七味白术散颗粒治疗婴幼儿轮状病毒腹泻病的临床研究
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摘要
目的：为了评价七味白术散颗粒治疗婴幼儿轮状病毒腹泻病的疗效并初步探讨其作用机理。方法：采用随机对照的方法。应用七味白术散颗粒与思密达加丽珠肠乐对照，治疗轮状病毒腹泻婴幼儿共118例，观察临床疗效及治疗前后血清IL-2、IL-6、IL-8、T-SOD等变化。结果：七味白术散颗粒组疗效优于对照组(p＜0.05)；对重型腹泻病的疗效明显优于对照组(p＜0.01)；大便轮状病毒抗原转阴率亦高于对照组。治疗后，血清IL-2、总SOD水平升高，治疗组优于对照组(p＜0.05)；血清IL-6、IL-8水平降低，治疗组优于对照组(p＜0.05)。结论：七味白术散颗粒具有抗病毒，免疫调节和增强机体清除自由基能力的作用；具有抗炎、抗腹泻作用；疗效优于对照组，且无不良反应。值得在治疗轮状病毒腹泻病中广泛推广。
Objective: To evaluate the therapeutic effect of Qiwei Baizhusan Granule(QWBZG) on infantile rotavirus diarrhea and to discover its therapeutic mechanism. Methods: The controlled observation method was adopted in the clinical study. There are 60 patients were observed in the QWBZG group .The controlled group of 58 patients was treated with Smecda and Bifidobiogen. Results: There was different in the treatment effect between QWBZG group and controlled group(p < 0.05). The QWBZG had significantly better effect on heavy patients ( p < 0.01 ) . Stool rotavirus antigen in the QWBZG group became negative more quickly than the controlled group. The serum level of IL-2 and T-SOD both rose in the two groups, but the QWBZG group was improved greatly ( p < 0.05 ) .The serum level of IL-6 and IL-8 were both decreased in the two groups, while statistical difference could be found between them(p < 0.05). Conclusion: The QWBZG is an effective and safe medicine in the treatment of rotavirus diarrhea. It has the action of anti-virus, immunoregulation and clearance of free radical. It has good effect on anti-inflammation and anti-diarrhea. It has a good
prospect of development and application.
Objective: To evaluate the therapeutic effect of Qiwei Baizhusan Granule(QWBZG) on infantile rotavirus diarrhea and to discover its therapeutic mechanism. Methods: The controlled observation method was adopted in the clinical study. There are 60 patients were observed in the QWBZG group .The controlled group of 58 patients was treated with Smecda and Bifidobiogen. Results: There was different in the treatment effect between QWBZG group and controlled group(p < 0.05). The QWBZG had significantly better effect on heavy patients ( p < 0.01 ) . Stool rotavirus antigen in the QWBZG group became negative more quickly than the controlled group. The serum level of IL-2 and T-SOD both rose in the two groups, but the QWBZG group was improved greatly ( p < 0.05 ) .The serum level of IL-6 and IL-8 were both decreased in the two groups, while statistical difference could be found between them(p < 0.05). Conclusion: The QWBZG is an effective and safe medicine in the treatment of rotavirus diarrhea. It has the action of anti-virus, immunoregulation and clearance of free radical. It has good effect on anti-inflammation and anti-diarrhea. It has a good
prospect of development and application.
