發(fā)布時間：2018-04-17 11:12

  本文選題：小兒厭食 + 芳香醒脾��； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:香苓開胃方具芳香醒脾,開胃和中之效,臨床用于治療小兒厭食癥。本課題進(jìn)行了香苓開胃方的臨床療效觀察,并進(jìn)行安全性評價、探討其部分藥效學(xué)機制,為研發(fā)小兒厭食院內(nèi)制劑提供臨床與實驗室依據(jù)。方法:1、臨床研究:收集符合納入標(biāo)準(zhǔn)的臨床病例60例(按20%脫失率計算收集72例),口服“香苓開胃方”,2周為一療程,連續(xù)服用四周。分別于治療后2周、治療后4周觀察主癥、次癥改善情況、體重變化,以及治療過程中是否出現(xiàn)不良反應(yīng)。療程結(jié)束后分析、評價其臨床療效與安全性。2、實驗研究:進(jìn)行單次給藥毒性試驗,評價香苓開胃方的安全性;通過小鼠胃排空、小腸推進(jìn)實驗,以及對大鼠胃液量、胃液p H、胃蛋白酶活力和膽汁分泌的影響,探討香苓開胃方治療小兒厭食癥的藥效學(xué)機制。結(jié)果:1、臨床研究結(jié)果:實際收集病例72例,選擇60例進(jìn)行統(tǒng)計分析。香苓開胃方治愈31例,顯效18例,有效9例,無效2例,總有效率96.7%。治療前后證候積分比較,除“形體”改變不明顯外(P0.05,差異無統(tǒng)計學(xué)意義),其余相關(guān)癥狀均可得到明顯改善,且體重增加,差異均有統(tǒng)計學(xué)意義(P0.05)。2、實驗研究結(jié)果:(1)單次給藥毒性試驗表明,香苓開胃組小鼠的最大給藥量為人全日用藥量的160倍,且未觀察到明顯毒性反應(yīng)。(2)小鼠胃排空和腸推進(jìn)影響實驗證實:香苓開胃高、中、低劑量組與正常對照組比較,差異無顯著意義(P0.05)。(3)對大鼠胃液分泌量、胃液p H值、胃蛋白酶活性、膽汁分泌的影響:與正常對照組比較,香苓開胃方低劑量能顯著提高大鼠胃蛋白酶活性(P0.01),而對大鼠胃液分泌量和胃液p H值影響均不明顯(P0.05)。香苓開胃湯高、低劑量組對大鼠膽汁分泌有促進(jìn)作用,其中香苓開胃方高劑量組在30min、60min和120min時與正常對照組相比能顯著增加膽汁分泌量,香苓開胃方低劑量組在30min與正常對照組比較,差異有統(tǒng)計學(xué)意義(P0.05,P0.01)。結(jié)論:香苓開胃方治療小兒厭食癥療效確切,安全可靠。其作用機制與提高大鼠胃蛋白酶活性、促進(jìn)膽汁分泌有關(guān)。值得進(jìn)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.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R272

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