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Shinta Masui [1; 2] and Shigeki Nabeshima [1] and Kazuhiko Ajisaka [1; 2] and Kei Yamauchi [1; 2] and Ryota Itoh [2] and Kazunari Ishii [2] and Toshinori Soejima [2] and Kenji Hiromatsu [2]

Academic Editor: Chang G. Son

1, General Medicine, Fukuoka University Hospital, Fukuoka, Japan, fukuoka-u.ac.jp

2, Department of Microbiology and Immunology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan, fukuoka-u.ac.jp

Received Apr 28, 2017; Accepted Jul 20, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Influenza remains an important infectious disease that causes major pandemic outbreaks worldwide. The currently available anti-influenza drugs, the M2 proton channel inhibitors amantadine and rimantadine and the neuraminidase inhibitors oseltamivir, zanamivir, and laninamivir, have made a remarkable contribution to the treatment of influenza [1]. Neuraminidase inhibitors have also been effective for patients infected with pandemic influenza 2009 [2, 3]. However, adverse effects, compliance problems, limited supply, and high cost are major concerns when prescribing neuraminidase inhibitors [4]. In addition, the future efficacy of these antivirals may be limited as stable, transmissible drug-resistant strains emerge, as happened with A/H1N1pdm [5–8]. Attention to new therapeutics for the treatment of influenza continues to be important.

Traditional herbal medicines have long played an important role in countries in the Far East, especially Japan, China, and Korea. Maoto (Ma-Huang-Tang in Chinese) is traditionally prescribed for acute febrile diseases or upper respiratory tract infection [9, 10]. We and others previously reported in nonrandomized [11, 12] and randomized controlled trials [13, 14] that maoto has clinical efficacy for seasonal influenza, without severe adverse effects. In our study of adult patients randomly assigned maoto granules, oseltamivir, or zanamivir, analysis was done of the duration of fever, total symptom score, and viral shedding. The results showed that maoto was well tolerated and that it had equivalent clinical and virological efficacy to oseltamivir and zanamivir in a group of healthy adults with seasonal influenza [13]. Our results were supported by a recent study of experimental infection with influenza virus in mice, in which the viral titer was decreased in the nasal and bronchoalveolar lavage fluids of mice treated with...

  

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