引文
[1] Osamu Nishio , Kiyohiko Matsui , Tornohiro Oka , et al . Rotavirus infection among infants with diarrhea in Pakstan| J ] . Pediatrics International. 2000 ,42:425-427．
[2] Colomina J, TeresaGil M ,Codoner P ,et al .Viral proteins VP1 ,VP2 ,VP6 and NSP2 are strongly precipitated by serum and fecal antibodies from children with rotavirus symptomatic infection[J] . J Med Virol, 1998 , 56 : 58
[3] 陆德源主编．医学微生物学[M]．第4版．北京：人民出版社，1996． 256-258
[4] Esles M . K ,Cohen J . Rotavirus gene structure and fuction[J].Microbiol Rev ,1989 ,53:410
[5] Horie Y , Masamune O , Nakagomic O . Three major alleles of rotavirus NSP4 proteins identified by sequence analysis [ J ] . J Gen Virol, 1997,78 : 2341
[6] Mirazimi A ,Nilsson M ,Sevensson L . The molecular champerone callnexin interacts with the NSP4 enterrotoxin of rotavirus in vivo and in vitro [ J ]. J Virol ,1998,72(11 ):8705
[7] Angel J, Tang B, Feng N ,et al .Srudies of the role for NSP4 in the pathogenesis of homologous murine rotavirus diarrhea[ J ] J Infect Dis ,1998 ,177:455
[8] Haffejee IE The epiemiology of rotavirus infections: a global perspective. J Pediatr Gastroenterol Nutr. 1995,20:275-286．
[9] Cao XR. Akihara S. Fang ZY. et al. Genetic variation in the VP4 and NSP4 genes of human rotavirus serotype 3 (G3 type) isolated in China and Japan .Microbiol Immunol. 1999,43:171-175．
[10] Ann Christine Nyquest. Rotavirus Vaccine[J].Pediatrics Annals ,1999,28(8) : 533-539
[11] Fang Zhaoyin ,Yang Hui , Zhang Jing , et al . Child rotavirus Infection in association with acute gastroen teritis in two Chinese sentinel hospitals[J] . Pediatrics International ,2000,42: 401-405
[12] Niwat Maneekam , Hiroshi Ushijima . Epidemiology of rotavirus infection in Thailand[J] .Pediatrics international ,2000,42:415-412．
[13] Glass RI . Rigore PE.Holman RC . et al. The epidemilolgy of rotavirus diarrhea in the United States: surveillance and estimates of disease burden. J Infect Dis. 1996． 174(suppl 1) : S5-11．
[14] Jeong Kee Seo , Jay G Sim . Overview of rotavirus Infections in Korea[J] . Pediatrics International ,2000,42:406-410．
[15] Ruggeri FM. Declich S. infection among children with diarrhea in Italy. Acute Paediatr suppl. 1999, 88: 66-71
[16] Matson Do, O'Ryan ML. Herrera I. et al . Recal antibody response to symptomatic and asymptomatic rotavirus infections.Jinfec Dis.l993,167:577-583
[17] Gentsch JR, Woods PA, Ra machandran M, et al .Review of Gand P typing results from a global collection of rotavirus, J Infect Dis, 1996,174(Suppl l):30-36
[18] Beards GM ,Desselberger U, Flewett TH. Temporal and geographical distributions of human rotavirus serotypes,1983-1988． J Clin Microbiol, 1989,27:2827-2833．
[19] Ramachandran M , Das BK, Vij A, et al .Unusual diverdiry of human rotavirus G and P genotypes in India.J Clin Miciobiol ,1996,34:436-439．
[20] Gouvea V, Castro L ,Timenetsky MDC, et al .Rotavirus serotype G5 associated with diarrhea
in Brazilian children .J Clin Microbiol. 1994,32:1408-1409.
[21]徐倏，温乐英，王健伟，等。中国部分城市A组转伏病毒感染状况调查及VP7血清型分析，中华实验和临床病毒学杂志，2001，15(1)：77-80
[22]方肇寅，齐锦，杨辉，等。我国1998-1999年流行的婴幼儿腹泻轮状病毒的分型研究，病毒学报，2001，17(1)：17-23
[23]赵聪敏，李为明．乳糖吸收不良和不耐受症．国外医学儿科学分册，1992，19(2：131-134)
[24]Keljo DJ, Kuhn M ,Smith A .Acidification of endosomes is not important for the entry of rotavirus into the cell .J Pediatr Gastroenterol Nutr, 1988,7(2):257-63
[25]Keljo DJ, Smith AK .Characterization of binding of simian rotavirus AS-Ⅱ to cultured epithelial cells. J Pediatr Gastroenterol Nutr, 1988,7(2):249-56
[26]王正明，张君儒，刘震等．婴儿秋季腹泻发病机理初步探讨[J]。中华儿科杂志，1986，24(4)：218-211．
[27]姚英民，邱红明，赵枫．轮状病毒全身感染与病理变化[J]．中华实验和临床病毒学杂志，1998，12(4)：389．
[28]岳伟，史鸽，李呈瑾．小儿轮状病毒腹泻合并多系统器官感染的临床分析[J]．河南医药信息，2002；10(8)：19
[29]李秀珍，龚四堂，区文玑，轮状病毒感染致肝损害和心肌损害342例临床分析[J]．新医学，32(5)：282-283
[30]周最明，刘瑾，封志纯，等．小儿轮状病毒相关性胰腺炎．第一军医大学学报．2001；21(12)：960
[31]Ushijima H, Xin KE, Nishimura S, et al. J Clin Micro, 1994;32(12):2893-2897.
