清肺解毒法治疗小儿呼吸道合胞病毒肺炎的临床研究
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摘要
小儿肺炎是危害儿童健康的常见呼吸系统疾病，世界卫生组织(WHO)将其列为全球三种重要的儿科疾病之一，本病也是我国卫生部要求重点防治的儿科四病之一。我国本病占儿科住院患儿的24.5-65.2％，5岁以下小儿每年死于本病的为30万，为此年龄组儿童第一位死亡原因。小儿肺炎中病毒感染约占50％。其中呼吸道合胞病毒(respiratory syncytial virus，RSV)是引起婴幼儿严重下呼吸道感染最重要的病原，90％以上的毛细支气管炎和多数病毒性肺炎由其引起。目前并无用于预防的疫苗，有效的抗病毒西药甚少。利巴韦林(ribavirin，又名三氮唑核苷、病毒唑)是西药治疗呼吸道合胞病毒感染唯一的抗病毒药物，但临床疗效并不十分令人满意，小剂量作用差，大剂量又易引起毒副作用。中医药在改善小儿肺炎临床症状和体征、缩短疾病疗程等方面具有特色和优势。导师汪受传教授认为，病毒性肺炎的主因是外感风温邪毒，病机多为肺气郁闭，痰热闭肺证为本病急性期的最常见证型，并提出呼吸道合胞病毒肺炎的主要症状咳、痰、喘是相互影响的，其治疗原则应为清肺解毒、止咳化痰平喘。清开灵注射液可用于多种病毒感染性疾病，但有关清开灵注射液为主加辨证论治口服中成药治疗小儿呼吸道合胞病毒肺炎的临床研究缺乏大样本、多中心、随机平行对照试验，故进行系统的、规范的临床研究，能够进一步观察中医药治疗小儿病毒性肺炎的特色和优势。
南京中医药大学儿科于2003年11月完成的“十五”国家科技攻关计划课题“小儿肺炎中医证治规律研究”(2001BA701A16b)，采用随机、对照、盲法、多中心的临床研究，共研究480例小儿肺炎住院病人，试验组的痊愈显效率为89.62％，利巴韦林对照组为73.92％。
按照前期临床研究结果，小儿病毒性肺炎证候分类中，痰热闭肺证占75％，风热犯肺证占16.25％，两者合计占91.25％，为小儿肺炎急性期的两个最常见证型，故选其作为本次临床研究的研究对象。两者中医辨证均属于“热证”范畴，但有病位在表在里之分。风热犯肺证属于表热证，痰热闭肺证属于里热证，清开灵注射液的主要功效为清肺解毒、疏风清热、化痰通络、醒神开窍，临床广泛用于多种病毒感染性疾病，故选择为试验组的基本用药；利巴韦林注射液是美国FDA唯一批准用于治疗呼吸道合胞病毒感染患者的药物，故选择为对照组的基本用药。本研究所用药物均为国家正式批准生产上市的药物，符合合法的、公认有效、可比的，并对本病最为有效安全的原则。两组基本治疗用药是目前学术界比较公认的治疗病毒性肺炎的有效药物，治疗方案经过多次中、西医专家的论证，基本能体现中、西医治疗病毒性肺炎的有效方案。
在大量前期研究工作基础上，本次研究以中医辨证论治的原则为指导，试验组应用清开灵注射液为主加辨证论治口服具有清肺解毒、止咳化痰平喘作用的中成药，风热犯肺证加用小儿咳喘灵口服液，痰热闭肺证加用儿童清肺口服液，对照组应用利巴韦林注射液加复方愈创木酚磺酸钾口服液，治疗小儿呼吸道合胞病毒肺炎风热犯肺证、痰热闭肺证，进行盲法、大样本、多中心、随机平行对照试验的临床研究，全国共有5个中心参加本次临床试验(天津中医药大学第一附属医院儿科、首都医科大学附属北京儿童医院中医科、南京中医药大学附属医院儿科、广东省中医院儿科、河南中医学院第一附属医院儿科)，数据管理与统计由“‘十五’国家科技攻关项目”数据管理中心统一管理。客观评价两种不同治疗方案治疗小儿呼吸道合胞病毒肺炎的临床疗效，为科学系统的评价中医药疗效的临床研究提供一种可借鉴的模式。
目的
主要目的：观察治疗前后发热(体温)、咳嗽、痰壅、气促(呼吸次数)、肺部听诊、X线全胸片、呼吸道合胞病毒病原学检测、食欲食量、精神、恶寒、紫绀、心率、面色、口渴、恶心呕吐、出汗、舌象等情况的变化，评价两种不同治疗方案治疗呼吸道合胞病毒性肺炎风热犯肺证、痰热闭肺证的临床疗效。
次要目的：观察血常规、肝、肾功能及可能出现的不良事件，对两种不同治疗方案的安全性作出评价。
方法
借助SAS 8.0软件，按1：1产生初筛病例编号所对应的分组，采用区组随机化方法制定随机表。遵循盲法、多中心、分层区组随机、平行对照的原则，在5个中心住院病例中，选择倾向于呼吸道合胞病毒性肺炎西医诊断和中医小儿肺炎喘嗽风热犯肺证、痰热闭肺证者证候诊断的患儿，严格按入选时间先后顺序，获得随机号，按随机号所对应的分组，接受初步治疗。采集患儿鼻咽部分泌物，应用抗病毒特异性单克隆抗体间接免疫荧光法作呼吸道合胞病毒抗原检测，阳性者列为研究病例。①试验组以清开灵注射液(主要成分为板蓝根、金银花、桅子、黄芩苷等提取物的灭菌水溶液，3个月～1岁10ml／次；＞1岁，≤3岁15 ml／次，1日1次。)静脉滴注，风热犯肺证加服小儿咳喘灵口服液(3月～2岁，每次5 ml，＞2岁，≤3岁7.5 ml／次，口服，1日3次。)，痰热闭肺证加服儿童清肺口服液(10 ml／次，口服，1日3次)。②对照组：不分证型，均用利巴韦林注射液(10 mg／kg·d)静脉滴注加口服复方愈创木酚磺酸钾口服液(3月～6月每次2.5ml，＞6个月，≤3岁每次5ml，口服，1日3次)。观察疗程均为10天。比较两组患儿治疗前后发热病例体温恢复正常的时间、咳嗽、痰壅、气促、肺部听诊、X线全胸片、食欲食量、紫绀、恶心呕吐等主要症状和次要症状的积分改善情况；呼吸道合胞病毒转阴的时间；两组综合疗效评价；并对两组患儿的疗效进行Logistic回归分析。
