银翘散最佳煎煮时间治疗(风热犯卫证)急性上呼吸道感染的疗效分析

目的:观察银翘散最佳煎煮时间治疗急性上呼吸道感染(风热犯卫证)的临床疗效及对外周血T淋巴细胞亚群的影响。方法:将127例患者随机按数字表法以1∶1分为对照组62例和试验组65例,对照组采用煮沸后12 min的银翘散汤剂,试验组采用煮沸后6 min的银翘散汤剂,每剂煎取药液200 m L,根据病情,分别给予100 m L/次,2~4次/d,口服。两组疗程均为3 d。观察降温起效时间、解热时间;进行治疗前后中医临床证候评分;检测治疗前后T淋巴细胞亚群水平;进行安全性评价。结果:试验组临床痊显率为69.23%,高于对照组的51.61%(P0.05);用药后3 h和6 h试验组体温低于对照组(P0.05);试验组起效时间和解热时间均短于对照组(P0.05);治疗后试验组咽痛、恶风、头胀痛、鼻塞评分低于对照组(P0.01);治疗后试验组CD3+CD4+和CD4+/CD8+高于对照组(P0.05),CD3+CD8+低于对照组(P0.05)。结论:煮沸后6 min的银翘散治疗急性上呼吸道感染(风热犯卫证)解热、改善症状、提高临床疗效、免疫调节方面均优于煮沸后12 min的银翘散,因此临床建议银翘散的最佳煎煮时间为煮沸后6 min左右。

Curative Effect Analysis of Best Decoction Time of Yinqiao San on Acute Upper Respiratory Infection (Wind Heat Invading Syndrome)

Objective: To observe clinical effect of the best decoction time of Yinqiao San and influence to peripheral blood T lymphocytes subpopulations in treating acute upper respiratory infection. Method: One hundred and twenty-two patients were randomly divided into control group (62 cases) and experimental group (65 cases) by random number table, patients in control group received Yinqiao San for 12 minutes'' boiling, patients in experimental group received Yinqiao San for 6 minutes'' boiling, 200 mL/dose, and according to state of an illness, 100 mL/time, 2-4 times/day. Courses of treatment were 3 days. And onset time of hypothermia and tiem of fever were observed. Before and after treatment, scores of traditional Chinese medicine(TCM) syndrome was graded. Levels of T lymphocytes subpopulations were also detected for safety evaluation. Result: The revealing rate of observation group was 69.23%, which was higher than that was 51.61% in control group (P<0.05). At the third and sixth hours after taking drugs, the temperature of observation group was lower than that in control group (P<0.05). The onset time and antipyretic time in observation group were both shorter than these data in control group (P<0.05). After treatment, Scores of sore throat, head pain, stuffy nose, bad wind in observation group were inferior to the scores in control group (P<0.01). The levels of CD3⁺ CD4⁺, and CD4⁺/CD8⁺ in observation group were superior to the levels in control group (P<0.05). While the CD3⁺ CD8⁺ standards in observation group were lower than these in control group (P<0.05). Conclusion: At the sixth minute after boiling, the Yinqiao San can treat acute upper respiratory infection (the wind heat invading syndrome), improve symptoms and clinical effects. Its immunoregulation was superior to the Yinqiao San which was at the twelfth minute after boiling. Thus, the best time for Yinqiao San boiling was about six minutes after elixation.