益气解毒法治疗普通感冒(气虚邪犯证)的疗效观察及对细胞因子HβD-2的影响
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摘要
目的:观察益气解毒法治疗普通感冒(气虚邪犯证)的临床疗效。方法:采用随机对照的方法,把40例普通感冒患者(气虚邪犯证)随机分为试验组20例,对照组20例。试验组采用感毒清颗粒加减配伍(咽痛甚加牛蒡子、板蓝根,表症明显加金银花、连翘,咳嗽甚加桔梗、苦杏仁)口服,每日3次。对照组采用复方氨酚烷胺胶囊,每天2次。3d1个疗程后对比临床治疗疗效及对人β-防御素-2(HβD-2)的变化情况。结果:完成观察的合格病例试验组19例,对照组19例。试验组的总有效率为100%、愈显率为42.1%,对照组的总有效率为94.7%、愈显率为31.5%,两组愈显率比较差异无统计学意义(P>0.05)。两组治疗后咽部症状、体征积分均较治疗前改善(P<0.05),但试验组效果优于对照组。试验组与对照组HβD-2水平治疗前、后及组间对照差异无统计学意义(P>0.05),试验组3天前后差值与对照组相比差异有统计学意义(P=0.05)。在用药过程中,试验组未发现明显不良事件;对照组出现不良事件6例,表现为头昏、嗜睡,不良事件发生率为31.58%。结论:益气解毒法能够改善普通感冒(气虚邪犯证)的各种症状,尤其是较好地缓解咽痛症状达到治疗普通感冒的目的。
Objective: To observe the clinical efficacy of treating common cold(syndrome of Qi deficiency and evil invasion) by tonifying Qi and detoxification. Method: 40 common cold patients manifested as Qi deficiency and evil invasion syndrome were randomly divided into treatment group(20 patients) and control group(20 patients). The treatment group was treated with oral administration of modified Ganduqing granules(patients with obvious sore throat added Niubangzi and Banlangen, patients with typical exterior symptom added Jinyinhua and Lianqiao,patients with severe cough added Jiegeng and Kuxingren), 3 times a day. The control group was treated with Compound Paracetamol and Amantadine Hydrochloride Capsule, 2 times a day. The clinical efficacy and the expression changes of human beta defense-2(HβD-2) were compared between the two groups after 3 days for a course. Result: Both the control group and the treatment group had 19 qualified cases of completed observation. Total effective rate was 100 % and cure rate was 42.1% in the treatment group. The total effective rate was 94.7 % and cure rate was up to 31.5% in the control group. The cure rates of two groups had no statistical significance(P>0.05). After treatment, pharyngeal symptom and symptoms integral were better in both groups(P<0.05). But the effect of the treatment group outdid that of the control group. The comparison of HβD-2 level had no statistical significance in the interior-group and inter-group before and after treatment(P>0.05). Compared with the control group, the difference of HβD-2 level before and after 3 days in the treatment group had statistical significance(P<0.05). During whole process of medication, no obvious adverse reaction was reported in the treatment group. However, 6 cases of adverse reaction was reported in the control group which manifested as dizziness or sleepiness with 31.58% incidence rate. Conclusion: Tonifying Qi and detoxification method can alleviate various symptoms of common cold(syndrome of Qi deficiency and evil invasion), especially in the relief of sore throat, to achieve the therapeutic purposes of common cold.
Objective: To observe the clinical efficacy of treating common cold(syndrome of Qi deficiency and evil invasion) by tonifying Qi and detoxification. Method: 40 common cold patients manifested as Qi deficiency and evil invasion syndrome were randomly divided into treatment group(20 patients) and control group(20 patients). The treatment group was treated with oral administration of modified Ganduqing granules(patients with obvious sore throat added Niubangzi and Banlangen, patients with typical exterior symptom added Jinyinhua and Lianqiao,patients with severe cough added Jiegeng and Kuxingren), 3 times a day. The control group was treated with Compound Paracetamol and Amantadine Hydrochloride Capsule, 2 times a day. The clinical efficacy and the expression changes of human beta defense-2(HβD-2) were compared between the two groups after 3 days for a course. Result: Both the control group and the treatment group had 19 qualified cases of completed observation. Total effective rate was 100 % and cure rate was 42.1% in the treatment group. The total effective rate was 94.7 % and cure rate was up to 31.5% in the control group. The cure rates of two groups had no statistical significance(P>0.05). After treatment, pharyngeal symptom and symptoms integral were better in both groups(P<0.05). But the effect of the treatment group outdid that of the control group. The comparison of HβD-2 level had no statistical significance in the interior-group and inter-group before and after treatment(P>0.05). Compared with the control group, the difference of HβD-2 level before and after 3 days in the treatment group had statistical significance(P<0.05). During whole process of medication, no obvious adverse reaction was reported in the treatment group. However, 6 cases of adverse reaction was reported in the control group which manifested as dizziness or sleepiness with 31.58% incidence rate. Conclusion: Tonifying Qi and detoxification method can alleviate various symptoms of common cold(syndrome of Qi deficiency and evil invasion), especially in the relief of sore throat, to achieve the therapeutic purposes of common cold.