结果
本次研究初筛病例入选340例，研究病例入选206例，全部数据与年龄、肺炎病程、既往病史、诊断等纳入标准相符合；脱落7例，脱落率3.39％，剔除0例，剔除率0.00％。符合方案集199例，全分析集206例，安全集206例。研究前的一般资料、主症、次症和理化检查结果，除身高外，两组间均无显著性差异(P＞0.05)，说明两组具有可比性。研究结束后，符合方案集试验组96例、对照组103例，试验组痊愈、显效、进步、无效例数为：64(66.6％)、26(27％)、6(6.4％)、0(0.00)，对照组为43(41.7％)、41(39.8％)、19(18.5％)、0(0.00)。经秩和检验，Z=-2.36，P＜0.001，试验组优于对照组(P＜0.001)，试验组痊愈显效率为93.6％，对照组痊愈显效率为81.5％，两组相比差别有高度统计学意义(P＜0.01)。症状、体征结果：体温、咳嗽、痰壅，气促(呼吸次数)，X线全胸片，食欲食量、呼吸道病毒病原学检查等指标好转情况，试验组均优于对照组。肺部听诊、紫绀、恶寒、面色、精神、出汗、口渴、恶心呕吐、出汗，两组比较，无显著性差异。临床安全性指标研究结果，未显示对于重要脏器有毒副作用。
结论
清开灵注射液静滴加辨证治疗口服中成药，是一种治疗RSV肺炎热证有效而安全的治疗方案，具有科学性和实用性，值得临床推广应用。
Children pneumonia is one of the commonly encountered respiratory systemdiseases, WHO defines it as one of the three most serious pediatric diseases, and it isone of the four pediatric diseases that the Administration for Health Care of Chinastresses prevention and cure, too. Children pneumonia covers 24.5-65.2% of thehospitalized children patients below 5 years old, and it results in deaths of 300thousand children patients below 5 years old, so it is the first death causes of 5-year-old children patients. Virus infection makes up 50% of Children pneumonia, ofwhich respiratory syncytial virus, RSV, is the important antigen ,which can cause theserious lower respiratory tract infection of infants and children, and also can causeover 90% bronchiolitis and most of the pneumonia. Although antibody exists in bodyafter infection, repeated infection is still commonly seen, however, its pathogenesisis not clear, and at present, there is no effective anti-virus vaccine. Ribavirin is theonly one to used as RSV virus infection, yet, its clinical effect is not satisfyingbecause small dose has no ideal effect, and large dose will bring toxic and adversereaction. Chinese medicine and Chinese herbal drugs have advantage in improvingchildren patients' symptoms and signs and shortening the course of treatment. ByTCM theory, the cause of virus pneumonia is externally contracting wind warm andpathogenic toxin, the