泻肺平喘合剂治疗喘憋性肺炎痰热闭肺证临床研究
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摘要
目的:从理论、临床两方面对泻肺平喘合剂治疗喘憋性肺炎痰热闭肺证的疗效进行系统观察和研究,并探讨其作用机理,为小儿本病本证的医治寻求新方法、新途径。方法:将符合西医毛细支气管和中医肺炎喘嗽痰热闭肺证诊断标准的60例患儿,随机分为治疗组和对照组各30例。两组均在常规治疗的基础上,治疗组给予泻肺平喘合剂灌肠,对照组给予小儿咳喘灵冲剂口服,七天为一疗程。七天后观察两组临床疗效,同时进行对照比较。结果:临床研究显示,治疗组总有效率为96.7%,对照组总有效率为86.7%,治疗组疗效明显优于对照组(P<0.05)。在改善发热、咳嗽、喉间痰鸣、喘憋、肺部啰音、x线胸片异常、T细胞亚群等主要症状、体征、辅助检查方面以及住院时间方面治疗组均优于对照组(P<0.05)。两组在改善鼻煽、精神异常、小便异常方面比较P>0.05,无差异。两组在改善紫绀、咽赤、口渴、大便异常方面比较P<0.05,有差异,治疗组优于对照组。两组在白细胞计数异常改善方面无差异(P>0.05)。同时治疗组疗效与小儿年龄、病情、病程有关(P<0.05):即年龄愈小疗效越差,年龄愈大疗效越好;病情愈轻疗效越好,病情愈重疗效越差;病程愈短疗效越好,病程愈长疗效越差。临床安全性指标研究结果表明:泻肺平喘合剂对于重要脏器无毒副作用。结论:泻肺平喘合剂治疗喘憋性肺炎痰热闭肺证是安全有效的,值得临床推广和应用。
Objective:By observing and investigating the curative effect of Xie Fei Ping Chuan Mixture on treating the disease of phlegm-heat obstracting lungs of children Bronchio1itis and its mechanisation through theory and clinic.We try to find a new method and way which can treat the disease of phlegm-heat obstracting lungs of children Bronchio1itis .Methods:According to the rule of stratified randomization, 60cases had been carefully chosen as study subjects according to the western medicine's diagnostic criterion of children's bronchiolitis and the TCM diagnostic criterion of accumulation of phlegm-heat syndrome of children's bronchiolitis. According to the rule of randomization, all subjects were divided into two groups,the treatment group and control group,30 cases of each. Both groups were given the routine treatment, at the same time,The treatment group was given Xie Fei Ping Chuan Mixture enema.The control group was infused cough and asthma granule oral , seven days for power spirit a treatment. After seven days , The total curative effect of observation between two groups. Results: Clinical studies show that the total efficiency of the treatment group is 96.7%,and the total efficiency of the control group is 86.7%, It indicated the total efficiency of the treatment group was much better than of the control group(P < 0.05). Being compared with the control group,The treatment group in improving main symptoms, signs, auxiliary examination and hospitalization treatment such as fever, cough, asthma, sputum throat to suppress,auscultation on lung, the abnormal condition of chest x-ray, T lymphocyte subsets were superior to the control group (P < 0.05). There was no difference in improving the nose incites, the mental disorders, and the abnormal urine between two groups (P > 0.05). The difference between the treatment group and the control group in improving cyanosis , pharyngeal redness, thirsty, abnormal defecate extisted (P < 0.05),the treatment group was better the control group. Two groups improved the abnormal total of WBC without difference (P>0.05). While the curative effect was relation to age, condition, course (P<0.05),such as:the age is smaller,the curative effect is worse,the age is bigger, the curative effect is betterr; the condition is more serious,the curative effect is worse, the condition is lighter,the curative effect is better;the course is shorter, the curative effect is better; the course is longer, the curative effect is worse. The treatment group clinical safety index results indicated the Xie Fei Ping Chuan Mixture was not with toxic side effects to vital organs.Conclusions: The Xie Fei Ping Chuan Mixture is safe and effective in treating the disease of phlegm-heat obstracting lungs of children Bronchio1itis .It is practical.