引文
[1]杨琪.2012年春季成都大慈寺社区115例感昌证型分布规律及感毒清治疗急性上呼吸道感染(邪热犯肺证)的临床疗效观察[D].成都:成都中医药大学,2012.
[2]徐伟.感毒清颗粒治疗急性上呼吸道感染(气虚邪犯证)的疗效及对细胞因子IFN-γ,IL-2的影响的临床研究[D].成都:成都中医药大学,2013.
[3]杨沁.感毒清治疗急性上呼吸道感染(邪犯肺卫证)的临床与实验研究[D].成都:成都中医药大学,2009.
[4]王振兴,曾强,张秀,等.感毒清咽痛方配方颗粒与中药饮片临床疗效对比观察[J].四川中医.2016.34(01):120-122.
[5]杨雯轩.感毒清颗粒对免疫功能影响的实验和临床研究[D].成都:成都中医药大学,2013.
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[11]姜春华.叶天士的温病、杂病的理论与治疗.新医药学杂志[J].1978.(08):8-13.
[12]Huang FC.Differential regulation of interleukin-8 and human beta-defensin 2 in Pseudomonas aeruginosa-infected intestinal epithelial cells[J].BMC Microbiol.2014.14:275.
[13]Yang W,Feng J,Xiang F,et al.Endogenous animal toxinlike humanβ-defensin 2 inhibits own K(+)channels through interaction with channel extracellular pore region[J].Cell Mol Life Sci.2015.72(4):845-53.
[14]Zhao Z,Mu ZL,Liu XW,et al.Expressions of Antimicrobial Peptides LL-37,Human Beta Defensin-2 and-3 in the Lesions of Cutaneous Tuberculosis and Tuberculids[J].Chin Med J(Engl).2016.129(6):696-701.
[15]Huang FC.De Novo sphingolipid synthesis is essential for Salmonella-induced autophagy and human beta-defensin 2expression in intestinal epithelial cells[J].Gut Pathog.2016.8:5.
[16]Coordes A,Andreou A,Erben U,et al.Recombinant human beta 2-defensin fusion proteins as a tool to investigate defensin structure and function in small human intestinal tissue samples[J].Inflamm Res.2012.61(12):1411-20.
[17]Tewary P,de la Rosa G,Sharma N,et al.β-Defensin 2 and3 promote the uptake of self or Cp G DNA,enhance IFN-αproduction by human plasmacytoid dendritic cells,and promote inflammation[J].J Immunol.2013.191(2):865-74.
[18]Yong X,Chen Y,Tao R,et al.Periodontopathogens and humanβ-defensin-2 expression in gingival crevicular fluid from patients with periodontal disease in Guangxi,China[J].J Periodontal Res.2015.50(3):403-10.
[19]Jenke AC,Zilbauer M,Postberg J,Wirth S.Humanβ-defensin2 expression in ELBW infants with severe necrotizing enterocolitis[J].Pediatr Res.2012.72(5):513-20.
[20]Liu S,He LR,Wang W,Wang GH,He ZY.Prognostic value of plasma humanβ-defensin 2 level on short-term clinical outcomes in patients with community-acquired pneumonia:a preliminary study[J].Respir Care.2013.58(4):655-61.
[21]Warnke PH,Voss E,Russo PA,et al.Antimicrobial peptide coating of dental implants:biocompatibility assessment of recombinant human beta defensin-2 for human cells[J].Int J Oral Maxillofac Implants.2013.28(4):982-8.
