Effect of adjuvant treatment with Xiyanping injection on the prognosis of viral encephalitis in children: a multicenter retrospective study

Wen Tian¹Yang Chen²Huazhang Liu³Danning Wen⁴Zhe Wang⁵Ying Li⁶Li Liu⁷Xiangna Yang⁸Xueyan Ma¹Yuanyuan Zhang⁹Chengjie Ma⁹Rongbing Wang⁹Qiaozhi Yang²Yibing Yan^3*Yukun Zhang^2*Xiaohong Gu^1*Wei Zhang^10*

• ¹Beijing University of Chinese Medicine, Beijing, China
• ²Liaocheng People's Hospital, Liaocheng, China
• ³Shandong First Medical University, Jinan, China
• ⁴Wuhan Jinyintan Hospital, Wuhan, China
• ⁵The Second Hospital of Tianjin Medical University, Tianjin, China
• ⁶Tianjin City Second People's Hospital, Tianjin, China
• ⁷Shanghai Jiao Tong University, Shanghai, China
• ⁸Guangzhou Medical University, Guangzhou, China
• ⁹Capital Medical University Beijing Ditan Hospital, Beijing, China
• ¹⁰Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China

Background: Viral encephalitis (VE), a central nervous system disorder with high mortality and disability rates, poses a serious threat to childhood development. Xiyanping injection (XYPI), an andrographolide sulfonate preparation widely used in China, exhibits anti-inflammatory, antiviral, antitumor, antibacterial and neuroprotective properties. Methods: We conducted a retrospective study of 635 pediatric inpatients with VE who were hospitalized at seven medical centers in China between January 2015 and December 2021. Risk factors for poor prognosis were compared between inpatients treated with XYPI (n=480) and those without XYPI treatment (n=155). Propensity score matching was performed to reduce potential confounding. Clinical symptoms, hospitalization costs, complications and sequelae were evaluated simultaneously. Results：Multivariate Logistic regression identified XYPI treatment as an independent protective factor for poor prognosis (odds ratio [OR] = 0.251, 95% confidence interval [CI]: 0.113 – 0.559, p < 0.001). XYPI significantly shortened the duration of fever and headache, reduced hospitalization costs, and lower the incidences of respiratory infections, myocardial injury, and sequelae (all p < 0.05). Conclusion: Adjuvant XYPI therapy may improve clinical outcomes and reduce the economic burden in pediatric VE; however, randomized trials are warranted to validate these findings.