[32]Hongou K,Konish T, Yagi S,et al.Pediatr Neurol, 1998; 18(4):354-357.
[33]Gregorio L, School TM, Sutton CL, et al. Pediatr, 1997; 99(5):739-743.
[34]周水珍，丘朋玲，孙道开；轮状病毒腹泻并惊厥24例[J]，实用儿科临床杂志。2001；16(2)：99-100
[35]宋新民，尹萍；肠溶阿司匹林为主治疗秋季腹泻的临床研究[J]，中国现代医学杂志，2002；12(1)：80
[36]李光．硝本地平治疗婴幼儿轮状病毒肠炎88例疗效观察[J]．医师进修杂志，1997，20(9)：504．
[37]刘万清，许红梅，张爱华，等．SIgA口服液治疗婴幼儿轮状病毒肠炎56例疗效观察[J]，临床儿科杂志，1995，13(4)：244．
[38]Schmitz J. Anti-rotavirus vaccinations[J]. Arch Pediatr, 1999,6(9): 979.
[39]陈宇，王禹，杨景云；婴幼儿轮状病毒肠炎微生态学改变[J]．黑龙江医药科学[J]，2001，24(1)：18-19．
[40]杨国峰，周鹏，王健伟；轮状病毒疫苗研究进展及其转基因植物疫苗的开发前景．生物技术通报，2001，1：16-19．
[41]Vesikari T, et al. Lance, 1983, ⅱ: 807-811.
[42]Kapikian AZ, et al. 11th Nobel Conference (Stockholm) Lund, Sweden: Student-literature, 1986: 192-214.
[43]Clark F, et al. Am J Dis Child, 1986, 140: 350-356.
[44]Midthum K, et al. J Virol, 1985, 83: 949-954.
[45]Herrann JE, et al. J Infect Dis, 1996, 174 (S1): S93-S97.
[46]Streekert D,et al.J Virol,1982,43:379.
[47]贺双腾，何飞舟，伍参荣，等．七味白术散对人轮状病毒在培养细胞内复制的抑制作用．中国中西医结合杂志，1995，15(11)：669-671
[48]伍参荣，杨波，胡建中，等，七味白术散对人轮状病毒感染乳鼠胸腺细胞程序性死亡和IL-2、IL-2R表达的影响，湖南中医学院学报，2001，21(3)：8-10
[49]王慕逖主编．儿科学[M]．第5版．北京：人民卫生出版社，2002：263-267
[50]王萍芬主编．中医儿科学．上海：上海科学技术出版社，1997：54
[51]Jones SC, et al. J Glin Patho,1993,46:1097
[52]全国腹泻病学术研讨会组委会．中国腹泻病诊断治疗方案[J]．中国实用儿科杂志，1998，13(6)：381
[53]Shirota K, et al.J Immunol. 1992, 77:7
[54]贺双腾，何飞舟，伍参荣，等．七味白术散治疗轮状病毒肠炎的临床与实验研究，中国中西医结合杂志，1996，16(3)：132-135
[55]彭新国，邱世翠，李彩玉，等．白术对小鼠免疫功能影响的实验研究．时珍国医国药2001，12(5)：396-397
[56]朱金照，冷恩仁，桂先勇，等．白术、藿香等中药对胃排空、肠推进影响的实验研究．中国中医基础医学杂志，2000；6(1)：21-23
[57]张子理，陈蔚文．党参、黄芪、白术、甘草提取部位对小肠上皮细胞增殖的影响．中药药理与临床，2002，18(1)：10-11
[58]张明发，沈雅琴，朱自平，等．木香的抗腹泻和抗炎作用．药物研究，1999，8(6)：16-17
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[2] Colomina J, TeresaGil M ,Codoner P ,et al .Viral proteins VP1 ,VP2 ,VP6 and NSP2 are strongly precipitated by serum and fecal antibodies from children with rotavirus symptomatic infection[J] . J Med Virol, 1998 , 56 : 58
[3] 陆德源主编．医学微生物学[M]．第4版．北京：人民出版社，1996． 256-258
[4] Esles M . K ,Cohen J . Rotavirus gene structure and fuction[J].Microbiol Rev ,1989 ,53:410
[5] Horie Y , Masamune O , Nakagomic O . Three major alleles of rotavirus NSP4 proteins identified by sequence analysis [ J ] . J Gen Virol, 1997,78 : 2341
