【作者】 程善廷；

【导师】 罗翌；

【作者基本信息】 广州中医药大学 ， 中医内科学， 2008， 硕士

【摘要】 研究背景:急性病毒性上呼吸道感染是人类的常见、多发病,约80%以上由病毒引起,我国流行病学调查结果显示,城区儿童患病率为86.8%,学生病假的73.0%均是由其造成的,因此急性病毒性上呼吸道感染的防治意义重要。目前西医西药对急性病毒性上呼吸道感染治疗多对症处理;中医中药在退热和抗病毒方面有一定优势,临床研究报道颇多。但对岭南具有兼挟湿证特点的外感发热证候却鲜有深入系统的研究报道。本课题根据名老中医周仲瑛教授治疗病毒性高热的经验结合岭南气候特点以清热解表祛湿为法选药研制成新香冲剂,对其方证毒效的相关性进行研究。研究目的:观察新香冲剂治疗岭南急性病毒性上呼吸道感染辩证属湿热郁表证、风热袭表证的临床疗效,探讨效关系;通过实验室病毒抗体检测,分析证型与病毒分布相关性。研究方法:按纳入和排除标准,选取广东省中医院急诊科门诊、留观及发热门诊患者120例,西医临床诊断为病毒性上呼吸道感染,中医诊断为湿热郁表、风热袭表证患者,采用随机单盲法(就诊卡号末尾数奇偶)分为治疗组和对照组,每组60例,两证型按1:1纳入各组。治疗组予新香冲剂口服(1袋/次,3次/日,共2日),对照组予抗病毒口服液(1支/次,3次/日,共2日),观察体温开始下降时间、首次降至正常时间、完全降至正常时间以及恶寒、汗出、咳嗽、咽痛、鼻塞、头痛、身困重、身酸痛、口渴等临床症状和体征变化:并对其中108例患者进行血清病毒抗体检测。研究结果:1.总体疗效:新香冲剂组对恶寒、鼻塞、头身困重、身酸痛症状改善优于对照组(P＜0.05);但抗病毒口服液组退热较新香冲剂组迅速(P＜0.05);两组体温首次降至正常时间、完全退热时间、体温改善程度、总有效率、其他伴随症状改善比较无显著性差异(P＞0.05)。2.证效关系:新香冲剂对热郁表证总有效率(86.7%)明显高于风热袭表证(73.3%),但两证型总有效率差异无显著性。治疗后湿热郁表证在开始退热时间,头身困重、身酸痛等伴随症状的改善优于风热袭表证(P＜0.05)。3.方效关系:湿热郁表证型内新香冲剂组与抗病毒口服液组间总有效率差异无显著性(P＞0.05);新香冲剂组在开始退热时间、体温首次降至正常时间较抗病毒口服液组短,但无统计学意义:新香冲剂组对身酸痛、头身困重症状改善优于抗病毒口服液组(P＜0.05)。4.证毒关系湿热郁表证型与风热袭表证中病毒频数分布差异无显著性(P＞0.05)。5.药物安全性临床观察过程中,两组均未见局部以及全身性不良反应或严重的毒副作用。结论:1.新香冲剂对急性病毒性上呼吸道感染辨证属湿热郁表证有良好的临床效果,退热迅速,可以明显改善头痛、鼻塞、头身困重、身酸痛等症状,且安全性和耐受性较好。2.湿热郁表证与风热袭表证中流感A/B、副流感、呼吸道合胞等病毒频数分布无显著性差异。更多还原

【Abstract】 BackgroundAcute upper respiratory tract infection is the most common multiple human diseases,about 80 percent caused by a virus,China’s epidemiological investigation showed that the prevalence rate for urban children 86.8%, 73.0%of the sick students are caused by the diseases,focus on prevention of acute upper respiratory tract infection control is important significance.Symptomatic treatment is a main method of Western Medicine Chinese medicine in the cooling and anti-virus advantage has a certain extent recently as research gradually depth,clinical efficacy has been continually enhanced.But for the Lingnan region unique Exogenous fever syndrome and more damp and heat evil in exterior syndrome has little in-depth research reports.According to the old topic of the Chinese Professor Zhou Zhongying’s treatment of the viral fever experience、Lingnan climatic characteristics,Xinxiang granule was made and to research relationship of prescription and effect,to discuss relationship of Syndromes、Virus.ObjectiveTo discuss relationship of prescription and effect of Xinxiang Granules in treating the Acute viral upper respiratory infection from Observing its treatment of the people with damp and heat and with wind and heat syndrome;to analysis relationship of distribution of the virus by laboratory detection.MethodsA total of 120 qualified patients were randomly divided into treatment and controlled groups(By clinics numbers at the end of card).The people with damp and heat syndrome,and with wind and heat was into the group by 1:1.Treatment group was treated by Xinxiang granule,and the control group was treated by Anti-virus oral liquid,to observe the time of the temperature beginning to droping,the first time to normal,fully droping to normal, and Wuhan,Han Chu,cough,pharyngodynia,stuffy nose,headache,body weight hardship,body pain,thirst,and other clinical signs and symptoms of change;of which 108 cases of patients was through laboratory virus antibody detection.Results1.Overall curative effect:Xinxiang granule group was superior to the Anti-virus oral liquid group on the improvement of the symptom of the chill, stuffy nose,body weight hardship,the body soring(P＜0.05);But the Anti-virus oral liquid group brought down a fever faster than the Xinxiang granule group(P＜0.05);Two groups had a non-significance difference on the time of the temperature beginning to droping,the first time to normal, of fully droping to normal,the other symptoms’ improvement(P＞0.05).2.Relationship of syndrome and effect:There was no significant in the difference of the two syndromes of the total efficiency.The damp and heat syndrome group was superior to the wind and heat syndrome group at the beginning of the cooling time,headache,stuffy nose,body weight hardship, body soring(P＜0.05).3.Relationship of prescription and effect:There was no significant in the difference of the total efficiency of the the Xinxiang granule and Anti-virus oral liquid on the damp and heat syndrome.There was no significant on the time of the temperature beginning to droping,the first time to normal the symptom of two groups.Xinxiang granule group was superior to the Anti-virus oral liquid group on the improvement of the symptom of the body weight hardship,the body soring(P＜0.05)4.Relationship of syndromes and virus:There was no significant in the frequency distribution of the virus of the damp and heat,wind and heat syndrome(P＞0.05).5.Drug SafetyNo obvious or serious side effects were observed in the test drug.Conclusion1.Xinxiang Granules treating people with damp and heat syndrome had a good clinical effect,a rapidly cooling,and significantly improved stuffy nose、headache、body weight hardship、body soring,and had a better safety and tolerance2.There was no significant in the frequency distribution of the virus of the damp and heat,wind and heat syndrome.更多还原