【摘要】：目的:對(duì)桔梗白虎顆粒治療小兒急性化膿性扁桃體炎胃火熾盛證的臨床療效進(jìn)行客觀(guān)研究分析,并通過(guò)藥物急性毒性實(shí)驗(yàn)初步評(píng)估其安全性,為臨床應(yīng)用提供依據(jù)。方法:(1)臨床研究:將符合納入標(biāo)準(zhǔn)的患兒隨機(jī)分為觀(guān)察組(桔梗白虎顆粒)和對(duì)照組(阿莫西林克拉維酸鉀分散片(7:1)),每組30例,臨床觀(guān)察1~2療程(3天一療程),觀(guān)察記錄并比較兩組治療前后的證候量化評(píng)分,對(duì)桔梗白虎顆粒的臨床療效進(jìn)行科學(xué)客觀(guān)的分析。(2)藥物急性毒性實(shí)驗(yàn):通過(guò)預(yù)實(shí)驗(yàn)測(cè)定小鼠半數(shù)致死量(LD50),再通過(guò)正式實(shí)驗(yàn)測(cè)定小鼠的1日最大耐受量,以初步評(píng)估桔梗白虎顆粒的安全性。結(jié)果:(1)臨床研究:桔梗白虎顆粒能有效促進(jìn)患兒扁桃體膿性分泌物的吸收、咽部充血的消退,并能改善飲食減少、大便干結(jié)的臨床癥狀。(1)治療后,兩組證候積分均低于治療前,差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示觀(guān)察組與對(duì)照組治療均有效。(2)觀(guān)察組與對(duì)照組治療后的總有效率分別為93.3%、86.7%,差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示觀(guān)察組治療本病優(yōu)于對(duì)照組;(3)治療后證候總積分、主積分對(duì)比,觀(guān)察組均低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示觀(guān)察組在改善總體證候、主要證候方面,臨床療效均優(yōu)于對(duì)照組;(4)治療后,兩組患兒扁桃體膿性分泌物、咽部充血的消退時(shí)間對(duì)比,觀(guān)察組低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),可認(rèn)為觀(guān)察組在扁桃體膿性分泌物吸收、咽部充血消退時(shí)間上優(yōu)于對(duì)照組;(5)治療后,兩組患兒扁桃體外觀(guān)、飲食、大便單項(xiàng)積分比較,觀(guān)察組均低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),可認(rèn)為觀(guān)察組在改善扁桃體外觀(guān)、飲食、大便癥狀方面,臨床療效優(yōu)于對(duì)照組;(6)治療后兩組證候次積分對(duì)比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),在改善次要證候方面兩組治療效果相當(dāng);(7)治療后,兩組患兒咽痛、吞咽困難程度、面色、唇色、口渴程度等單項(xiàng)積分比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),提示在改善這些證候方面,兩組療效相當(dāng)。(8)治療前后兩組患兒血細(xì)胞分析結(jié)果組間對(duì)比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。(9)觀(guān)察組和對(duì)照組患兒治療前后血細(xì)胞分析結(jié)果自身對(duì)比,差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組在改善血細(xì)胞分析結(jié)果異常方面均有效。(10)觀(guān)察組在治療期間未出現(xiàn)不良反應(yīng),對(duì)照組在治療期間出現(xiàn)3例輕度大便稀溏、惡心、飲食減少反應(yīng),兩組例數(shù)相比,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),可認(rèn)為兩組在是否會(huì)引起不良反應(yīng)方面無(wú)可比性。(2)急性毒性實(shí)驗(yàn):預(yù)實(shí)驗(yàn)未測(cè)得半數(shù)致死量(LD50),故通過(guò)正式實(shí)驗(yàn)測(cè)得桔梗白虎顆粒小鼠1日最大耐受量為78.0g/kg,相當(dāng)于成人(60kg)每日用量的200.0倍,可以初步認(rèn)為桔梗白虎顆粒臨床用藥安全。結(jié)論:通過(guò)對(duì)桔梗白虎顆粒的臨床療效觀(guān)察及急性毒性實(shí)驗(yàn),表明桔梗白虎顆粒為治療小兒急性化膿性扁桃體炎胃火熾盛證的有效方藥,且該藥無(wú)明顯毒副作用及不良反應(yīng),臨床應(yīng)用安全有效,值得臨床推廣。
[Abstract]:Aim: to study and analyze the clinical efficacy of Platycodon grandiflorum Baihu granule in treating acute suppurative tonsillitis in children with incandescent stomach fire syndrome, and to evaluate its safety through acute toxicity test of drugs, so as to provide evidence for clinical application. Methods: (1) Clinical study: the children who met the inclusion criteria were randomly divided into two groups: observation group (Platycodon grandiflorum granule) and control group (amoxicillin-clavulanate potassium dispersible tablet (7:1),) with 30 cases in each group. We observed 1-2 courses of treatment (3 days a course of treatment), observed and compared the quantitative scores of syndrome before and after treatment between the two groups. Objective and scientific analysis was carried out on the clinical efficacy of Platycodon grandiflorum White Tiger granules. (2) Acute toxicity test: half lethal dose (LD50) of mice was determined by pre-test, and then the maximum tolerance dose of 1 day was measured by formal experiment. To evaluate the safety of Platycodon grandiflorum White Tiger granules. Results: (1) Clinical study: Platycodon grandiflorum white tiger granule can effectively promote the absorption of purulent secretion of tonsillar, dissipate the congestion of pharynx, and improve the clinical symptoms of diet reduction and stool dry knot. (1) after treatment, it can promote the absorption of suppurative secretion of tonsil and the regression of pharynx congestion. The scores of the two groups were significantly lower than those before treatment (P0.05), suggesting that the treatment of the observation group and the control group were effective. (2) the total effective rates of the observation group and the control group after treatment were 93.3% and 86.7%, respectively. The difference was statistically significant (P0.05), suggesting that the observation group is better than the control group in the treatment of this disease; (3) after treatment, the total integral and main integral of the syndrome in the observation group were lower than those in the control group, the difference was statistically significant (P0.05), suggesting that the observation group is superior to the control group in improving the overall syndrome and the main syndrome aspects; (4) after treatment, the regression time of tonsillar purulent secretion and pharyngeal congestion in the two groups was significantly lower than that in the control group (P0.05), and it could be considered that the observation group was absorbed in tonsillar purulent secretion. The time of regression of pharynx congestion was better than that of control group. (5) after treatment, the scores of tonsillar appearance, diet and stool in the two groups were significantly lower than those in the control group (P0.05), and the observation group could be regarded as improving tonsillar appearance and diet. In the aspect of stool symptoms, the clinical efficacy was better than that in the control group. (6) after treatment, there was no significant difference between the two groups in the scores of syndrome scores (P0.05), and the therapeutic effect of the two groups was the same in improving secondary syndrome; (7) after treatment, there was no significant difference in the scores of dysphagia, facial color, lip color and thirst degree between the two groups (P0.05). (8) there was no significant difference in the results of blood cell analysis between the two groups before and after treatment (P0.05). (- 9). The results of blood cell analysis in the observation group and the control group were self-comparison before and after treatment. The difference was statistically significant (P0.05), suggesting that the two groups were effective in improving the abnormal results of blood cell analysis. (10) the observation group had no adverse reaction during the treatment, while the control group had 3 cases of mild loose stool and nausea during the treatment period. There was no significant difference in the number of cases between the two groups (P0.05). There was no significant difference between the two groups in terms of whether they would cause adverse reactions. (2) Acute toxicity experiment: no half lethal dose (LD50) was measured in the pre-test, but no significant difference was found between the two groups in terms of whether or not they would cause adverse reactions. It is concluded that the maximum tolerance of Platycodon grandiflorum White Tiger granule is 78.0 g / kg, which is 200.0 times that of adult (60kg) daily. It can be concluded that Platycodon grandiflorum White Tiger granule is safe for clinical use. Conclusion: through the observation of clinical curative effect and acute toxicity experiment of Platycodon grandiflorum White Tiger granule, it is shown that Platycodon grandiflorum White Tiger granule is an effective prescription for treating acute suppurative tonsillitis in children, and it has no obvious side effects and adverse reactions. The clinical application is safe and effective and worthy of clinical popularization.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R276.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 張克;牛國(guó)順;鄧?yán)?李寅超;;鮮蘆根水提物對(duì)小鼠細(xì)胞免疫功能的影響[J];中醫(yī)研究;2016年10期