[6] Mirazimi A ,Nilsson M ,Sevensson L . The molecular champerone callnexin interacts with the NSP4 enterrotoxin of rotavirus in vivo and in vitro [ J ]. J Virol ,1998,72(11 ):8705
[7] Angel J, Tang B, Feng N ,et al .Srudies of the role for NSP4 in the pathogenesis of homologous murine rotavirus diarrhea[ J ] J Infect Dis ,1998 ,177:455
[8] Haffejee IE The epiemiology of rotavirus infections: a global perspective. J Pediatr Gastroenterol Nutr. 1995,20:275-286．
[9] Cao XR. Akihara S. Fang ZY. et al. Genetic variation in the VP4 and NSP4 genes of human rotavirus serotype 3 (G3 type) isolated in China and Japan .Microbiol Immunol. 1999,43:171-175．
[10] Ann Christine Nyquest. Rotavirus Vaccine[J].Pediatrics Annals ,1999,28(8) : 533-539
[11] Fang Zhaoyin ,Yang Hui , Zhang Jing , et al . Child rotavirus Infection in association with acute gastroen teritis in two Chinese sentinel hospitals[J] . Pediatrics International ,2000,42: 401-405
[12] Niwat Maneekam , Hiroshi Ushijima . Epidemiology of rotavirus infection in Thailand[J] .Pediatrics international ,2000,42:415-412．
[13] Glass RI . Rigore PE.Holman RC . et al. The epidemilolgy of rotavirus diarrhea in the United States: surveillance and estimates of disease burden. J Infect Dis. 1996． 174(suppl 1) : S5-11．
[14] Jeong Kee Seo , Jay G Sim . Overview of rotavirus Infections in Korea[J] . Pediatrics International ,2000,42:406-410．
[15] Ruggeri FM. Declich S. infection among children with diarrhea in Italy. Acute Paediatr suppl. 1999, 88: 66-71
[16] Matson Do, O'Ryan ML. Herrera I. et al . Recal antibody response to symptomatic and asymptomatic rotavirus infections.Jinfec Dis.l993,167:577-583
[17] Gentsch JR, Woods PA, Ra machandran M, et al .Review of Gand P typing results from a global collection of rotavirus, J Infect Dis, 1996,174(Suppl l):30-36
[18] Beards GM ,Desselberger U, Flewett TH. Temporal and geographical distributions of human rotavirus serotypes,1983-1988． J Clin Microbiol, 1989,27:2827-2833．
[19] Ramachandran M , Das BK, Vij A, et al .Unusual diverdiry of human rotavirus G and P genotypes in India.J Clin Miciobiol ,1996,34:436-439．
[20] Gouvea V, Castro L ,Timenetsky MDC, et al .Rotavirus serotype G5 associated with diarrhea
in Brazilian children .J Clin Microbiol. 1994,32:1408-1409.
