Clinical dosage form evaluation of Chinese medicine in the treatment of acute upper respiratory tract infection in pediatric patients

  1, the characteristics of pediatric upper sensation and the advantages of Chinese and Western medicine treatment upper sensation is a general term for acute inflammation of the nose, nasopharynx and pharynx. Since infants and young children have short nasal cavity, no nasal hair, narrow postnasal passage, throat, tender mucous membrane, rich blood vessels, non-specific and specific immune function of the respiratory tract are poor, so they are prone to respiratory tract infections. Data show that more than 90% of the etiology of pediatric upper sense is caused by viruses, such as rhinovirus, coronavirus, influenza virus, parainfluenza virus, respiratory syncytial virus, adenovirus, coxsackie virus, echovirus, herpes simplex virus, EBV, etc.. Therefore, some experts point out that antibiotics should not be given for the common cold, and symptomatic treatment is of primary importance, including rest, adequate hydration, fever reduction and reduction of khat symptoms. However, there is a widespread abuse of antibiotics at home and abroad, resulting in huge economic waste, the increase of drug-resistant bacteria and unnecessary toxic side effects, the main reasons are: the etiological diagnosis of acute upper influenza has not been promoted, the selection of antibiotics based on experience has great limitations; doctors are afraid of taking risks, and strive to “insurance”, even if they think it is a viral infection also The family’s request to use antibiotics also put pressure on doctors. In addition, fever is the main manifestation of acute upper childhood infection, but fever is caused by a variety of reasons, not the application of antibiotics, so the empirical antibiotic treatment for febrile children should also be abandoned.  In addition, it is believed that children’s internal organs are delicate, the skin fence is not dense, the external function is not solid, coupled with the cold and warmth do not know how to self-regulate, often due to sudden changes in the four seasons of the climate, cold and warmth is not normal, external evil to take advantage of the deficiency, the occurrence of this disease; and because children are “pure Yang body”, “Yang often have excess, Yin is often insufficient “Therefore, fever is the most common clinical condition, and rapid reduction of fever is its main treatment purpose. Modern pharmacological research shows that the treatment of pediatric upper sensation Chinese medicine, generally has a strong antiviral, antipyretic and anti-inflammatory, enhance the body’s immune effect. For example, the oral solution of pediatric fever rapid Qing has good inhibitory effect on influenza A1, A3 and B viruses, and the protection experiment on FM1 virus infected mice and the pathological observation of respiratory and immune organs prove that the drug has antiviral and immune enhancing effects.  The advantage of soup is that it can be flexibly added or reduced according to the different conditions of each child, thus giving full play to the characteristics and advantages of Chinese medicine, and in the process of heating and decocting, the active ingredients of the medicine can be dissolved and diffused into the liquid to the maximum extent, and the bioavailability is high, which cannot be replaced by other forms. It can be replaced by other dosage forms and will remain the main dosage form for the treatment of upper sensation for a long time in the future.  Oral liquid is an oral liquid dosage form made by extracting the active ingredients of traditional Chinese medicine with reasonable technology and filling under aseptic or semi-sterile conditions, which is an improvement on the basis of tonics and concoctions and has the characteristics of fast absorption, small dosage and convenient administration. Some of them have been made into fruit flavors, which are more acceptable to children and improve the compliance of children taking medicine. For example, the oral liquid for children’s fever and cough has good effect on children’s upper fever.  2.3. Granules Chinese medicine granules are made by extracting and clarifying net herbs, concentrating them into clear paste, drying under reduced pressure, crushing, dry pressing and granulating or adding a small amount of excipients to dry pressing or wet granulating and drying, which is a new dosage form developed on the basis of tonics and syrups, with the advantages of small dosage, convenient administration and good compliance of children. Such as pediatric pharyngeal flat granules for pediatric acute pharyngitis, acute tonsillitis and other upper respiratory tract infections, has a good therapeutic effect.  2.4. Injection Chinese medicine injection is a new dosage form of modern Chinese medicine, which provides a new dosage form and drug delivery route for the treatment of acute diseases and serious illnesses in Chinese medicine, and has the characteristics of fast onset of action and small and accurate dosage compared with oral dosage form. For example, Qingkailing injection has good efficacy for children with high fever that does not subside. However, due to the complex composition of Chinese medicine, the toxic side effects of Chinese medicine injection have been reported repeatedly in recent years, which should be noted. The preparation process, quality and stability of injections need to be further improved.  2.5. Nebulizer Chinese medicine nebulizer is the use of ultrasonic nebulization to make the drug solution into fog particles, through breathing so that the drug acts directly on the nasopharynx, trachea, etc., into the lungs, the drug quickly diffuse, absorption, direct inhibition of viral replication, rapid relief of clinical symptoms. Pharmacokinetic studies have confirmed that when ultrasonic nebulized inhalation is administered, the local concentration of the drug in the respiratory tract is high, and its pharmacological effects can be maximized.  2.6. Enema Enema is a decoction of drugs into a liquid retained in the enema, not only to solve the problem of difficult to take drugs for children, but also due to the rectal administration of drugs fully absorbed, rapid action, drugs absorbed into the blood through the rectum directly into the circulation, reducing the destruction of drugs by the liver, improve the blood concentration, while avoiding the impact of oral administration of gastric acid and pepsin on the drug and drug-induced gastrointestinal reactions. Therefore, rectal drug delivery has the advantages of rapid efficacy, small side effects, convenient use, and maintaining the characteristics of traditional Chinese medicine tonics.  At present, there are many kinds of Chinese medicines suitable for the treatment of pediatric epilepsy, but due to the different composition of drugs in different formulas, there are certain differences in the indications.  3.2. Reasonable choice of dosage form As the absorption of drugs has a certain relationship with the dosage form of drugs, different drug dosage forms can affect the absorption, strength of action, site of action, onset and duration of action, and toxic side effects of drugs in the body. Therefore, the choice of dosage form should not only be convenient for storage, carrying and taking, but most importantly, it should be determined according to the different nature of the disease and the physical and chemical properties of the drug itself, so as to maximize the effect of the drug and improve the clinical efficacy.