桃金娘油在耳鼻喉科疾病中的应用进展

本文综述了桃金娘油的药理及临床,并对近5年来桃金娘油药物在耳鼻喉科临床应用进展情况进行回顾。标准桃金娘油肠溶胶囊在治疗鼻炎及鼻窦炎、咽炎、扁桃体炎、分泌性中耳炎等疾病均有报道,标准桃金娘油肠溶胶囊疗效确切,不良反应少,已广泛应用于耳鼻喉科疾病中。     

舒利迭联合标准桃金娘油治疗AECOPD的疗效观察

目的探讨沙美特罗氟替卡松（舒利迭）联合标准桃金娘油在慢性阻塞性肺疾病急性期（AECOPD）的临床疗效。方法 40患者随机分为对照组和治疗组（舒利迭加标准桃金娘油）各20例。两组入院期间均给于常规抗感染、吸氧和平喘对症治疗,试验组加用舒利迭和标准桃金娘油,共随访观察2周,观察2组患者的症状及血气改善情况、肺功能情况并分析。结果治疗组（舒利迭加标准桃金娘油）在临床效果,祛痰作用和综合临床评价等方面都较治疗前明显改善（P〈0.05）。结论舒利迭和标准桃金娘油共同作用对AECOPD患者疗效确切,使用安全,值得临床常规使用。     

桃金娘的化学成分、药理作用和临床应用研究进展

桃金娘为桃金娘科桃金娘属植物,以根、叶和果入药,具有养血、止血、涩肠、固精之功效。桃金娘的成熟果实富含黄酮苷、酚类;根和树皮含有鞣质、生物碱等;叶的主要成分为桃金娘油,同时富含黄酮苷、水解鞣质。桃金娘具有抗氧化、抗菌、抗病毒、降糖等药理活性,还可治疗呼吸系统、耳鼻喉疾病,在医药、保健品和化妆品行业中具有广泛的应用价值。主要对桃金娘的化学成分、药理作用及临床应用研究进行综述,为桃金娘资源的综合利用和开发研究提供科学依据。     

标准桃金娘油治疗慢性阻塞性肺疾病的系统评价

目的系统评价标准桃金娘油治疗慢性阻塞性肺疾病(COPD)的疗效。方法计算机检索Cochrane图书馆、PubMed、EMBASE、中国生物医学文献数据库(CBM)、中文学术期刊全文数据库(CNKI)、维普(VIP),检索时间自建库截止至2012年2月。对纳入的随机对照试验(RCT)进行方法学质量评估,并用RevMan 5.0软件进行Meta分析。结果共纳入6个RCT,研究结果显示,标准桃金娘油联合常规治疗组的总有效率明显优于常规治疗组,差异有统计学意义[RR=1.21,95%CI(1.04,1.41),P=0.01];标准桃金娘油联合常规治疗组的总有效率与盐酸氨溴索联合常规治疗组相似,差异无统计学意义[RR=1.11,95%CI(0.96,1.29),P=0.15]。在改善患者血气分析结果方面,标准桃金娘油组不仅明显优于空白对照,还明显优于盐酸氨溴索。结论标准桃金娘油可用于治疗COPD。但因纳入研究质量较低,上述结论还需高质量、大样本的研究进一步验证。     

桉柠蒎软胶囊的质量控制和临床应用研究进展

桉柠蒎软胶囊是由北京九和药业生产的新一代黏液促排药物,其有效成分为桉油精、柠檬烯、α-蒎烯,与标准桃金娘油（吉诺通,德国保时佳大药厂生产）相同,分别来源于桃金娘科桉属植物、芸香科桔属植物、松科松属植物,临床广泛用于治疗耳鼻喉科及其他呼吸系统疾病.现对其质量控制方法和临床应用进行总结,以期为临床合理应用提供参考.     