mechanism of the disease is accumulation of phlegm-heat inlung .Because the main symptoms of RSV pneumonia, including cough, phlegmand asthma, are influenced each other, the treatment method should be clearinglung-heat and stopping cough, dissipating phlegm and relieving asthma. QingKailing injection is a kind of pure Chinese herbal injection produced in the base of
Angong Niuhuang Pills, which is used widely in various virus infection diseases. But,treating children RSV pneumonia with Qing Kailing injection and oral traditionalChinese patent medicines according to the treatment based on syndromedifferentiation lacks large sample, multiply centered and randomized, paralleled andcontrolled study, so we conduct this systemic and standard clinical research to reflectthe advantage on treatment of children virus pneumonia with Chinese medicine andherbs.
Study on patterns and treatment rules of children pneumonia is a one of thetenth five-year national subjects in natural scientific and technical study, it took therandomized, double-blind, placebo-controlled and multiply centered study and theresult showed accumulation of phlegm-heat in lung syndrome is the main pattern inacute children pneumonia, the effective rate in the tested group is 89.62%, andribavirin group is 73.92%.
On the base of last study, we conducted large sample, multiply centered andrandomized, paralleled and controlled clinical study with Qing Kailing injection andoral traditional Chinese patent medicines according to the treatment based onsyndrome differentiation, five centers in China joined the study , figures andstatistics are arranged uniformly.
Objective
Main objective: to evaluate the clinical effect of the different treatment plans intreating RSV with the method of watching fever, cough, phlegm, asthma andauscultation on lung, X-ray of chest, the virus and pathogen examine, appetite,aversion to cold, vitality ,cyanosis, cardiac rhythm, expression, thirst, nausea,sweating, tongue picture, degree of blood oxygen saturation.
Second objective: to detect the safety of Qing Kailing injection by watchingblood routine, liver and kidney function and impossible adverse reaction.
