冬菀止咳颗粒治疗急性支气管炎(风寒袭肺证)的临床及实验研究

Clinical and Experimental Research on Dongyuanzhike Granule in Treating Acute Bronchitis with Syndrome of Wind-cold Attacking Lung

目的:探讨冬菀止咳颗粒对急性支气管炎(风寒袭肺证)的疗效和“肺鼻同治”理论的实效性。方法:采用随机双盲双模拟多中心的临床观察方法对412名急性支气管炎患者进行与通宣理肺汤疗效对照,用动物试验测试冬菀止咳颗粒镇咳,祛痰,抗炎,抗菌,抗病毒,解热作用。结果:临床观察表明试验组疗效明显高于对照组(P<0.01),中医症状积分比较,P<0.01。动物试验表明冬菀止咳颗粒明显降低电刺激对豚鼠呼吸振幅变化的影响和氨水气雾引起的小鼠咳嗽;能促使小鼠以721型分光光度于558nm波长处比色测定的排酚红量明显增多,促进大鼠排痰量明显增多,高剂量下明显对抗蛋清引起的大鼠足跖肿胀,降低冰醋酸所致小鼠腹腔毛细血管通透性增加;牛津杯法体外抗菌试验表明0.5g生药量/ml时对乙型链球菌、大肠杆菌有体外抑制作用,1.0g生药量/ml时对金黄色葡萄球菌,肺炎球菌,乙型链球菌,大肠杆菌有体外抑制作用,降低金黄色葡萄球菌引起的小鼠病死率;对体内外流感病毒感染具有较明显的抑制作用;对酵母所致家兔体温升高有明显解热作用。结论:冬菀止咳颗粒治疗急性支气管炎(风寒袭肺证)效果明显,具备明显镇咳,祛痰,抗炎,抗病毒,解热作用和一定抗菌作用。应用“肺鼻同治”理论指导治疗风寒袭肺所致的咳嗽证可进一步提高临床疗效。

Objective： To discuss the curative effect of Dongyuanzhike Granule on acute bronchitis with syndrome of wind-cold attacking lung and the actual effect of ＂together treatment of lung and nose＂ theory. Methods： Contrasted with the curative effect of Tongxuan Lifei decoction, 412 patients with acute bronchitis were given clinical observation with a multicenter randomized double-blind and double-simulation method. And the effects of Dongyuanzhike Granule on preventing cough, eliminating phlegm, anti-inflammatory, anti-virus, and antipyretic were tested by animal experiment. Results： Clinical observation showed that the experimental group was significantly higher than control group, P 〈 0.01 ; and the comparison of traditional Chinese medicine symptom score, P 〈 0.01. Animal experiment showed that Dongyuanzhike Granule can significantly lower the effect of electrical stimulation on changes of cavy breathing amplitude and the mouse cough induced by ammonia; it significantly increased the amount of phenol red of mice colorimetric determination with 721-nm spectrophotometer in 558nm wavelength, and obviously increased the amount of eliminated phlegm. In high doses it can induce obviously opposite rat voix pedis swelling induced by albumen, and reduce the increased capillary permeability of mouse abdomihal cavity induced by glacial acetic acid. Oxford cup in vitro antibacterial medicine cup showed that it had vitro inhibitory action on beta streptococcus and colibacillus with crude drug content of 0.5g/ml; it had vitro inhibitory action on staphylococcus aureus, pnettmococcus, beta streptococcus and colibaeillus with crude drug content of 1.0g/ml, and decreased the death rote of mice caused hy staphylococcus aureus. It had significant inhibition action on vivo and vitro influenza virus infection and had the obvious anfipyrefic effect on rabbit fervescence caused by yeast. Conclusion： Dongyuanzhike Granule has obvious effects on acute bronchitis with syndrome of wind-cold attacking lung in terms of significant preventing cough effect, eliminating phlegm effect, anti-inflammatory, anti-virus, and antipyretic effects and certain antibacterial effect. Applleation of ＂together treatment of lung and nose＂ theory to guide treatment of cough caused by wind-cold attacking lung can be used to further enhance clinical efficacy.