Objective:By observing and investigating the curative effect of Xie Fei Ping Chuan Mixture on treating the disease of phlegm-heat obstracting lungs of children Bronchio1itis and its mechanisation through theory and clinic.We try to find a new method and way which can treat the disease of phlegm-heat obstracting lungs of children Bronchio1itis .Methods:According to the rule of stratified randomization, 60cases had been carefully chosen as study subjects according to the western medicine's diagnostic criterion of children's bronchiolitis and the TCM diagnostic criterion of accumulation of phlegm-heat syndrome of children's bronchiolitis. According to the rule of randomization, all subjects were divided into two groups,the treatment group and control group,30 cases of each. Both groups were given the routine treatment, at the same time,The treatment group was given Xie Fei Ping Chuan Mixture enema.The control group was infused cough and asthma granule oral , seven days for power spirit a treatment. After seven days , The total curative effect of observation between two groups. Results: Clinical studies show that the total efficiency of the treatment group is 96.7%,and the total efficiency of the control group is 86.7%, It indicated the total efficiency of the treatment group was much better than of the control group(P < 0.05). Being compared with the control group,The treatment group in improving main symptoms, signs, auxiliary examination and hospitalization treatment such as fever, cough, asthma, sputum throat to suppress,auscultation on lung, the abnormal condition of chest x-ray, T lymphocyte subsets were superior to the control group (P < 0.05). There was no difference in improving the nose incites, the mental disorders, and the abnormal urine between two groups (P > 0.05). The difference between the treatment group and the control group in improving cyanosis , pharyngeal redness, thirsty, abnormal defecate extisted (P < 0.05),the treatment group was better the control group. Two groups improved the abnormal total of WBC without difference (P>0.05). While the curative effect was relation to age, condition, course (P<0.05),such as:the age is smaller,the curative effect is worse,the age is bigger, the curative effect is betterr; the condition is more serious,the curative effect is worse, the condition is lighter,the curative effect is better;the course is shorter, the curative effect is better; the course is longer, the curative effect is worse. The treatment group clinical safety index results indicated the Xie Fei Ping Chuan Mixture was not with toxic side effects to vital organs.Conclusions: The Xie Fei Ping Chuan Mixture is safe and effective in treating the disease of phlegm-heat obstracting lungs of children Bronchio1itis .It is practical.
引文
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[9]高晔珩,麻黄研究进展,陕西中医学院学报,2003;6(26):60.
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[11]柏正平,郑兵,卜献春.复方复方葶苈子胶囊止咳祛痰作用的实验研究.湖南中医药导报,2000;6(5):41～42.
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[1]崔怀景,阎素婷.中西医结合治疗小儿毛细支气管炎60例[J].四川中医,2003, 21(4):64-65.
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[3]倪昭海.双黄连并复方丹参注射液治疗小儿毛细支气管炎54例[J].中国中医急症,2005,14(8):791.
[4]冯晓纯,安笑然.解痉定喘止哮汤加减治疗毛细支气管炎45例[J] .中国社区医师(综合版),2006,8(8):52.
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[8]王菊霞,王岩,徐永红.小青龙汤加减治疗婴幼儿毛细支气管炎43例[J].中医儿科杂志,2007,3(4):38-39.
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[2]国家中医药管理局,中华人民共和国中医药行业标准·中医病证诊断疗效标准,第一版,南京:南京大学出版社.
[3]汪受传.中医儿科学,北京:中国中医药出版社,2002;9:70-71.
[4]郑筱萸,中药新药临床研究指导原则,北京:中国医药科技出版社,2004;12.
[5] Heilman CA.Respiratory and parainflunenza viruses.J Infect Dis,1990;160:402.
[6]王峥,刘长山.毛细支气管炎的诊治和预防进展.[J].国外医学(儿科学分册),2003,30(03):126-129.
[7]王钰,梅爱农.婴幼儿呼吸道合胞病毒感染的机制.[J].现代诊断与治疗,2003,14(5):296-298.
