Clinical application guideline of combination with traditional Chinese medicine and Western medicine in the prevention and treatment of acute pharyngitis (2025)_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Jianxin ¹ , ZHOU Huifang ² , HE Weiping ³ , GUO Ying ² , GUO Yu ⁴ , LI Yunying ⁵ , JIAO Fengying ⁶ , MAO Dehong ⁷ , LIU Yuaxian ⁸ , WANG Jiaxi ⁹ , LIU Jing ¹ , WANG Ningyu ¹⁰ , LUO Wenlong ¹¹ , ZHAO Yulin ¹² , GAO Xia ¹³ , ZHU Dongdong ¹⁴ , ZHANG Sulin ¹⁵ , WANG Renzhong ¹⁶ , LIU Peng ³ , ZHENG Zhaoye ¹⁷ , ZHANG Gehua ¹⁸ , TAO Shudong ¹⁹ , LIU Daxin ⁹ ,  RUAN Yan ³ , on Behalf of the Ear, Nose and Throat Medicines Research Professional Committee of the China Association of Chinese Medicine

1. Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, P. R. China;
2. General Hospital of Tianjin Medical University, Tianjin 300052, P. R. China;
3. The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, P. R. China;
4. Shanghai Hospital of Traditional Chinese Medicine, Shanghai 200082, P. R. China;
5. Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, P. R. China;
6. The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, P. R. China;
7. Yongchuan District Hospital of Traditional Chinese Medicine, Chongqing, Chongqing 402160, P. R. China;
8. Shenzhen Hospital of Traditional Chinese Medicine, Shenzhen 518033, P. R. China;
9. Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100071, P. R. China;
10. Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, P. R. China;
11. The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;
12. The First Affiliated Hospital of Zhengzhou University, Zhengzhou 451191, P. R. China;
13. Gulou Hospital, Affiliated to Medical School of Nanjing University, Nanjing 210008, P. R. China;
14. China-Japan Union Hospital, Jilin University, Changchun 130033, P. R. China;
15. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430023, P. R. China;
16. Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, P. R. China;
17. The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300250, P. R. China;
18. The Third Affiliated Hospital of Zhong Shan University, Guangzhou 510000, P. R. China;
19. Tianjin Third Central Hospital, Tianjin 300170, P. R. China;

Corresponding?author：

RUAN Yan, Email: ruanyan63@163.com

Keywords：

Integrated traditional Chinese and Western medicine; Acute pharyngitis; Guideline

DOI：

10.7507/1672-2531.202512155

Video：

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Abstract Full text Figures/Tables Video References Cited by

Acute pharyngitis is a common respiratory disease. The combination of traditional Chinese and Western medicine has been proven effective in alleviating pharyngeal pain and systemic symptoms, as well as reducing the use of antibiotics. However, standardized clinical practice guideline was lacking. To address this, the Ear, Nose and Throat Medicines Research Professional Committee of the China Association of Chinese Medicine, in collaboration with over 20 domestic hospitals, has formed a multidisciplinary expert team of both Chinese and Western medical practitioners. Following the principles, methods, and steps of evidence-based guideline development, we identified clinical issues (three background questions and seven clinical questions) through literature review and expert consensus. Based on existing evidence-based guidelines at domestic and overseas, and the results of systematic reviews/meta-analyses, they considered the quality of evidence, weighed the pros and cons of intervention measures, and took into account patient preferences and values. Through the Delphi expert consensus meeting, we formulated 27 recommendations covering the assessment, laboratory and imaging tests, identification of danger signals, and both Chinese and Western medical treatment and prevention measures for acute pharyngitis.

Citation： WANG Jianxin, ZHOU Huifang, HE Weiping, GUO Ying, GUO Yu, LI Yunying, JIAO Fengying, MAO Dehong, LIU Yuaxian, WANG Jiaxi, LIU Jing, WANG Ningyu, LUO Wenlong, ZHAO Yulin, GAO Xia, ZHU Dongdong, ZHANG Sulin, WANG Renzhong, LIU Peng, ZHENG Zhaoye, ZHANG Gehua, TAO Shudong, LIU Daxin, RUAN Yan, on Behalf of the Ear, Nose and Throat Medicines Research Professional Committee of the China Association of Chinese Medicine. Clinical application guideline of combination with traditional Chinese medicine and Western medicine in the prevention and treatment of acute pharyngitis (2025). Chinese Journal of Evidence-Based Medicine, 2026, 26(7): 766-776. doi: 10.7507/1672-2531.202512155 Copy

