Use of Chinese herbal medicines for acute cough in China: an online survey
Use of Chinese herbal medicines for acute cough in China: an online survey
Introduction: anti-microbial resistance is a complex and evolving global public health threat. Promoting effective alternative treatments is an important way to reduce the unnecessary use of antibiotics. This study aimed to identify the use of treatments for acute cough in China, including Chinese herbal medicines (CHMs) and their association with avoidance of antibiotics and participants’ reported clinical recovery.
Methods: an online retrospective treatment outcome survey was conducted. Retrospective clinical information was collected on participants who either were experiencing acute cough, or had experienced acute cough in the last 3 months. Participants were recruited through WeChat (a QR code or a link to the online survey), using snowball sampling. We analysed the usage of different CHMs, changes in symptoms as measured by Likert scales and subsequent use of antibiotics.
Results: a total of 25,583 participants completed the online questionnaire, covering all 34 province-level administrative units in China. Respondents had a median age of 25 years (73.5%, aged 18–39). Most respondents reported sputum (65.8%). Nearly half of the participants (45.3%) reported using antibiotics, 39.4% using CHMs, 27.1% and 20.9% using non-antibiotic Western medications and home remedies respectively. Fewer participants took antibiotics after taking CHMs (14.4%), compared to those who started with home remedies (17.6%), or non-antibiotic Western medications (24.5%). The recommendation of doctors (62.4%) and pharmacies (32.1%) were the most common reason for choosing CHMs. Participant-reported clinical recovery was similar (same median of 4 on a 1–5 Likert self-rating scale) regardless of type of CHM. The five CHMs associated with the lowest proportions of subsequent antibiotic use were individualised Chinese herbal formulae, Xiao Qing Long granule, Xian Zhu Li liquid, Chuan Bei Pi Pa Gao and Shi Wu Wei Long Dan Hua pill. The most commonly used herbs in the Chinese patent medicines were Glycyrrhizae radix et rhizome, Platycodonis radix, Pinelliae rhizome, Armeniacae semen amarum, Ephedrae herba, and Citri reticulatae pericarpium.
Conclusion: almost 40% of participants with acute cough used CHMs. The proportion of participants who subsequently used antibiotics after CHMs was lower than other treatments. CHMs have a potential role for symptom relief thus reducing antibiotic use.
Acute cough, Antibiotics, Chinese herbal medicine, Retrospective treatment outcome, Survey
Xia, Ruyu
394737f7-9ef2-4036-970e-a47eb559b737
Hu, Xiaoyang
65904b24-3775-4b14-9532-eb703a056655
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Wen, Lingzi
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Graz, Bertrand
d4cdfda1-e7d8-4b59-b1ef-baaf0db6393c
Liu, Jianping
37712d9a-587a-48e0-a92d-084dced87ab0
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Fei, Yutong
38d05d9e-30d7-48b4-b86d-768abefede0c
29 August 2023
Xia, Ruyu
394737f7-9ef2-4036-970e-a47eb559b737
Hu, Xiaoyang
65904b24-3775-4b14-9532-eb703a056655
Moore, Michael
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Wen, Lingzi
f64ca9b5-7bee-4e15-ba83-f8214c9f72f8
Graz, Bertrand
d4cdfda1-e7d8-4b59-b1ef-baaf0db6393c
Liu, Jianping
37712d9a-587a-48e0-a92d-084dced87ab0
Willcox, Merlin
dad5b622-9ac2-417d-9b2e-aad41b64ffea
Fei, Yutong
38d05d9e-30d7-48b4-b86d-768abefede0c
Xia, Ruyu, Hu, Xiaoyang, Moore, Michael, Stuart, Beth, Wen, Lingzi, Graz, Bertrand, Liu, Jianping, Willcox, Merlin and Fei, Yutong
(2023)
Use of Chinese herbal medicines for acute cough in China: an online survey.
European Journal of Integrative Medicine, 62, [102292].
(doi:10.1016/j.eujim.2023.102292).
Abstract
Introduction: anti-microbial resistance is a complex and evolving global public health threat. Promoting effective alternative treatments is an important way to reduce the unnecessary use of antibiotics. This study aimed to identify the use of treatments for acute cough in China, including Chinese herbal medicines (CHMs) and their association with avoidance of antibiotics and participants’ reported clinical recovery.
Methods: an online retrospective treatment outcome survey was conducted. Retrospective clinical information was collected on participants who either were experiencing acute cough, or had experienced acute cough in the last 3 months. Participants were recruited through WeChat (a QR code or a link to the online survey), using snowball sampling. We analysed the usage of different CHMs, changes in symptoms as measured by Likert scales and subsequent use of antibiotics.
Results: a total of 25,583 participants completed the online questionnaire, covering all 34 province-level administrative units in China. Respondents had a median age of 25 years (73.5%, aged 18–39). Most respondents reported sputum (65.8%). Nearly half of the participants (45.3%) reported using antibiotics, 39.4% using CHMs, 27.1% and 20.9% using non-antibiotic Western medications and home remedies respectively. Fewer participants took antibiotics after taking CHMs (14.4%), compared to those who started with home remedies (17.6%), or non-antibiotic Western medications (24.5%). The recommendation of doctors (62.4%) and pharmacies (32.1%) were the most common reason for choosing CHMs. Participant-reported clinical recovery was similar (same median of 4 on a 1–5 Likert self-rating scale) regardless of type of CHM. The five CHMs associated with the lowest proportions of subsequent antibiotic use were individualised Chinese herbal formulae, Xiao Qing Long granule, Xian Zhu Li liquid, Chuan Bei Pi Pa Gao and Shi Wu Wei Long Dan Hua pill. The most commonly used herbs in the Chinese patent medicines were Glycyrrhizae radix et rhizome, Platycodonis radix, Pinelliae rhizome, Armeniacae semen amarum, Ephedrae herba, and Citri reticulatae pericarpium.
Conclusion: almost 40% of participants with acute cough used CHMs. The proportion of participants who subsequently used antibiotics after CHMs was lower than other treatments. CHMs have a potential role for symptom relief thus reducing antibiotic use.
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Accepted/In Press date: 14 August 2023
e-pub ahead of print date: 15 August 2023
Published date: 29 August 2023
Additional Information:
Funding Information:
Ruyu Xia, Jianping Liu, and Yutong Fei were funded by the National Key Research and Development Project (grant no. 2018YFE0102300 ). Xiaoyang Hu was funded by the National Institute of Health Research (NIHR) School for Primary Care Research (SPCR) , (Launching fellowship 304116 ). Merlin Willcox was funded by the National Institute of Health Research (NIHR) , (grant CL-2016-26-005 ). The Global Network for Anti-Microbial Resistance and Infection Prevention (Global-NAMRIP) awarded pump-priming funding to support this research through the EPSRC (grant EP/MO27260/1 ). All funding organization has had no role in the survey's design, implementation, and analysis.
Publisher Copyright:
© 2023
Keywords:
Acute cough, Antibiotics, Chinese herbal medicine, Retrospective treatment outcome, Survey
Identifiers
Local EPrints ID: 483072
URI: http://eprints.soton.ac.uk/id/eprint/483072
ISSN: 1876-3820
PURE UUID: fdccb65c-d195-4802-b6f0-b5d6c5b469e3
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Date deposited: 23 Oct 2023 16:30
Last modified: 18 Mar 2024 03:39
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Contributors
Author:
Ruyu Xia
Author:
Lingzi Wen
Author:
Bertrand Graz
Author:
Jianping Liu
Author:
Yutong Fei
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