Treatment of Herpangina Patients with Xiyanping Injection: A Retrospective Study Based on the Hospital Electronic Medical Record System

Abstract Background: Although we have made tremendous medical advances in recent decades in vaccine and supportive therapies, the treatment of herpangina has not experienced such rapid advancement. Xiyanping injection(XYP) is a Chinese prescription with andrographolide as the main components. XYP shows strong inhibitory effects against enterovirus 71 virus,and existence of dose-response relationships in pharmacology studies. However, herpangina still lack specific therapeutics. The present study aimed to demonstrate the “real-world” experiences of herpangina in China using XYP therapy,to provide a basis for treatment of herpangina in children. Methods: We analyzed data of patients (≤70 years) diagnosed with herpangina and used XYP between October 2006 to October 2016 from the large electronic data warehouse (EDW), a multiple sources including hospital information system（HIS） data of “tertiary grade A hospitals” in China. Statistical analyses were performed by SAS9.2 and R.25 software. We present the following article in accordance with the STROBE Statement reporting checklist. Results: A total of 3423 patients of herpangina were retrieved for the analysis in this study. The mean age of the patient population was 2.66 years. Herpangina patients are often with multiple diagnosis, of which hand-foot-and-mouth disease(HFMD), bronchopneumonia and febrile seizure present a higher probability. Antibiotics were the most prescribed (17.61%) except for XYP, followed by ascorbate (10.40%). Conclusions: This study is the first comprehensive retrospective review of herpangina for XYP that has been used in a clinical setting. The present findings of clinical characteristics are fairly consistent with previous clinical studies. Clinical medication use of herpangina were basically in accordance with Expert Consensus of Herpangina in China(2019).Meanwhile, there are abuse problems of antibiotics and antivirals. Despite the underlying mechanisms in antibacterial and antiviral of XYP, the exact clinical efficacy is yet to be revealed. The efficacy and safety of XYP with Western medicines has not been studied.