發(fā)布時間：2018-01-18 04:04

  本文關(guān)鍵詞：雙參鎮(zhèn)咳湯治療感染后咳嗽（風咳證）的臨床與實驗研究　出處：《南京中醫(yī)藥大學》2017年碩士論文　論文類型：學位論文

  更多相關(guān)文章： 感染后咳嗽 風咳證 雙參鎮(zhèn)咳湯 動物試驗 臨床試驗

【摘要】：目的.：評價導師經(jīng)驗方雙參鎮(zhèn)咳湯治療感染后咳嗽(風咳證)的臨床與實驗療效。方法：1.文獻研究:通過對近十年來(2006年～2016年)有關(guān)感染后咳嗽和風咳證的文章進行閱讀和分析,歸納其現(xiàn)代醫(yī)學病因、發(fā)病機制、治療及轉(zhuǎn)歸、風咳證的溯源、理法方藥、臨床治療等,深入分析感染后咳嗽與風咳證的聯(lián)系。綜述目前中西醫(yī)關(guān)于感染后咳嗽認識及治療存在的不足。2.動物試驗:將氨水誘發(fā)咳嗽的小鼠模型110只,隨機分為模型對照組、蘇黃止咳膠囊中藥對照組、開瑞坦西藥對照組、雙參湯組處方1的4個劑量組、經(jīng)導師加減的雙參湯處方2的4個劑量組(分別相當于臨床劑量的2倍、1倍、1/2倍、1/4倍)每組各10只,對小鼠第一聲咳嗽的時間(潛伏期),3分鐘內(nèi)咳嗽的次數(shù)進行記錄,進行統(tǒng)計學分析。將卵蛋白誘發(fā)過敏性支氣管痙攣的豚鼠模型120只,隨機分為空白對照組、模型對照組、蘇黃止咳膠囊中藥對照組、開瑞坦西藥對照組、雙參湯組處方1的4個劑量組、經(jīng)導師加減的雙參湯處方2的4個劑量組(分別相當于臨床劑量的2倍、1倍、1/2倍、1/4倍)每組各10只,對豚鼠自停止噴霧到出現(xiàn)喘息性抽搐的時間(潛伏期),及發(fā)生跌倒休克的動物數(shù)進行記錄,結(jié)果進行統(tǒng)計學處理3.臨床試驗:將符合感染后咳嗽風咳證納入標準的60名患者,按簡單隨機分組法分兩組:試驗組30例,予導師經(jīng)驗方"雙參鎮(zhèn)咳湯" 口服;對照組30例,予"惠菲寧(美敏偽麻溶液)"治療。療程均為兩周。觀察兩組患者治療前后的中醫(yī)證候積分情況,采用SPSS 19.0進行統(tǒng)計分析,比較兩組療效差異。結(jié)果:1.文獻歸納總結(jié)出了感染后咳嗽風咳證中西醫(yī)醫(yī)學的認識,但仍存在以下不足:現(xiàn)代醫(yī)學方面:(1)國際上尚未有公認的診斷標準。(2)缺乏具備診斷意義的理化指標。(3)以對癥治療為主,副作用明顯。(4)沒有療效評價的統(tǒng)一指標。中醫(yī)學方面:(1)在本病的歸屬上尚無一致認識。(2)缺少統(tǒng)一的中醫(yī)證候?qū)W觀察指標。(3)無一致的治療方案(4)多數(shù)中西醫(yī)結(jié)合治療還不很成熟,多為簡單機械地中藥加西藥聯(lián)合治療。2.通過動物試驗,處方1和處方2在所試劑量范圍內(nèi)對氨水引發(fā)小鼠咳嗽模型及卵白蛋白引發(fā)豚鼠支氣管痙攣模型有減少咳嗽次數(shù)、延長咳嗽潛伏期的作用。對氨水引發(fā)小鼠咳嗽模型處方2作用優(yōu)于處方1,且處方2等倍劑量組與模型組相比,具有顯著統(tǒng)計學差異(P0.05);對卵白蛋白引發(fā)豚鼠支氣管痙攣模型處方1稍優(yōu)于處方2,但與模型組相比,無顯著統(tǒng)計學差異。兩個處方的最佳藥效劑量基本均為臨床等倍劑量。3.臨床試驗結(jié)果:1)兩組治療后主癥咳嗽,次癥咽癢、氣急及中醫(yī)證候總積分均較治療前改善(P0.05)。2)與對照組相比,治療2周后,試驗組在咳嗽,咽癢及中醫(yī)證候總積分上明顯好轉(zhuǎn)(P0.05)。3)兩組的臨床療效上,治療2周后試驗組控顯率為70%,總有效率為100%;對照組控顯率33.3%,總有效率為96.7%,兩組的總有效率相比具有顯著統(tǒng)計學差異,且試驗組的療效優(yōu)于對照組(P0.05)。結(jié)論:導師經(jīng)驗方雙參鎮(zhèn)咳湯在動物試驗和臨床觀察中都對感染后咳嗽有較好的鎮(zhèn)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.

【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R256.11

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