蒙药额日赫木—8对SARS 的临床疗效及对受试动物机体免疫功能影响的研究 - 试卷题库,课时课件,试题中心,课件中心,论文,免费下载,教案,计划总结,德育工作

【摘要】目的观察蒙药额日赫木—8 对SARS 的临床疗效及对受试动物机体免疫功能影响。方法 (1)蒙药的临床筛选：在SARS 暴发流行初期，内蒙古科委紧急组织有关蒙医学专家，查阅大量相关古籍文献，经过多轮论证，严格筛选，专项采方，最后确定蒙药“额日赫木—8”方剂用于SARS 临床观察。(2)动物实验：委托解放军302医院药学部对蒙药额日赫木—8与临床同步进行动物实验。试验目的：观察蒙药额日赫木—8对受试动物（正常小鼠与药物所致免疫功能低下小鼠）机体免疫功能的影响。(3)临床观察：在SARS 暴发流行期间，对内蒙古自治区医院在2003年4～5月收治的SARS 住院患者选取21例作为临床对照组，给以抗病毒，预防感染，免疫调节，营养支持，对症治疗；另选取21例SARS 住院病人作为治疗组，在上述治疗基础上加用蒙药额日赫木—8，3g/次，2次/日，冲服，疗程10天。观察两组SARS患者治疗前后的发热、头痛、全身疼痛、乏力、咳嗽、胸闷、呼吸困难、腹泻；白细胞计数，淋巴细胞总数，血小板计数，血尿素氮，血肌酐，谷丙转氨酶，谷草转氨酶；动脉血氧饱和度，胸部X线检查17项指标。结果 (1)治疗组较对照组发热天数平均缩短2.0天，组间差异有显著性，P<0.05；且体温改善疗效积分2.31±0.60，较对照组1.40±0.64，组间差异有显著性，P<0.001。(2)治疗组动脉血氧饱和度，治疗前后组内差异有显著性，P<0.05。(3)两组间胸部X线阴影改善积分治疗组优于对照组，组间差异有显著性，P<0.05。（4）动物实验证实：①蒙药额日赫木—8能增加环磷酰胺模型小鼠血清溶血素含量；②额日赫木—8高剂量及左旋咪唑均能明显增加正常小鼠血清溶血素含量。结论 (1)对本组SARS病人研究结果显示：在西药治疗的基础上加服蒙药额日赫木—8对缩短发热周期，改善机体缺氧，促进肺部阴影吸收有一定的效果。 (2)蒙药额日赫木—8对正常小鼠免疫反应有增强作用及对环磷酰胺所致免疫反应抑制有较强的拮抗作用。其机理有待进一步扩大验证。

    【关键词】   严重急性呼吸综合征（SARS）；额日赫木-8，蒙药；动物试验

    Investigating the clinical efficacy on severe acute respiratory syndrome (SARS) and the immunity of the animals experimented on with Mongolian traditional medicine，erihemu-8

    MA Guo-qiang，ZHANG Han-feng， WANG Li-qin，et al.Respiratory Department， Inner Mongolia Autonomous Region Hospital，Huhehaote 010017，China

    【Abstract】 Objectives To investigate the clinical efficacy of severe acute respiratory syndrome(SARS) and the immunity of the animals experimented on with Mongolian traditional medicine，Erihemu-8.Methods (1)Clinical choice of Mongolian traditional medicine： at the beginning of the epidemicity of SARS. Inner Mongolia Science Committee emergently organized certain Mongolian medicinal experts， they consulted plenty of the related traditional medicine books and literature and finally decided that Mongolian traditional medicine， Erihemu-8， could be used on the cases of SARS after many turns of arguments and the strict choosing of different recipes.(2)Animal experiments： The medical institute of PLA hospital 302 was asked to do the experiments on animals with Erihemu-8 meanwhile it was put into clinical use. Experiment objectives： to investigate the effect of Mongolian traditional medicine， Erihemu-8，on the immunity of the healthy mice and the ones which have weak immunity caused by medicine. (3)Clinical investigation： during the epidemicity of SARS， 21 SARS patients were admitted by Inner Mongolian Hospital between April and May ， 2003. as a controlled group who were treated with anti-virus， antibiotic， immunization and allowance of nutrients： and another 21 SARS patients as clinical treatment group who were treated with both Erihemu-8 (3g once， twice a day， taken orally ， ten days in all ) and the above medicines. 17 parameters of subjects in the two groups are provided for the symptom with fever， headache， pantalgia， fatigue， cough， chest pain， short breath， palpitation； and the test of white cell count，lymphatic cell count， platelet count， blood urea nitrogen， creatinine， alanine aminotransferase， aspartate aminotransferase， oxygen saturation， chest x-ray were taken.Results (1)The results have shown that the fever lasting days in the treatment group are two days less than those in the controlled group on averages， which shows significant difference(p<0.005). The therapeutic score of temperature improvement in treatment group(2.31±0.6) was much higher than that in the controlled group(1.40±0.64)， which also shows significant difference(P<0.001).(2)The oxygen saturation in the treatment group was significantly different before and after the treatment(P<0.05). （3） The improved score of image by the chest x-ray examination in the treatment group was prior to that in the controlled group(P<0.05). （4）The experiments on the animals taking Erihemu-8 proved as follows： ① The amount of the serum hemolysin of the mice animal model made with cyclophosphamide has been increased. ② Both Erihemu-8 and levamisole hydrochloride can obviously increase the amount of serum hemolysin in the healthy mouse examples.Conclusion   (1)The results of the research on the SARS patients have shown that the Erihemu-8 Mongolian traditional medicine combined with western medicine can abbreviate lasting fever time， improve the oxygen shortage， and have an obvious effect on improving pulmonary foci. (2)The Mongolian traditional medicine， Erihemu-8， has the effect on increasing immunity of the healthy mice and the mice animal model with weak immunity caused with cyclophosphamide. Its mechanism should be further identified in the clinical medicine practice.

    【Key words】 severe acute respiratory syndrome（SARS）；erihemu-8， Mongolian medicine；animal experiments

    在2003年抗击SARS期间，我国政府为筛选抗SARS中蒙药物，组织紧急科研攻关。为此我们承担了内蒙古科委下达的“蒙药额日赫木-8对SARS的临床疗效研究”课题。在此同时，国家中医药管理局也紧急启动了SARS的基础和临床科研攻关计划，采取分批滚动，步步跟进方式，第1、2批定点在北京、广东、天津共设立了13个临床研究课题，第3批定点在内蒙古、山西、河北省。因此，我们研究的项目被列入第3批国家定点攻关课题之一，进行对蒙药额日赫木-8对SARS临床疗效更进一步深入研究［1］。

    1 资料与方法

    1.1 蒙药的临床筛选　　在SARS暴发流行初期，内蒙古科委紧急组织有关蒙医学专家，查阅大量相

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