Page 55 - วารสารกรมการแพทย์แผนไทยฯ ปีที่ 5 ฉบับที่ 3

Journal of Thai Traditional & Alternative Medicine Vol. 5 No. 3 September - December 2007 ÚˆÛ

The numbers of patients who would choose the pre- were observed from Day 2 of the treatment, i.e., nasal
viously prescribed medication or a new medication congestion/runny nose, sore throat, headache, myal-
were significantly different between the two groups gia, fatigue, and chill were also significantly less se-
(p < 0.05). vere than those of Day 0, while coughing was signifi-
cantly better on Day 6 (Table 2). For the paracetamol
Discussion group, it took longer than 2 days for headache, myal-

According to the Weekly Epidemiological Sur- gia, fatigue, and sore throat to be significantly less
veillance Report of the Bureau of Epidemiology, De- severe than those of Day 0, while nasal congestion/
partment of Disease Control, in 2006 there were 16,146 runny nose and cough did not significantly improve
reported cases of influenza with no death in Thailand even on Day 6 (Table 1).
and there were 88,841 reported cases of pneumonia When comparing the two groups, it was found
that required hospitalization and 765 deaths, 20 per- that the severity of cough, fatigue, and overall symp-
4
cent of which were caused by the influenza virus. toms of the group receiving both paracetamol and A.
th
In 2007, up to the 48 week (November 25-December paniculata was significantly less than those of the
1, 2007), there were 15,179 reported cases of influ- paracetamol group since Day 4 of the treatment. The
enza and 7 deaths and 78,140 admitted cases of pneu- therapeutic efficacy of A. paniculata was also evi-
20
monia and 757 deaths. These figures indicate that dent in terms of patient satisfaction, as 80 percent of
influenza is still one of several health problems in the patients receiving A. paniculata together with
Thailand that can cost the nation up to a thousand paracetamol said that they would choose the same
million baht or more in of medical care costs and medications again next time they have influenza, while
productivity losses. only 20 percent of the patients in the paracetamol
As the treatment of influenza is symptomatic, group would choose paracetamol again if they get
some modern medicines, e.g., antipyretics, influenza. However, there were some patients com-
antitussives, expectorants, antihistamines and nasal plaining that the number of capsules of A. paniculata
decongestants, may be taken for symptomatic relief, to be taken were too many. Hence, to increase pub-
if necessary. In addition, some antiviral agents, e.g., lic acceptance and compliance in the future, this herbal
oseltamivir, amantadine or rimantadine, may also be medicine should be made in the form of standardized
taken within the first 48 hours in order to reduce the extract instead.
severity of the symptoms and help patients the re- The results of the present study therefore sup-
cover quicker. However, these medications must be port the use of A. paniculata to help reduce certain
imported from overseas and some are expensive and respiratory and constitutional symptoms of influenza
not easily accessible by the public. Therefore, if and help patients to recover sooner, which is similar
Andrographis paniculata, an indigenous medicinal to its traditional use in cases of influenza by Chinese
6-7
plant of Thailand, can help influenza patients to re- and Indian people. The efficacy of A. paniculata in
cover sooner, it would significantly help the country relieving various respiratory and constitutional symp-
to save on medical-care costs and prevent productiv- toms of influenza is similar to its previously reported
12-14
ity loss as a results of influenza. efficacy in common cold suggesting that the herbûs
Beneficial effect of A. paniculata was noted in active constituents, total lactones, are effective not
this study as it was found that in the paracetamol only for milder symptoms of the common cold but
group, only three parameters, i.e., body temperature, also for more severe symptoms of influenza. The phar-
the severity of malaise and the overall symptoms, were macological activities that account for its therapeutic
significantly lower than those of Day 0 from Day 2 of efficacy in the common cold and influenza are likely
the treatment. However, when A. paniculata was due to its immunomodulating effect, antipyretic ac-
9-10
concomitantly given, additional therapeutic effects tivity and anti-inflammatory action.