[21]徐倏，温乐英，王健伟，等。中国部分城市A组转伏病毒感染状况调查及VP7血清型分析，中华实验和临床病毒学杂志，2001，15(1)：77-80
[22]方肇寅，齐锦，杨辉，等。我国1998-1999年流行的婴幼儿腹泻轮状病毒的分型研究，病毒学报，2001，17(1)：17-23
[23]赵聪敏，李为明．乳糖吸收不良和不耐受症．国外医学儿科学分册，1992，19(2：131-134)
[24]Keljo DJ, Kuhn M ,Smith A .Acidification of endosomes is not important for the entry of rotavirus into the cell .J Pediatr Gastroenterol Nutr, 1988,7(2):257-63
[25]Keljo DJ, Smith AK .Characterization of binding of simian rotavirus AS-Ⅱ to cultured epithelial cells. J Pediatr Gastroenterol Nutr, 1988,7(2):249-56
[26]王正明，张君儒，刘震等．婴儿秋季腹泻发病机理初步探讨[J]。中华儿科杂志，1986，24(4)：218-211．
[27]姚英民，邱红明，赵枫．轮状病毒全身感染与病理变化[J]．中华实验和临床病毒学杂志，1998，12(4)：389．
[28]岳伟，史鸽，李呈瑾．小儿轮状病毒腹泻合并多系统器官感染的临床分析[J]．河南医药信息，2002；10(8)：19
[29]李秀珍，龚四堂，区文玑，轮状病毒感染致肝损害和心肌损害342例临床分析[J]．新医学，32(5)：282-283
[30]周最明，刘瑾，封志纯，等．小儿轮状病毒相关性胰腺炎．第一军医大学学报．2001；21(12)：960
[31]Ushijima H, Xin KE, Nishimura S, et al. J Clin Micro, 1994;32(12):2893-2897.
[32]Hongou K,Konish T, Yagi S,et al.Pediatr Neurol, 1998; 18(4):354-357.
[33]Gregorio L, School TM, Sutton CL, et al. Pediatr, 1997; 99(5):739-743.
[34]周水珍，丘朋玲，孙道开；轮状病毒腹泻并惊厥24例[J]，实用儿科临床杂志。2001；16(2)：99-100
[35]宋新民，尹萍；肠溶阿司匹林为主治疗秋季腹泻的临床研究[J]，中国现代医学杂志，2002；12(1)：80
[36]李光．硝本地平治疗婴幼儿轮状病毒肠炎88例疗效观察[J]．医师进修杂志，1997，20(9)：504．
[37]刘万清，许红梅，张爱华，等．SIgA口服液治疗婴幼儿轮状病毒肠炎56例疗效观察[J]，临床儿科杂志，1995，13(4)：244．
[38]Schmitz J. Anti-rotavirus vaccinations[J]. Arch Pediatr, 1999,6(9): 979.
[39]陈宇，王禹，杨景云；婴幼儿轮状病毒肠炎微生态学改变[J]．黑龙江医药科学[J]，2001，24(1)：18-19．
[40]杨国峰，周鹏，王健伟；轮状病毒疫苗研究进展及其转基因植物疫苗的开发前景．生物技术通报，2001，1：16-19．
[41]Vesikari T, et al. Lance, 1983, ⅱ: 807-811.
[42]Kapikian AZ, et al. 11th Nobel Conference (Stockholm) Lund, Sweden: Student-literature, 1986: 192-214.
[43]Clark F, et al. Am J Dis Child, 1986, 140: 350-356.
[44]Midthum K, et al. J Virol, 1985, 83: 949-954.
[45]Herrann JE, et al. J Infect Dis, 1996, 174 (S1): S93-S97.
[46]Streekert D,et al.J Virol,1982,43:379.
[47]贺双腾，何飞舟，伍参荣，等．七味白术散对人轮状病毒在培养细胞内复制的抑制作用．中国中西医结合杂志，1995，15(11)：669-671
[48]伍参荣，杨波，胡建中，等，七味白术散对人轮状病毒感染乳鼠胸腺细胞程序性死亡和IL-2、IL-2R表达的影响，湖南中医学院学报，2001，21(3)：8-10
[49]王慕逖主编．儿科学[M]．第5版．北京：人民卫生出版社，2002：263-267
[50]王萍芬主编．中医儿科学．上海：上海科学技术出版社，1997：54
[51]Jones SC, et al. J Glin Patho,1993,46:1097
[52]全国腹泻病学术研讨会组委会．中国腹泻病诊断治疗方案[J]．中国实用儿科杂志，1998，13(6)：381
[53]Shirota K, et al.J Immunol. 1992, 77:7
[54]贺双腾，何飞舟，伍参荣，等．七味白术散治疗轮状病毒肠炎的临床与实验研究，中国中西医结合杂志，1996，16(3)：132-135
[55]彭新国，邱世翠，李彩玉，等．白术对小鼠免疫功能影响的实验研究．时珍国医国药2001，12(5)：396-397
[56]朱金照，冷恩仁，桂先勇，等．白术、藿香等中药对胃排空、肠推进影响的实验研究．中国中医基础医学杂志，2000；6(1)：21-23
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