香苓开胃方治疗厌食症临床疗效观察及实验研究

发布时间：2018-04-17 11:12

本文选题：小儿厌食 + 芳香醒脾　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:香苓开胃方具芳香醒脾,开胃和中之效,临床用于治疗小儿厌食症。本课题进行了香苓开胃方的临床疗效观察,并进行安全性评价、探讨其部分药效学机制,为研发小儿厌食院内制剂提供临床与实验室依据。方法:1、临床研究:收集符合纳入标准的临床病例60例(按20%脱失率计算收集72例),口服“香苓开胃方”,2周为一疗程,连续服用四周。分别于治疗后2周、治疗后4周观察主症、次症改善情况、体重变化,以及治疗过程中是否出现不良反应。疗程结束后分析、评价其临床疗效与安全性。2、实验研究:进行单次给药毒性试验,评价香苓开胃方的安全性;通过小鼠胃排空、小肠推进实验,以及对大鼠胃液量、胃液p H、胃蛋白酶活力和胆汁分泌的影响,探讨香苓开胃方治疗小儿厌食症的药效学机制。结果:1、临床研究结果:实际收集病例72例,选择60例进行统计分析。香苓开胃方治愈31例,显效18例,有效9例,无效2例,总有效率96.7%。治疗前后证候积分比较,除“形体”改变不明显外(P0.05,差异无统计学意义),其余相关症状均可得到明显改善,且体重增加,差异均有统计学意义(P0.05)。2、实验研究结果:(1)单次给药毒性试验表明,香苓开胃组小鼠的最大给药量为人全日用药量的160倍,且未观察到明显毒性反应。(2)小鼠胃排空和肠推进影响实验证实:香苓开胃高、中、低剂量组与正常对照组比较,差异无显著意义(P0.05)。(3)对大鼠胃液分泌量、胃液p H值、胃蛋白酶活性、胆汁分泌的影响:与正常对照组比较,香苓开胃方低剂量能显著提高大鼠胃蛋白酶活性(P0.01),而对大鼠胃液分泌量和胃液p H值影响均不明显(P0.05)。香苓开胃汤高、低剂量组对大鼠胆汁分泌有促进作用,其中香苓开胃方高剂量组在30min、60min和120min时与正常对照组相比能显著增加胆汁分泌量,香苓开胃方低剂量组在30min与正常对照组比较,差异有统计学意义(P0.05,P0.01)。结论:香苓开胃方治疗小儿厌食症疗效确切,安全可靠。其作用机制与提高大鼠胃蛋白酶活性、促进胆汁分泌有关。值得进一步深入研究。
[Abstract]:Objective: Xiangling Kaiwei prescription has the effect of aromatherapy to awaken spleen, appetizer and moderate effect, and is used in the treatment of anorexia in children.The clinical curative effect of Xiangling Kaiwei prescription was observed, the safety evaluation was carried out, and some pharmacodynamic mechanisms were discussed, which provided the clinical and laboratory basis for the research and development of children anorexia hospital preparations.Methods: clinical study: 60 cases were collected according to the inclusive criteria (72 cases were collected according to the 20% loss rate, and 72 cases were taken orally "Xiangling Kaiwei" for 2 weeks as a course of treatment and taken continuously for four weeks.The main symptoms, secondary symptoms, weight changes and adverse reactions were observed 2 weeks after treatment and 4 weeks after treatment.At the end of the course of treatment, the clinical efficacy and safety were evaluated. 2. Experimental study: single dose toxicity test was performed to evaluate the safety of Xiangling Kaiwei recipe; gastric emptying in mice, small intestine propulsion test, and gastric juice volume in rats,The effects of gastric juice pH, pepsin activity and bile secretion on the pharmacodynamics of Xiangling Kaiwei recipe in treating anorexia in children were discussed.Results 1. Clinical study results: 72 cases were collected and 60 cases were selected for statistical analysis.31 cases were cured, 18 cases were markedly effective, 9 cases were effective and 2 cases were ineffective. The total effective rate was 96.7.The symptom scores before and after treatment were significantly improved, except that the change of "physique" was not obvious (P0.05), and the other symptoms were significantly improved, and the weight increased.The results of the experiment showed that the maximum dose of mice in Xiangling appetizer group was 160 times as much as that of mice in the whole day, the results of the experiment showed that the maximum dose was 160 times that of the mice in the Xiangling appetizer group, and the results showed that the maximum dose was 160 times that of the mice in the Xiangling appetizer group.The effects of gastric emptying and intestinal propulsion on gastric emptying and intestinal propulsion in mice were not observed. The results showed that there was no significant difference in gastric secretion and gastric juice pH between the high, middle and low dose groups and the normal control group.Pepsin activity and the effect of bile secretion: compared with the normal control group, the low dose of Xiangling Kaiwei recipe could significantly increase the activity of pepsin in rats (P 0.01), but had no significant effect on the secretion of gastric juice and pH value of gastric juice in rats.Xiangling Kaiwei decoction could promote the secretion of bile in rats with high dose and low dose. The high dose group of Xiangling Kaiwei decoction could significantly increase the amount of bile secretion when compared with the normal control group at 30min or 60min and 120min.There was a significant difference between the low dose group of Xiangling Kaiwei recipe and the normal control group in 30min.Conclusion: Xiangling Kaiwei recipe is effective and safe in the treatment of infantile anorexia.The mechanism is related to the enhancement of pepsin activity and the promotion of bile secretion in rats.It is worth further study.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R272

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