双参镇咳汤治疗感染后咳嗽（风咳证）的临床与实验研究

发布时间：2018-01-18 04:04

本文关键词：双参镇咳汤治疗感染后咳嗽（风咳证）的临床与实验研究　出处：《南京中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的.：评价导师经验方双参镇咳汤治疗感染后咳嗽(风咳证)的临床与实验疗效。方法：1.文献研究:通过对近十年来(2006年～2016年)有关感染后咳嗽和风咳证的文章进行阅读和分析,归纳其现代医学病因、发病机制、治疗及转归、风咳证的溯源、理法方药、临床治疗等,深入分析感染后咳嗽与风咳证的联系。综述目前中西医关于感染后咳嗽认识及治疗存在的不足。2.动物试验:将氨水诱发咳嗽的小鼠模型110只,随机分为模型对照组、苏黄止咳胶囊中药对照组、开瑞坦西药对照组、双参汤组处方1的4个剂量组、经导师加减的双参汤处方2的4个剂量组(分别相当于临床剂量的2倍、1倍、1/2倍、1/4倍)每组各10只,对小鼠第一声咳嗽的时间(潜伏期),3分钟内咳嗽的次数进行记录,进行统计学分析。将卵蛋白诱发过敏性支气管痉挛的豚鼠模型120只,随机分为空白对照组、模型对照组、苏黄止咳胶囊中药对照组、开瑞坦西药对照组、双参汤组处方1的4个剂量组、经导师加减的双参汤处方2的4个剂量组(分别相当于临床剂量的2倍、1倍、1/2倍、1/4倍)每组各10只,对豚鼠自停止喷雾到出现喘息性抽搐的时间(潜伏期),及发生跌倒休克的动物数进行记录,结果进行统计学处理3.临床试验:将符合感染后咳嗽风咳证纳入标准的60名患者,按简单随机分组法分两组:试验组30例,予导师经验方"双参镇咳汤" 口服;对照组30例,予"惠菲宁(美敏伪麻溶液)"治疗。疗程均为两周。观察两组患者治疗前后的中医证候积分情况,采用SPSS 19.0进行统计分析,比较两组疗效差异。结果:1.文献归纳总结出了感染后咳嗽风咳证中西医医学的认识,但仍存在以下不足:现代医学方面:(1)国际上尚未有公认的诊断标准。(2)缺乏具备诊断意义的理化指标。(3)以对症治疗为主,副作用明显。(4)没有疗效评价的统一指标。中医学方面:(1)在本病的归属上尚无一致认识。(2)缺少统一的中医证候学观察指标。(3)无一致的治疗方案(4)多数中西医结合治疗还不很成熟,多为简单机械地中药加西药联合治疗。2.通过动物试验,处方1和处方2在所试剂量范围内对氨水引发小鼠咳嗽模型及卵白蛋白引发豚鼠支气管痉挛模型有减少咳嗽次数、延长咳嗽潜伏期的作用。对氨水引发小鼠咳嗽模型处方2作用优于处方1,且处方2等倍剂量组与模型组相比,具有显著统计学差异(P0.05);对卵白蛋白引发豚鼠支气管痉挛模型处方1稍优于处方2,但与模型组相比,无显著统计学差异。两个处方的最佳药效剂量基本均为临床等倍剂量。3.临床试验结果:1)两组治疗后主症咳嗽,次症咽痒、气急及中医证候总积分均较治疗前改善(P0.05)。2)与对照组相比,治疗2周后,试验组在咳嗽,咽痒及中医证候总积分上明显好转(P0.05)。3)两组的临床疗效上,治疗2周后试验组控显率为70%,总有效率为100%;对照组控显率33.3%,总有效率为96.7%,两组的总有效率相比具有显著统计学差异,且试验组的疗效优于对照组(P0.05)。结论:导师经验方双参镇咳汤在动物试验和临床观察中都对感染后咳嗽有较好的镇咳效果。
[Abstract]:Objective: To evaluate the tutor experience. Shuangshen Decoction in the treatment of cough cough after infection (wind cough syndrome) clinical and experimental efficacy. Methods: 1. literature research: Based on the recent ten years (2006 ~ 2016) related cough after infection and wind cough syndrome articles were read and analyzed, summed up the modern medical pathogenesis the pathogenesis, treatment, and outcome of the wind cough syndrome of prescription, clinical treatment, in-depth analysis of cough after infection with the wind cough syndrome linked. The review of current traditional Chinese and Western Medicine on the understanding and treatment of cough after infection problems of.2. animal experiment: the ammonia induced cough in mice model 110, random divided into model control group, Chinese medicine control group Suhuangzhike capsule clarityne, western medicine group, 4 dose groups of Shuangshen Decoction group of 1 prescriptions, 4 dose groups after the prescription of Shuangshen Decoction and mentor 2 (respectively, equivalent to clinical dose 2 times, 1 times, 1/2 times, 1/4 times) each 10 rats in each group of mice, the first cough time (incubation period), the number of 3 minutes of cough were recorded for statistical analysis. The ovalbumin induced allergic bronchospasm guinea pig model of 120 rabbits were randomly divided into control group, model control group, Suhuang capsule of traditional Chinese medicine group, western medicine clarityne the control group, 4 dose groups of Shuangshen Decoction group of 1 prescriptions, 4 dose groups after the prescription of Shuangshen Decoction and mentor 2 (respectively, equivalent to clinical dose 2 times, 1 times, 1/2 times, 1/4 times) with 10 rats in each group of guinea pigs, self stop spraying into asthmatic convulsions time (latency), and the number of animal falls with shock records, the results were statistically analyzed in 3. clinical