[22]De Paula VS,Pomin VH,Valente AP.Unique properties of humanβ-defensin 6(hβD6)and glycosaminoglycan complex:sandwich-like dimerization and competition with the chemokine receptor 2(CCR2)binding site[J].J Biol Chem.2014.289(33):22969-79.
[2]徐伟.感毒清颗粒治疗急性上呼吸道感染(气虚邪犯证)的疗效及对细胞因子IFN-γ,IL-2的影响的临床研究[D].成都:成都中医药大学,2013.
[3]杨沁.感毒清治疗急性上呼吸道感染(邪犯肺卫证)的临床与实验研究[D].成都:成都中医药大学,2009.
[4]王振兴,曾强,张秀,等.感毒清咽痛方配方颗粒与中药饮片临床疗效对比观察[J].四川中医.2016.34(01):120-122.
[5]杨雯轩.感毒清颗粒对免疫功能影响的实验和临床研究[D].成都:成都中医药大学,2013.
[6]葛均波,徐永健.内科学[M].北京:人民卫生出版社.13.
[7]钟南山,刘又宁.呼吸病学[M].北京:人民卫生出版社.385-387.
[8]中国医师协会呼吸医师分会,中国医师协会急诊医师分会.普通感冒规范诊治的专家共识[J].中华内科杂志.2012.51(4):330-333.
[9]中华人民共和国卫生部.中药新药临床研究指导原则(第二辑)[M].北京:中国医药科技出版社.58-60.
[10]李建生,王至婉,李素云,等.普通感冒中医证候诊断标准(2013版)[J].中医杂志.2014.55(04):350-351.
[11]姜春华.叶天士的温病、杂病的理论与治疗.新医药学杂志[J].1978.(08):8-13.
[12]Huang FC.Differential regulation of interleukin-8 and human beta-defensin 2 in Pseudomonas aeruginosa-infected intestinal epithelial cells[J].BMC Microbiol.2014.14:275.
[13]Yang W,Feng J,Xiang F,et al.Endogenous animal toxinlike humanβ-defensin 2 inhibits own K(+)channels through interaction with channel extracellular pore region[J].Cell Mol Life Sci.2015.72(4):845-53.
[14]Zhao Z,Mu ZL,Liu XW,et al.Expressions of Antimicrobial Peptides LL-37,Human Beta Defensin-2 and-3 in the Lesions of Cutaneous Tuberculosis and Tuberculids[J].Chin Med J(Engl).2016.129(6):696-701.
[15]Huang FC.De Novo sphingolipid synthesis is essential for Salmonella-induced autophagy and human beta-defensin 2expression in intestinal epithelial cells[J].Gut Pathog.2016.8:5.
[16]Coordes A,Andreou A,Erben U,et al.Recombinant human beta 2-defensin fusion proteins as a tool to investigate defensin structure and function in small human intestinal tissue samples[J].Inflamm Res.2012.61(12):1411-20.
[17]Tewary P,de la Rosa G,Sharma N,et al.β-Defensin 2 and3 promote the uptake of self or Cp G DNA,enhance IFN-αproduction by human plasmacytoid dendritic cells,and promote inflammation[J].J Immunol.2013.191(2):865-74.
[18]Yong X,Chen Y,Tao R,et al.Periodontopathogens and humanβ-defensin-2 expression in gingival crevicular fluid from patients with periodontal disease in Guangxi,China[J].J Periodontal Res.2015.50(3):403-10.
[19]Jenke AC,Zilbauer M,Postberg J,Wirth S.Humanβ-defensin2 expression in ELBW infants with severe necrotizing enterocolitis[J].Pediatr Res.2012.72(5):513-20.
[20]Liu S,He LR,Wang W,Wang GH,He ZY.Prognostic value of plasma humanβ-defensin 2 level on short-term clinical outcomes in patients with community-acquired pneumonia:a preliminary study[J].Respir Care.2013.58(4):655-61.
[21]Warnke PH,Voss E,Russo PA,et al.Antimicrobial peptide coating of dental implants:biocompatibility assessment of recombinant human beta defensin-2 for human cells[J].Int J Oral Maxillofac Implants.2013.28(4):982-8.
[22]De Paula VS,Pomin VH,Valente AP.Unique properties of humanβ-defensin 6(hβD6)and glycosaminoglycan complex:sandwich-like dimerization and competition with the chemokine receptor 2(CCR2)binding site[J].J Biol Chem.2014.289(33):22969-79.