[8]李鲁明,王丽平.毛细支气管炎患儿细胞免疫功能与喘息发作的关系.[[J].实用儿科临床杂志,2003,18(5):400.
[9]高晔珩,麻黄研究进展,陕西中医学院学报,2003;6(26):60.
[10]雷载权,中药学,上海:上海科学技术出版社,1997;6:240.
[11]柏正平,郑兵,卜献春.复方复方葶苈子胶囊止咳祛痰作用的实验研究.湖南中医药导报,2000;6(5):41～42.
[12]李仪奎,刘青云,沈映君等.中药药理学[M].北京:中国中医药出版社,1997:98.
[13]韩军.甘草的药理作用与临床价值[J].实用医药杂志,2003;20(8):17.
[14]戴贵东,闫琳.伪麻黄碱镇痛、抗炎作用的研究.陕西医学杂志,2003;32(7):45.
[15]江苏新医学院编.中药大辞典.(下册)上海:上海人民科技出版社,1977; 2222.
[16]王爱芳.白虎汤的研究.药学通报,1981;(3):61.
[17]赵铁华,杨鹤松,邓淑华等.黄芩叶总黄酮解热作用的实验研究.中国中医药科技,2001:8(3):179-175.
[18]李鸣真.热毒清注射液拆方的药效学研究.中国实验方剂学杂志,1996;2(6):24.
[19]杜立阳,刘悦.青黛颗粒抗炎、镇痛作用的实验研究.中国医科大学学报,2003,32(4):456-457.
[20]沉玉先,魏伟,徐叔云,等.白芍总甙的药理作用及机制[A],吴曙光,抗炎免疫药理学进展[M],上海:第二军医大学出版社,1997:162～167.
[21]王访,苏耀海.甘草的药理作用及临床应用.时珍国医国药,2002,13(5):303～304.
[22]王秀汪主编.药理学.北京:人民卫生出版社,1990:178.
[23] Kimura Y et al.J Pharm Pharmacol 1997:49(8):816～822.
[24]徐理纳,徐德成,张向嘉等.阿魏酸钠抗血小板聚集作用的机理研究对TXA2/PGI2平衡的影响[J].中国医学科学院学报,1984;(6):414.
[25]蔡美珠,唐礴,曾喻.婴幼儿病毒性肺炎免疫功能指标检测的临床意义.中国现代医学杂志,2006;16(15):2346～2347.
[26]陈晓城.麻黄的药理作用研究进展.实用中医药杂志,2005;21(1):84～85.
[27]中国医学科学院血液研究所.大青叶及其所含有效成份靛玉红对免疫系统功能的影响.中华内科杂志,1979;18(2):83.
[28]张鸿炼,吴文蔚.白芍总甙的药理作用与临床应用[J].中国医院药学杂志,1995,8:371.
[29]王斌.白芍总甙对佐剂性关节炎大鼠关节损伤的保护作用中国药理学与毒理学杂志[J].,1996,10:211.
[30] Zheng Y(郑尧),He JH(何景华) ,Gao JH(高建华),etal.effect of Glycyrrhizia polysaccharide on macrophage phagocytosis in mice.J China Med Drugs(中医药学刊),2003,21:254～255.
[1]崔怀景,阎素婷.中西医结合治疗小儿毛细支气管炎60例[J].四川中医,2003, 21(4):64-65.
[2]郑仪宁.中西医结合治疗婴幼儿毛细支气管炎60例.现代中西医结合杂志,2005.14(5):615.
[3]倪昭海.双黄连并复方丹参注射液治疗小儿毛细支气管炎54例[J].中国中医急症,2005,14(8):791.
[4]冯晓纯,安笑然.解痉定喘止哮汤加减治疗毛细支气管炎45例[J] .中国社区医师(综合版),2006,8(8):52.
[5]郭鲜贞.中西医结合治疗小儿急性毛细支气管炎疗效观察[J].湖北中医杂志,2006,28(1):31.
[6]高红伟.中西医结合治疗治疗小儿急性毛细支气管炎45例[J].河南中医杂志,2006,26(7):55.
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