trials: 60 patients with post infectious cough wind cough syndrome criteria, according to a simple random grouping method is divided into two groups: 30 cases in the experimental group, to guide teachers "experience of Shuangshen oral antitussive Decoction"; The control group of 30 cases, treated with "Hui Feining (Pseudoephedrine Hydrochloride Chlorphenamine Maleate and Dextromethorphan Hydrobromide Solution)". The treatment lasted for two weeks. To observe the TCM Syndromes of two groups of patients before and after treatment, SPSS 19 was used for statistical analysis, comparison of efficacy between the two groups. Results: 1. the literature summarized the understanding of post infection cough wind cough syndrome of traditional Chinese medicine and Western medicine medicine, but there are still the following problems: modern medicine: (1) International has not yet accepted diagnostic criteria. (2) the lack of physical and chemical indicators have diagnostic significance. (3) for symptomatic treatment, obvious side effects. (4) there is no unified index in the evaluation of curative effect of traditional Chinese medicine: (. 1) there is no unanimity in the disease attributable to. (2) lack of unified science of TCM syndromes observed. (3) no consistent treatment (4) the majority of integrated traditional Chinese and Western medicine treatment is not very mature, multi joint treatment of.2. through animal experiments for the simple machinery of traditional Chinese medicine with western medicine, prescription 1 and prescription 2 In the range of reagent amount of ammonia caused mice cough model and ovalbumin have decrease the frequency of cough in guinea pig model induced bronchospasm, extend the cough incubation period of cough induced by ammonia. The effect is better than that of model 2 prescription prescription 1 and 2 times, compared with the prescription dose group and the model group, the difference was statistically significant (P0.05) lead to ovalbumin; guinea pig bronchial spasm model is slightly better than the 1 Prescription prescription 2, but compared with the model group, there was no statistically significant difference. The best dose of two prescriptions were the basic test results to clinical doses of.3. clinical trial: 1) the main symptoms of cough in two groups after treatment, secondary symptoms of itchy throat, total score shortness of breath and TCM syndromes were better than those before treatment (P0.05).2) compared with the control group, after 2 weeks of treatment, the experimental group in cough, pharyngeal itching and total score of Chinese medicine symptom significantly improved (P0.05).3) the clinical curative effect of two groups, 2 weeks of treatment The experimental group after the control rate was 70%, the total effective rate was 100%; the control group control rate was 33.3%, the total effective rate was 96.7%, the total efficiency of the two groups compared to the difference was statistically significant, and the efficacy of the experimental group than the control group (P0.05). Conclusion: the tutor experience of Shuangshen Decoction in the animal experiment of cough and the clinical observation of cough after infection has antitussive effect better.

【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R256.11

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