Methods
According to the following principle: single blind、stratified randomization、equal control multicentre clinical study, In 5 Centers hospitalization, 206 cases hadbeen carefully chosen as study subjects according to the western medicine's diagnostic criterion of children's virus pneumonia and the TCM diagnostic criterionof "wind and heat invasion of lung" syndrome and "accumulation ofphlegrn-heat"syndrome of children's virus pneumonia, whose legal guardian knowthe fact and consent. According to the rule of randomization, all subjects weredivided into two groups, trial group and controlled group.The ration was 1:1.Therandomized code envelope was also created by SAS 8.0 computer program. NanjingUniversity of TCM provides the investigational products and the randomized codeform.①Qing kai ling injection group: The 96 patients in the trial group were treatedwith Qing kai ling injection(the key component is the sterile water solution ofextractive from isatis root、flos lonicerae、cape jasmine fruit、baicalin etc.,10ml everytime for 3 month to 1 year, 15ml everytime for exceed 1 year to3 years old.) andChinese formulated products;②The 103 patients in the control group were treatedwith Ribavirin injection (10mg/kg.d))and Compound guaiacol potassium sulfonaleoral solution, the time of therapy is 10 day for each group. Compare the conditionof the integration amelioration for present symptoms(integration decrease meanssymptome amelioration) such as time of body temperature from fever to normal,cough, phlegm blockage, accelerated breathing, auscultation of lung , appetiteand,cyanosis, nausea and vomitting, the time of RSV darkening etc., then getting theLogistic regression analysis for the curative effect of two groups.
Results
There are, prior to the study, no significant differences between the two groups'general information, the leading symptoms and signs, secondary symptoms and signsand physical examinations and laboratory tests except for the body height. It meansthat the two groups can be compared. 96 cases of trial group and 103 cases ofcontrolled group accorded with the Per-Protocol(PP). The cured, significant effective,improved and ineffective cases of trial group were 64(66.6%)、26(27%)、6(6.4%)、0(0.00). The cured, significant effective, improved and ineffective cases ofcontrolled group were 43(41.7%)、41(39.8%)、19(18.5%)、0(0.00). With rank sumtest ,it showed that Z=-2.36, P＜0.001.The effect of trial group was much betterthan of the controlled group. Compared with the controlled group, the indexes of trial group of the symptoms, signs, physical examinations and laboratory testsincluding cough, flaring of nares, auscultation on lung, cyanopathy, urine, limb,X-ray of chest were much better. There are no significant differences between thetwo groups in treating fever, sputum, short breath, aversion to cold, feces, vitality,sweating, thirst, nausea, blood routine test and the virus test of the secretion of noseand throat. The study of clinical safety showed that Qingfei oral liquid had not anyharms and side effects on important organs, cough, phlegm blockage , acceleratedbreathing and the time for RSV darkening are all entering Logistic model, The resultdisplay that the model is established. (P＜0.05) . The 4 symptomatic regressioncoefficient is -1.676, -1.420, 1.14, -0.593 respectively ,The modulus for the threesymptomatic (cough, phlegm blockage, accelerated breathing) regression coefficientis bigger.
Conclusions:
The treatment plan which Qing kai ling injection and Chinese formulatedproducts for oral use is effective and safe in treating "wind and heat invasion oflung" syndrome and "accumulation of phlegm-heat" syndrome of children'srespiratory syncytial viral pneumonia.
