养阴利咽汤治疗慢性咽炎的临床和实验研究
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摘要
慢性咽炎是临床常见症、多发病,其临床表现为以咽喉干燥,痒痛不适,咽内异物感或灼热感、干咳少痰等为主要特征。中医药治疗该病有独特的优势。本课题应用中医理论及现代技术,从临床与实验两方面观察了导师汪冰教授用于临床多年的经验方养阴利咽汤治疗慢性咽炎的疗效。临床观察中,口服养阴利咽汤治疗慢性咽炎70例,治愈率38.85%,总有效率94.29%,明显优于西药对照组(P<0.01)。实验研究采用药理学、组织学以及生物化学方法,制造家兔、小鼠和大鼠的不同病理模型,结果表明养阴利咽汤具有良好的抗炎、抑菌、化痰、止咳、改善微循环等作用,从而达到治疗慢性咽炎的目的。
Chronic pharyngitis(CP) have an higher attack of rate and the most obvious syndromes are that pharyngalgia,dry throat,tussiculation,dry cough,pharyngeal hot feeling,foreign body sensation of pharynx etc.The Traditional Chinese Medicine has special advantage in the aspects of curing CP. This project was selected to seek an effective recipe in treating CP and to study the treating mechanism of it. In the guidance of the theory of traditional Chinese medicine and clinical practice, the cause and pathogenesis on is reviewed in the article. And curative effect and mechanism of Yangyinliyantang(YYLYT) treating CP is researched systematically. In clinical study,70 cases of CP were treated with YYLYT, the clinical cure rate is 38.85%, the total effective rate is 94.29%. The curative effect is better than that of the control group(P<0.01). Pharmacological procedures were utilized to investigate these effects of YYLYT as anti-inflammation, Qi-regulating and phlegm-transformation, and preventive treatment on various kinds of animal model induced among mice, rats or rabbits respectively, supplemented by histopathological and biochemical procedure.Experimental research indicates:preventive and therapeutic effects of YYLYT on CP should be associated with its inhibitng effect on inflammatory changes and to the improving effect blood rheoolgy in pharyngeal mucosa.
Chronic pharyngitis(CP) have an higher attack of rate and the most obvious syndromes are that pharyngalgia,dry throat,tussiculation,dry cough,pharyngeal hot feeling,foreign body sensation of pharynx etc.The Traditional Chinese Medicine has special advantage in the aspects of curing CP. This project was selected to seek an effective recipe in treating CP and to study the treating mechanism of it. In the guidance of the theory of traditional Chinese medicine and clinical practice, the cause and pathogenesis on is reviewed in the article. And curative effect and mechanism of Yangyinliyantang(YYLYT) treating CP is researched systematically. In clinical study,70 cases of CP were treated with YYLYT, the clinical cure rate is 38.85%, the total effective rate is 94.29%. The curative effect is better than that of the control group(P<0.01). Pharmacological procedures were utilized to investigate these effects of YYLYT as anti-inflammation, Qi-regulating and phlegm-transformation, and preventive treatment on various kinds of animal model induced among mice, rats or rabbits respectively, supplemented by histopathological and biochemical procedure.Experimental research indicates:preventive and therapeutic effects of YYLYT on CP should be associated with its inhibitng effect on inflammatory changes and to the improving effect blood rheoolgy in pharyngeal mucosa.
引文
[1]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·慢喉痹.南京,南京中医药大学出版社,1994；1(2)：125-128
[2]郑筱萸中药新药临床研究指导原则(试行)[S]北京,中国科技医药出版社,2002：59
[3]彭顺林,钟渠.慢性咽炎动物模型研究.成都中医药大学学报,1993；22(1)：51-53
[4]陈奇.中药药理研究方法学.北京：人民卫生出版社,1993.356
[5]徐淑云,卡如濂,陈修,等.药理实验方法学.第二版.北京：人民卫生出版社,1991：714.