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1. Miller KM, Carapetis JR, Van Beneden CA, et al. The global burden of sore throat and group A streptococcus pharyngitis: a systematic review and meta-analysis. EClinicalMedicine, 2022, 48: 101458.
2. Wu S, Peng X, Yang Z, et al. Estimated burden of group a streptococcal pharyngitis among children in Beijing, China. BMC Infect Dis, 2016, 16(1): 452.
3. Advisory Group on Antibiotic Stewardship Programme in Primary Care, Chan AMW, Au WWY, et al. Antibiotic management of acute pharyngitis in primary care. Hong Kong Med J, 2019, 25(1): 58-63.
4. Gunnarsson R, Ebell MH, W?chtler H, et al. Association between guidelines and medical practitioners' perception of best management for patients attending with an apparently uncomplicated acute sore throat: a cross-sectional survey in five countries. BMJ Open, 2020, 10(9): e037884.
5. Balogun R, Knobloch A. Antibiotics for the treatment of sore throat. Am Fam Physician, 2022, 105(6): 587-588.
6. Wilcox CR, Moore M, Little P. Use of antibiotics for acute sore throat and tonsillitis in primary care. Br J Gen Pract, 2022, 72(716): 136-137.
7. Butler AM, Brown DS, Newland JG, et al. Comparative safety and attributable healthcare expenditures following inappropriate versus appropriate outpatient antibiotic prescriptions among adults with upper respiratory infections. Clin Infect Dis, 2023, 76(6): 986-995.
8. Butler AM, Brown DS, Durkin MJ, et al. Association of inappropriate outpatient pediatric antibiotic prescriptions with adverse drug events and health care expenditures. JAMA Netw Open, 2022, 5(5): e2214153.
9. Hamilton JL, McCrea Ii L. Streptococcal pharyngitis: rapid evidence review. Am Fam Physician, 2024, 109(4): 343-349.
10. 張霞, 謝雁鳴, 李光熙, 等. 中醫藥治療急性咽炎的優勢與問題探討. 中國中藥雜志, 2017, 42(19): 3819-3825.
11. Huang Y, Wu T, Zeng L, et al. Chinese medicinal herbs for sore throat. Cochrane Database Syst Rev, 2012, (3): CD004877.
12. 李澤鵬, 李文建, 孫志佳. 中成藥治療急性咽炎數據挖掘及網狀Meta分析. 山東大學耳鼻喉眼學報, 2023, 37(4): 111-118.
13. ESCMID Sore Throat Guideline Group, Pelucchi C, Grigoryan L, et al. Guideline for the management of acute sore throat. Clin Microbiol Infect, 2012, 18(Suppl 1): 1-28.
14. Aertgeerts B, Agoritsas T, Siemieniuk RAC, et al. Corticosteroids for sore throat: a clinical practice guideline. BMJ, 2017, 359: j5654.
15. 姚曉燕, 邊永君, 高揚, 等. 《中醫藥單用/聯合抗生素治療急性咽炎疾病臨床實踐指南》臨床應用評價與修訂意見. 中國中藥雜志, 2018, 43(24): 4765-4770.
16. 中西醫聯合防治策略標準研究項目組. 《中西醫聯合防治優勢病種臨床應用指南》制定技術規范. 中國中西醫結合雜志, 2024, 44(4): 389-398.
17. 陳耀龍, 楊克虎, 王小欽, 等. 中國制訂/修訂臨床診療指南的指導原則(2022版). 中華醫學雜志, 2022, 102(10): 697-703.
18. 陳耀龍, 周奇, 崔榮榮, 等. 基于AGREE Ⅱ的中醫藥臨床指南質量評價. 中國循證醫學雜志, 2016, 16(11): 1331-1337.
19. Wang X, Zhou Q, Chen Y, et al. Using RIGHT (Reporting Items for Practice Guidelines in Healthcare) to evaluate the reporting quality of WHO guidelines. Health Res Policy Syst, 2020, 18(1): 75.
20. Mustafa Z, Ghaffari M. Diagnostic methods, clinical guidelines, and antibiotic treatment for group A streptococcal pharyngitis: a narrative review. Front Cell Infect Microbiol, 2020, 10: 563627.
21. Sykes EA, Wu V, Beyea MM, et al. Pharyngitis: approach to diagnosis and treatment. Can Fam Physician, 2020, 66(4): 251-257.
22. Krüger K, T?pfner N, Berner R, et al. Clinical practice guideline: sore throat. Dtsch Arztebl Int, 2021, 118(11): 188-194.
23. Reinholdt KB, Rusan M, Hansen PR, et al. Management of sore throat in Danish general practices. BMC Fam Pract, 2019, 20(1): 75.
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Chinese Journal of Evidence-Based Medicine

Clinical application guideline of combination with traditional Chinese medicine and Western medicine in the prevention and treatment of acute pharyngitis (2025)

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