南京中医药大学儿科于2003年11月完成的“十五”国家科技攻关计划课题“小儿肺炎中医证治规律研究”(2001BA701A16b)，采用随机、对照、盲法、多中心的临床研究，共研究480例小儿肺炎住院病人，试验组的痊愈显效率为89.62％，利巴韦林对照组为73.92％。
按照前期临床研究结果，小儿病毒性肺炎证候分类中，痰热闭肺证占75％，风热犯肺证占16.25％，两者合计占91.25％，为小儿肺炎急性期的两个最常见证型，故选其作为本次临床研究的研究对象。两者中医辨证均属于“热证”范畴，但有病位在表在里之分。风热犯肺证属于表热证，痰热闭肺证属于里热证，清开灵注射液的主要功效为清肺解毒、疏风清热、化痰通络、醒神开窍，临床广泛用于多种病毒感染性疾病，故选择为试验组的基本用药；利巴韦林注射液是美国FDA唯一批准用于治疗呼吸道合胞病毒感染患者的药物，故选择为对照组的基本用药。本研究所用药物均为国家正式批准生产上市的药物，符合合法的、公认有效、可比的，并对本病最为有效安全的原则。两组基本治疗用药是目前学术界比较公认的治疗病毒性肺炎的有效药物，治疗方案经过多次中、西医专家的论证，基本能体现中、西医治疗病毒性肺炎的有效方案。
在大量前期研究工作基础上，本次研究以中医辨证论治的原则为指导，试验组应用清开灵注射液为主加辨证论治口服具有清肺解毒、止咳化痰平喘作用的中成药，风热犯肺证加用小儿咳喘灵口服液，痰热闭肺证加用儿童清肺口服液，对照组应用利巴韦林注射液加复方愈创木酚磺酸钾口服液，治疗小儿呼吸道合胞病毒肺炎风热犯肺证、痰热闭肺证，进行盲法、大样本、多中心、随机平行对照试验的临床研究，全国共有5个中心参加本次临床试验(天津中医药大学第一附属医院儿科、首都医科大学附属北京儿童医院中医科、南京中医药大学附属医院儿科、广东省中医院儿科、河南中医学院第一附属医院儿科)，数据管理与统计由“‘十五’国家科技攻关项目”数据管理中心统一管理。客观评价两种不同治疗方案治疗小儿呼吸道合胞病毒肺炎的临床疗效，为科学系统的评价中医药疗效的临床研究提供一种可借鉴的模式。
目的
主要目的：观察治疗前后发热(体温)、咳嗽、痰壅、气促(呼吸次数)、肺部听诊、X线全胸片、呼吸道合胞病毒病原学检测、食欲食量、精神、恶寒、紫绀、心率、面色、口渴、恶心呕吐、出汗、舌象等情况的变化，评价两种不同治疗方案治疗呼吸道合胞病毒性肺炎风热犯肺证、痰热闭肺证的临床疗效。
次要目的：观察血常规、肝、肾功能及可能出现的不良事件，对两种不同治疗方案的安全性作出评价。
方法
借助SAS 8.0软件，按1：1产生初筛病例编号所对应的分组，采用区组随机化方法制定随机表。遵循盲法、多中心、分层区组随机、平行对照的原则，在5个中心住院病例中，选择倾向于呼吸道合胞病毒性肺炎西医诊断和中医小儿肺炎喘嗽风热犯肺证、痰热闭肺证者证候诊断的患儿，严格按入选时间先后顺序，获得随机号，按随机号所对应的分组，接受初步治疗。采集患儿鼻咽部分泌物，应用抗病毒特异性单克隆抗体间接免疫荧光法作呼吸道合胞病毒抗原检测，阳性者列为研究病例。①试验组以清开灵注射液(主要成分为板蓝根、金银花、桅子、黄芩苷等提取物的灭菌水溶液，3个月～1岁10ml／次；＞1岁，≤3岁15 ml／次，1日1次。)静脉滴注，风热犯肺证加服小儿咳喘灵口服液(3月～2岁，每次5 ml，＞2岁，≤3岁7.5 ml／次，口服，1日3次。)，痰热闭肺证加服儿童清肺口服液(10 ml／次，口服，1日3次)。②对照组：不分证型，均用利巴韦林注射液(10 mg／kg·d)静脉滴注加口服复方愈创木酚磺酸钾口服液(3月～6月每次2.5ml，＞6个月，≤3岁每次5ml，口服，1日3次)。观察疗程均为10天。比较两组患儿治疗前后发热病例体温恢复正常的时间、咳嗽、痰壅、气促、肺部听诊、X线全胸片、食欲食量、紫绀、恶心呕吐等主要症状和次要症状的积分改善情况；呼吸道合胞病毒转阴的时间；两组综合疗效评价；并对两组患儿的疗效进行Logistic回归分析。
结果
本次研究初筛病例入选340例，研究病例入选206例，全部数据与年龄、肺炎病程、既往病史、诊断等纳入标准相符合；脱落7例，脱落率3.39％，剔除0例，剔除率0.00％。符合方案集199例，全分析集206例，安全集206例。研究前的一般资料、主症、次症和理化检查结果，除身高外，两组间均无显著性差异(P＞0.05)，说明两组具有可比性。研究结束后，符合方案集试验组96例、对照组103例，试验组痊愈、显效、进步、无效例数为：64(66.6％)、26(27％)、6(6.4％)、0(0.00)，对照组为43(41.7％)、41(39.8％)、19(18.5％)、0(0.00)。经秩和检验，Z=-2.36，P＜0.001，试验组优于对照组(P＜0.001)，试验组痊愈显效率为93.6％，对照组痊愈显效率为81.5％，两组相比差别有高度统计学意义(P＜0.01)。症状、体征结果：体温、咳嗽、痰壅，气促(呼吸次数)，X线全胸片，食欲食量、呼吸道病毒病原学检查等指标好转情况，试验组均优于对照组。肺部听诊、紫绀、恶寒、面色、精神、出汗、口渴、恶心呕吐、出汗，两组比较，无显著性差异。临床安全性指标研究结果，未显示对于重要脏器有毒副作用。
结论
清开灵注射液静滴加辨证治疗口服中成药，是一种治疗RSV肺炎热证有效而安全的治疗方案，具有科学性和实用性，值得临床推广应用。
Children pneumonia is one of the commonly encountered respiratory systemdiseases, WHO defines it as one of the three most serious pediatric diseases, and it isone of the four pediatric diseases that the Administration for Health Care of Chinastresses prevention and cure, too. Children pneumonia covers 24.5-65.2% of thehospitalized children patients below 5 years old, and it results in deaths of 