[6]李仪奎,王钦茂,周金黄,等.中药药理实验方法学.上海：科学技术出版社,1991.299
[7]陈奇.中药药理研究方法学.北京：人民卫生出版社,1993.366-367
[8]陈奇.中药药理研究方法学.北京：人民卫生出版社,1993.641-642
[9]李仪奎,王钦茂,周金黄,等.中药药理实验方法学.上海：科学技术出版社,1991.398
[10]陈意振,鲁莉萍,邹波,等.应用PCR技术检测小儿呼吸道病原体的研究.中国优生与遗传杂志.1997；5：44—45.
[11]杨永弘,沈叙庄,胡翼云.从新关注A族p溶血性链球菌感染.国外医学儿科学分册.1995：22：234
[12]Quinn A, Ward K, Fisehetti VA, et al. Immunologieal relationship between the class Ⅰepitope of strepltococcal M protein Infect Immun.1998;66;4418-4424
[13]CosteA. ENT diseases associated with allergic rhinitis:a review of the literature. Ann Otolaryngol Chir Cervicofac.2000;117:168 - 173.
[14]Ashbangh CD, Moser TJ, Shearer MH, et al. Bacterial determinants of persistent throat colonization and the associated immune response in a primate model of human group A streptococcal pharyngeal infection. Cell Mierobiol.2000;2:283 -292.
[15]郑中立.耳鼻咽喉科诊断学.91-293北京：人民卫生出版社,1996；211-211,291-294,329-330
[16]黄选兆.耳鼻咽喉科学.四版.北京：人民卫生出版社；1995；85-86
[17]王士贞.中医耳鼻喉科学.中国中医药出版社：2003；158
[18]王士贞.中医耳鼻喉科学.中国中医药出版社：2003；162
[19]王本祥.现代中药药理与临床.第一版.天津.天津科技翻译出版公司：2004；732-733
[20]康厚墉,谭斌.慢性咽炎中西医结合治疗近况[J].中西医结合杂志,2003；11(3)：154
[21]Storr M, MeiningA,Allescher HD.Pathophysiology and pharmacyological treatment of gastroesophageal reflux disease.Dig Dis.2000; 18:87-89
[1]司惠琴.蔡福养治疗喉痹经验.河南中医,1998;18(5)：27-29.
[2]李春芳.朱祥成教授治疗虚性喉痹的临床经验.浙江中医学院学报,2000;24(3) ：64-65
[3]梁书新,马素平,高连青.慢性喉痹的辩证施护.忻山西医药杂志,2007；36(11) ：32-33
[4]郑沙盟.慢性咽炎的中医治疗.浙江中医学院学报,2001；25(3)：57-58
[5]张永泉,李烁,刘琳.慢性咽炎的中医辩证与临床治疗.医药产业咨讯,2006；3(27) ：29-31
[6]孙淑兰.慢喉痹的辩证治疗.河北中医,2001；23(8)：45-46
[7]谢坚.李慈春.滋阴利咽汤治疗慢性咽炎65例[J].现代中西医结合杂志,2004；13(9)：1162.
[8]王玉兰..青木香汤治疗慢性咽炎36例.新中医,1997;29(8)：45
[9]陈国锋.干祖望论虚火喉痹中的脾虚阴火证.中医杂志,,2004；37(3)：153
[10]江洁.养阴清肺法为主辨证治疗慢性咽炎咳嗽54例[J].上海中医药杂志,1997；(5)：18.
[11]孙剑光.利咽汤治疗慢性咽炎168例.新中医,2003；31(12)：40
[12]朱龙义,韩风云.滋阴养血法治疗慢性咽炎328例[J].黑龙江中医,1999；(4)：28.
[13]张世宇.清润利咽汤治疗慢性咽炎105例.四川中医,2000;6(18):52
[14]杨德放.理气化痰法治疗慢性咽炎66例[J].陕西中医,1995；16(5):204.
[15]王彦奎,苏春芝,刘晓云.紫蝶饮治疗慢性咽炎72例临床观察[J].河北中医,2004;26(10)：737.
