title: A randomized, controlled trial comparing traditional herbal medicine and neuraminidase inhibitors in the treatment of seasonal influenza.
abstract: The herbal medicine, maoto, has been traditionally prescribed to patients with influenza in Japan. To better understand the efficacy of maoto for the treatment of influenza, a randomized trial was conducted for comparison with oseltamivir or zanamivir. Adult patients with influenza symptoms, including fever, positive for quick diagnostic kit for influenza within 48 h of fever onset were assessed for enrollment. The data of 28 patients randomly assigned to maoto (n = 10), oseltamivir (n = 8), or zanamivir (n = 10) were analyzed for the duration of fever (>37.5°C) and total symptom score from symptom cards recorded by the patient. Viral isolation and serum cytokine measurements were also done on days 1, 3, and 5. Maoto granules, a commercial medical dosage form, are made from four plants: Ephedra Herb, Apricot Kernel, Cinnamon Bark, and Glycyrrhiza Root. Median durations of fever of patients assigned maoto, oseltamivir, or zanamivir were 29, 46, or 27 h, respectively, significantly different for maoto and oseltamivir. No significant between-group differences were found in total symptom score among three groups. Viral persistent rates and serum cytokine levels (IFN-α, IL-6, IL-8, IL-10, and TNF-α) during the study period showed no differences among three groups. The administration of oral maoto granules to healthy adults with seasonal influenza was well tolerated and associated with equivalent clinical and virological efficacy to neuraminidase inhibitors.
authors.affiliation: General Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. snabeshi@fukuoka-u.ac.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nabeshima
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Kashiwagi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ajisaka
authors.forename: Shinta
authors.initials: S
authors.lastname: Masui
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeoka
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ikematsu
authors.forename: Seizaburo
authors.initials: S
authors.lastname: Kashiwagi
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D016207:Cytokines / Q000097:blood; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D005260:Female; D005334:Fever / Q000821:virology; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification; D053122:Influenza A Virus, H3N2 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000188:drug therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D009439:Neuraminidase / Q000037:antagonists & inhibitors*; D053139:Oseltamivir / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D053243:Zanamivir / Q000627:therapeutic use*
chemical_list: D000998:Antiviral Agents; D016207:Cytokines; D004365:Drugs, Chinese Herbal; D004791:Enzyme Inhibitors; D053139:Oseltamivir; D009439:Neuraminidase; D053243:Zanamivir