300thousand children patients below 5 years old, so it is the first death causes of 5-year-old children patients. Virus infection makes up 50% of Children pneumonia, ofwhich respiratory syncytial virus, RSV, is the important antigen ,which can cause theserious lower respiratory tract infection of infants and children, and also can causeover 90% bronchiolitis and most of the pneumonia. Although antibody exists in bodyafter infection, repeated infection is still commonly seen, however, its pathogenesisis not clear, and at present, there is no effective anti-virus vaccine. Ribavirin is theonly one to used as RSV virus infection, yet, its clinical effect is not satisfyingbecause small dose has no ideal effect, and large dose will bring toxic and adversereaction. Chinese medicine and Chinese herbal drugs have advantage in improvingchildren patients' symptoms and signs and shortening the course of treatment. ByTCM theory, the cause of virus pneumonia is externally contracting wind warm andpathogenic toxin, the mechanism of the disease is accumulation of phlegm-heat inlung .Because the main symptoms of RSV pneumonia, including cough, phlegmand asthma, are influenced each other, the treatment method should be clearinglung-heat and stopping cough, dissipating phlegm and relieving asthma. QingKailing injection is a kind of pure Chinese herbal injection produced in the base of
Angong Niuhuang Pills, which is used widely in various virus infection diseases. But,treating children RSV pneumonia with Qing Kailing injection and oral traditionalChinese patent medicines according to the treatment based on syndromedifferentiation lacks large sample, multiply centered and randomized, paralleled andcontrolled study, so we conduct this systemic and standard clinical research to reflectthe advantage on treatment of children virus pneumonia with Chinese medicine andherbs.
Study on patterns and treatment rules of children pneumonia is a one of thetenth five-year national subjects in natural scientific and technical study, it took therandomized, double-blind, placebo-controlled and multiply centered study and theresult showed accumulation of phlegm-heat in lung syndrome is the main pattern inacute children pneumonia, the effective rate in the tested group is 89.62%, andribavirin group is 73.92%.
On the base of last study, we conducted large sample, multiply centered andrandomized, paralleled and controlled clinical study with Qing Kailing injection andoral traditional Chinese patent medicines according to the treatment based onsyndrome differentiation, five centers in China joined the study , figures andstatistics are arranged uniformly.
