| Objective1.This study aimed to compare the sensitivities and rates of viral detection among oropharyngeal swab (OPS), nasopharyngeal swab (NPS) and NW in adults with acute pharyngitis by using Taqman real-time polymerase chain reaction (PCR) and virus culture, and to analyze the viral distribution of acute pharyngitis.2.To observed the clinical curative effect of acute pharyngi(?)s treated by Yinqiao Powder. And to inspect the antiviral effect of Yinqiao Powder in vivo.Methods1. the detection of respiratory viruses of acute pharyngitis:the inclusion were that accorded with the diagnosis criteria of acute pharyngitis and acute pharyngeal tumefaction,18years≤Age<60years, history of acute pharyngitis≤3days. Three consecutive samples were collected from each patient with acute pharyngitis by experienced physicians, in the following order oropharyngeal swab (OPS), nasopharyngeal swab (NPS) and nasal wash (NW). The specimens were tested for15respiratory viruses by PCR including influenza virus (A, B), parainfluenza virus (PIV1,2,3,4), rhinovirus, respiratory syncytial virus (RSV), adenovirus, enterovirus (EV), human coronavirus (HCoV-229E,OC43, NL63and HKU1), human metapneumovirus (HMPV). Also the specimens were tested for7respiratory viruses by virus culture, including Flu A, Flu B, PIV1, PIV2, PIV3, RSV, ADV.2. The clinical curative effect of acute pharyngitis treated by Yinqiao Powder:the inclusion were the same as above, in addition the patients should be viral laboratory-confirmed diagnosed. The patients were divided into two groups, Yinqiao Powder group or control group, suiting themselves. The clinical curative effect was observed with self-refit symptom scale. 3. We use NIH mice which were intranasal inoculated with H1N1strain of influenza A virus, to observe the living conditions, determinate lung index, to observed pathological changes by hematoxylin-eosin staining (HE staining). Results1. During the study period,115patients of acute pharyngitis were enrolled,345specimens were collected. There were23positive specimens tested by virus culture, the positive detection rate was3.67%. The sequence of viruses amount displayed from the highest to the lowest, which was human coronavirus, influenza virus, rhinovirus, adenovirus, parainfluenza virus, enterovirus, respiratory syncytial virus and human metapneumovirus.2. PCR and virus culture detection showed that the detection rate of different specimens displayed from highest, to lowest, which was NPS, OPS and NW.3.115patients of acute pharyngitis were enrolled. The mean days from onset of illness to samples collection were2.5days (SD,1.0). A total of80patients (70%,80/115) were detected at least one type of virus. NPS samples identified81.25%(65/80) the infected patients, which was the highest detection rate. NW samples detected47.5%(38/80) of the infected patients and OPS samples60%(48/80). The detection rate of any virus in NPS was significant higher than that in NW (P<0.01) and OPS (P<0.01) respectively. In detection of all viruses, the sensitivity of NPS was significantly higher than NW (74%[95%CI=66-83] vs.45%[95%CI=35-55], P<0.01) and OPS (74%[95%CI=66-83] vs.48%[95%CI=39-59], P<0.01) respectively.4. The clinical research of clinical curative effect of Yinqiao Powder included80patients (60patients of Yinqiao Powder group,20patients of control group). For symptom improvement, the Yinqiao Powder group was better than control group. After3days of treatment, for the symptom and sign improvement of sore throat, throat sensation, redness and swollen of uvula and pharyngeal mucosa, redness and swollen of lateral pharyngeal bands, the Yinqiao Powder was significant better than control group (P<0.05). After6days of treatment, for the symptom and sign improvement of sore throat, redness and swollen of uvula and pharyngeal mucosa, the Yinqiao Powder was significant better than control group (P<0.05)5. The antiviral effect of Yinqiao Powder in vivo showed total Yinqiao Powder extract (300mg/kg/d) could reduced the the systemic symptoms, lung index, the scope of the rat lung lesions (P<0.05).ConclusionIn adults, acute pharyngitis were caused by many kinds of respiratory viruses, and the major pathogen were human coronavirus, influenza virus and rhinovirus. The choice of specimen would markedly affect the detection rate of respiratory viruses. In this study we concluded the NPS collection was the best cost-utility sampling method in patients with acute pharyngitis.Yinqiao Powder made the significant symptom and sign improvement of acute viral pharyngitis. And Yinqiao Powder also was effective to influenza in vivo. Therefore Yinqiao Powder was powered to the treatment of acute viral pharyngitis, especially for the influenza infection. |
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