[16]冯道光,冯飞.咽炎宝治疗慢性咽炎286例实用中医药杂志,2004；20(9)：505.
[17]梁晓阳.金嗓散结丸治疗慢性咽炎疗效观察[J].中华实用中西医杂志,2005；18(13)：167.
[18]殷辛龙,郑宏冰.超声雾化吸入中草药煎液治疗慢性咽炎50例.新中医,1997；27(6)：52
[19]祁友松,全功主,付艾妮,等.自拟清咽雾化剂治疗慢性咽炎的疗效观察[J].辽宁中医杂志,2004,31(8)：664.
[20]刘金凤,李娜,祁丕东,等.利咽饮袋泡剂的制备及临床应用中成药.2005,7(6)：附16.
[21]乔孝伟.咽炎康的制备及临床应用[J].中成药,2005,27(2)：245.
[22]汪国华.咽喉舒含吮剂的研制.时珍国药研究2003；4：27161
[23]王仲秋..咽喉茶用于慢性咽炎168例疗效分析.数理医药学杂志,1997；10(3)：288
[24]王瑞友,钱英.贴穴针刺治疗慢性咽炎64例.中国针灸,2000;5:28(6)：64-64
[25]俞国桥.温针治疗慢性咽炎28例[J].上海针灸杂志,1995,14(5)：209.
[26]李天荣.太冲穴位注射治疗慢性咽炎100例.上海针灸杂志,2002；16(6)：11
[27]黄东胜,施翠兰.穴位敷贴配合电疗治疗梅核气187例.新中医,2003；29(7)：33
[30]郑贤明,程春荣.银针放血治疗慢性咽炎150例[J].中医外科杂志,1997,(2)：43.
[2]郑筱萸中药新药临床研究指导原则(试行)[S]北京,中国科技医药出版社,2002：59
[3]彭顺林,钟渠.慢性咽炎动物模型研究.成都中医药大学学报,1993；22(1)：51-53
[4]陈奇.中药药理研究方法学.北京：人民卫生出版社,1993.356
[5]徐淑云,卡如濂,陈修,等.药理实验方法学.第二版.北京：人民卫生出版社,1991：714.
[6]李仪奎,王钦茂,周金黄,等.中药药理实验方法学.上海：科学技术出版社,1991.299
[7]陈奇.中药药理研究方法学.北京：人民卫生出版社,1993.366-367
[8]陈奇.中药药理研究方法学.北京：人民卫生出版社,1993.641-642
[9]李仪奎,王钦茂,周金黄,等.中药药理实验方法学.上海：科学技术出版社,1991.398
[10]陈意振,鲁莉萍,邹波,等.应用PCR技术检测小儿呼吸道病原体的研究.中国优生与遗传杂志.1997；5：44—45.
[11]杨永弘,沈叙庄,胡翼云.从新关注A族p溶血性链球菌感染.国外医学儿科学分册.1995：22：234
[12]Quinn A, Ward K, Fisehetti VA, et al. Immunologieal relationship between the class Ⅰepitope of strepltococcal M protein Infect Immun.1998;66;4418-4424
[13]CosteA. ENT diseases associated with allergic rhinitis:a review of the literature. Ann Otolaryngol Chir Cervicofac.2000;117:168 - 173.
[14]Ashbangh CD, Moser TJ, Shearer MH, et al. Bacterial determinants of persistent throat colonization and the associated immune response in a primate model of human group A streptococcal pharyngeal infection. Cell Mierobiol.2000;2:283 -292.