Objective
Main objective: to evaluate the clinical effect of the different treatment plans intreating RSV with the method of watching fever, cough, phlegm, asthma andauscultation on lung, X-ray of chest, the virus and pathogen examine, appetite,aversion to cold, vitality ,cyanosis, cardiac rhythm, expression, thirst, nausea,sweating, tongue picture, degree of blood oxygen saturation.
Second objective: to detect the safety of Qing Kailing injection by watchingblood routine, liver and kidney function and impossible adverse reaction.
Methods
According to the following principle: single blind、stratified randomization、equal control multicentre clinical study, In 5 Centers hospitalization, 206 cases hadbeen carefully chosen as study subjects according to the western medicine's diagnostic criterion of children's virus pneumonia and the TCM diagnostic criterionof "wind and heat invasion of lung" syndrome and "accumulation ofphlegrn-heat"syndrome of children's virus pneumonia, whose legal guardian knowthe fact and consent. According to the rule of randomization, all subjects weredivided into two groups, trial group and controlled group.The ration was 1:1.Therandomized code envelope was also created by SAS 8.0 computer program. NanjingUniversity of TCM provides the investigational products and the randomized codeform.①Qing kai ling injection group: The 96 patients in the trial group were treatedwith Qing kai ling injection(the key component is the sterile water solution ofextractive from isatis root、flos lonicerae、cape jasmine fruit、baicalin etc.,10ml everytime for 3 month to 1 year, 15ml everytime for exceed 1 year to3 years old.) andChinese formulated products;②The 103 patients in the control group were treatedwith Ribavirin injection (10mg/kg.d))and Compound guaiacol potassium sulfonaleoral solution, the time of therapy is 10 day for each group. Compare the conditionof the integration amelioration for present symptoms(integration decrease meanssymptome amelioration) such as time of body temperature from fever to normal,cough, phlegm blockage, accelerated breathing, auscultation of lung , appetiteand,cyanosis, nausea and vomitting, the time of RSV darkening etc., then getting theLogistic regression analysis for the curative effect of two groups.
Results
There are, prior to the study, no significant differences between the two groups'general information, the leading symptoms and signs, secondary symptoms and signsand physical examinations and laboratory tests except for the body height. It meansthat the two groups can be compared. 96 cases of trial group and 103 cases ofcontrolled group accorded with the Per-Protocol(PP). The cured, significant effective,improved and ineffective cases of trial group were 64(66.6%)、26(27%)、6(6.4%)、0(0.00). The cured, significant effective, improved and ineffective cases ofcontrolled group were 43(41.7%)、41(39.8%)、19(18.5%)、0(0.00). With rank sumtest ,it showed that Z=-2.36, P＜0.001.The effect of trial group was much betterthan of the controlled group. Compared with the controlled group, the indexes of trial group of the symptoms, signs, physical examinations and laboratory testsincluding cough, flaring of nares, auscultation on lung, cyanopathy, urine, limb,X-ray of chest were much better. There are no significant differences between thetwo groups in treating fever, sputum, short breath, aversion to cold, feces, vitality,sweating, thirst, nausea, blood routine test and the virus test of the secretion of noseand throat. The study of clinical safety showed that Qingfei oral liquid had not anyharms and side effects on important organs, cough, phlegm blockage , acceleratedbreathing and the time for RSV darkening are all entering Logistic model, The resultdisplay that the model is established. (P＜0.05) . The 4 symptomatic regressioncoefficient is -1.676, -1.420, 1.14, -0.593 respectively ,The modulus for the threesymptomatic (cough, phlegm blockage, accelerated breathing) regression coefficientis bigger.
Conclusions:
The treatment plan which Qing kai ling injection and Chinese formulatedproducts for oral use is effective and safe in treating "wind and heat invasion oflung" syndrome and "accumulation of phlegm-heat" syndrome of children'srespiratory syncytial viral pneumonia.
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