2 趙妮;鄧毅;劉靚;董金香;曼瓊;楊志軍;;甘草內(nèi)生菌20株有效菌株發(fā)酵物與宿主水煎液、總黃酮、總皂苷體外抑菌活性對(duì)比研究[J];中醫(yī)研究;2016年05期

3 陳永超;;阿莫西林克拉維酸鉀對(duì)小兒化膿性扁桃體炎的療效[J];臨床醫(yī)學(xué);2016年04期

4 薛芳喜;姚景春;劉奮;;牛蒡子苷元對(duì)小鼠免疫功能的影響[J];中華中醫(yī)藥學(xué)刊;2016年02期

5 石朝萍;;小兒急性化膿性扁桃體炎26例臨床分析[J];世界最新醫(yī)學(xué)信息文摘;2015年31期

6 張順辰;張紅新;;小兒熱速清口服液聯(lián)合注射用阿莫西林鈉克拉維酸鉀治療急性化膿性扁桃體炎的臨床觀(guān)察[J];中國(guó)藥房;2015年27期

7 馮果;陳娟;劉文;吳增光;陳運(yùn);魏孟梅;;天花粉有效成分及藥理活性研究進(jìn)展[J];微量元素與健康研究;2015年06期

8 孟艷;;中西醫(yī)結(jié)合治療小兒急性化膿性扁桃體炎340例研究[J];世界最新醫(yī)學(xué)信息文摘;2015年67期

9 胡愛(ài)娥;;扁桃體局部點(diǎn)刺法治療風(fēng)熱型小兒急性扁桃體炎30例總結(jié)[J];湖南中醫(yī)雜志;2015年07期

10 于光志;楊珊妹;曹宏;;清熱散結(jié)湯治療小兒急性扁桃體炎肺胃熱盛證38例臨床觀(guān)察[J];中醫(yī)兒科雜志;2015年04期

相關(guān)博士學(xué)位論文 前1條

1 謝勇;桔梗中皂苷的免疫佐劑活性研究[D];浙江大學(xué);2008年

相關(guān)碩士學(xué)位論文 前3條

1 吳正;麻黃的應(yīng)用源流及其配伍規(guī)律研究[D];南京中醫(yī)藥大學(xué);2016年

2 武劍;柴胡多糖對(duì)巨噬細(xì)胞免疫功能的調(diào)節(jié)及對(duì)TLR4信號(hào)通路的影響[D];復(fù)旦大學(xué);2012年

3 高陽(yáng);牛蒡苷元鈣拮抗和抗流感病毒作用的實(shí)驗(yàn)研究[D];遼寧中醫(yī)學(xué)院;2001年

，

本文編號(hào)：2456024