[15]郑中立.耳鼻咽喉科诊断学.91-293北京：人民卫生出版社,1996；211-211,291-294,329-330
[16]黄选兆.耳鼻咽喉科学.四版.北京：人民卫生出版社；1995；85-86
[17]王士贞.中医耳鼻喉科学.中国中医药出版社：2003；158
[18]王士贞.中医耳鼻喉科学.中国中医药出版社：2003；162
[19]王本祥.现代中药药理与临床.第一版.天津.天津科技翻译出版公司：2004；732-733
[20]康厚墉,谭斌.慢性咽炎中西医结合治疗近况[J].中西医结合杂志,2003；11(3)：154
[21]Storr M, MeiningA,Allescher HD.Pathophysiology and pharmacyological treatment of gastroesophageal reflux disease.Dig Dis.2000; 18:87-89
[1]司惠琴.蔡福养治疗喉痹经验.河南中医,1998;18(5)：27-29.
[2]李春芳.朱祥成教授治疗虚性喉痹的临床经验.浙江中医学院学报,2000;24(3) ：64-65
[3]梁书新,马素平,高连青.慢性喉痹的辩证施护.忻山西医药杂志,2007；36(11) ：32-33
[4]郑沙盟.慢性咽炎的中医治疗.浙江中医学院学报,2001；25(3)：57-58
[5]张永泉,李烁,刘琳.慢性咽炎的中医辩证与临床治疗.医药产业咨讯,2006；3(27) ：29-31
[6]孙淑兰.慢喉痹的辩证治疗.河北中医,2001；23(8)：45-46
[7]谢坚.李慈春.滋阴利咽汤治疗慢性咽炎65例[J].现代中西医结合杂志,2004；13(9)：1162.
[8]王玉兰..青木香汤治疗慢性咽炎36例.新中医,1997;29(8)：45
[9]陈国锋.干祖望论虚火喉痹中的脾虚阴火证.中医杂志,,2004；37(3)：153
[10]江洁.养阴清肺法为主辨证治疗慢性咽炎咳嗽54例[J].上海中医药杂志,1997；(5)：18.
[11]孙剑光.利咽汤治疗慢性咽炎168例.新中医,2003；31(12)：40
[12]朱龙义,韩风云.滋阴养血法治疗慢性咽炎328例[J].黑龙江中医,1999；(4)：28.
[13]张世宇.清润利咽汤治疗慢性咽炎105例.四川中医,2000;6(18):52
[14]杨德放.理气化痰法治疗慢性咽炎66例[J].陕西中医,1995；16(5):204.
[15]王彦奎,苏春芝,刘晓云.紫蝶饮治疗慢性咽炎72例临床观察[J].河北中医,2004;26(10)：737.
[16]冯道光,冯飞.咽炎宝治疗慢性咽炎286例实用中医药杂志,2004；20(9)：505.
[17]梁晓阳.金嗓散结丸治疗慢性咽炎疗效观察[J].中华实用中西医杂志,2005；18(13)：167.
[18]殷辛龙,郑宏冰.超声雾化吸入中草药煎液治疗慢性咽炎50例.新中医,1997；27(6)：52
[19]祁友松,全功主,付艾妮,等.自拟清咽雾化剂治疗慢性咽炎的疗效观察[J].辽宁中医杂志,2004,31(8)：664.
[20]刘金凤,李娜,祁丕东,等.利咽饮袋泡剂的制备及临床应用中成药.2005,7(6)：附16.
[21]乔孝伟.咽炎康的制备及临床应用[J].中成药,2005,27(2)：245.
[22]汪国华.咽喉舒含吮剂的研制.时珍国药研究2003；4：27161
[23]王仲秋..咽喉茶用于慢性咽炎168例疗效分析.数理医药学杂志,1997；10(3)：288
[24]王瑞友,钱英.贴穴针刺治疗慢性咽炎64例.中国针灸,2000;5:28(6)：64-64
[25]俞国桥.温针治疗慢性咽炎28例[J].上海针灸杂志,1995,14(5)：209.
[26]李天荣.太冲穴位注射治疗慢性咽炎100例.上海针灸杂志,2002；16(6)：11
[27]黄东胜,施翠兰.穴位敷贴配合电疗治疗梅核气187例.新中医,2003；29(7)：33
[30]郑贤明,程春荣.银针放血治疗慢性咽炎150例[J].中医外科杂志,1997,(2)：43.