Ju-ying Zhang
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Trials / Issue 1/2016
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-016-1217-4

Other articles of this Issue 1/2016

Trials 1/2016 Go to the issue