标准桃金娘油治疗稳定性肺结核并慢性阻塞性肺病急性发作期30例

目的：观察标准桃金娘油在治疗稳定性肺结核并慢性阻塞性肺病（COPD）急性发作期的疗效。方法：60例稳定性肺结核并COPD急性发作期患者随机分成两组,每纽各30例。治疗组在常规治疗（控制感染,解痉平喘）基础上口服标准桃金娘油300mg,po tid;对照组仅给予常规治疗。观察两组治疗前后肺功能、动脉血气及临床症状。结果：治疗后,治疗组第1秒用力呼气客积（FEV1）和FEV．占预计值百分比,血气及临床症状评分等有明显改善（P〈0．05）,与对照组比较,差异有统计学意义（P〈0．05）。结论：标准桃金娘油治疗稳定性肺结核并COPD急性发作期有效。     

雾化吸入桃金娘油对全麻围手术期患者防治呼吸道感染的疗效观察

目的 全麻插管术后患者呼吸道感染高发,探讨运用雾化吸入桃金娘油防治围手术期呼吸道感染的方法和疗效.方法 根据防治方法不同,将患者随机分为三组,分别用桃金娘油雾化、常规雾化及不予雾化吸入三种方式处理,将临床资料进行回顾性对比分析.结果 以常规雾化为对照组相比,桃金娘油(吉诺通)组总有效率明显高出,差异有统计学意义(P<0.05),而对非雾化组的差异性更明显(P<0.05).结论 桃金娘油防治呼吸道感染方面其具有独特的作用机理,将其运用到全麻围手术期雾化吸入能有效的防治全麻手术患者的呼吸道感染.     

标准桃金娘油肠溶胶囊治疗儿童急性支气管炎的临床观察

目的观察标准桃金娘油肠溶胶囊用于儿童急性支气管炎的临床疗效。方法将167例急性支气管炎患儿随机分为观察组89例和对照组78例。观察组给予标准桃金娘油肠溶胶囊口服,对照组给予盐酸氨溴索片口服。比较2组临床疗效、平均病程及不良反应。结果观察组总有效率为93.3%高于对照组的89.7%,平均病程为(11.24±2.15)d短于对照组的(13.41±2.51)d,胃肠道反应发生率为3.8%低于对照组的16.9%,差异均有统计学意义(P<0.05和P<0.01)。2组均未出现肝、肾功能异常。结论标准桃金娘油肠溶胶囊治疗儿童急性支气管炎疗效显著,不良反应少。     

标准桃金娘油肠溶胶囊治疗慢性支气管炎感染加重期的疗效观察

目的　探讨标准桃金娘油 (MgrtolStandardized)肠溶胶囊治疗慢性支气管炎感染加重期的疗效。方法　 98例患者被随机分为两组 :A组 (实验组 )、B组 (对照组 )。分别口服标准桃金娘油肠溶胶囊及氨溴索片 ,观察相关指标并进行比较。结论　A组在疗效上明显优于B组 ,P <0 0 5 ,标准桃金娘油肠溶胶囊是值得推荐的治疗呼吸道炎症的良效药物     

润喉汤联合标准桃金娘油治疗慢性喉炎的疗效观察

目的探讨润喉汤联合标准桃金娘油治疗慢性喉炎的疗效。方法选择本院门诊慢性喉炎病例60例,随机分为观察组和对照组各30例。观察组用中药润喉汤1剂/d煎服,联合标准桃金娘油胶囊1粒/次,3次/d口服。对照组单纯用标准桃金娘油胶囊（用法同上）,4周一疗程,治疗后门诊随访6个月,对2组病例的治疗效果进行评价。结果总有效率分别是观察组86.67%,对照组60.0%,观察组明显优于对照组（P〈0.01）。结论润喉汤联合标准桃金娘油治疗慢性喉炎是较为有效的治疗方法。     

标准桃金娘油治疗慢性支气管炎和COPD的系统评价

目的:系统评价标准桃金娘油治疗慢性支气管炎和慢性阻塞性肺疾病(COPD)的疗效及安全性。方法:计算机检索Co-chrane图书馆(2011年第3期)、EMbase、PubMed、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)关于标准桃金娘油治疗慢性支气管炎和COPD的随机对照试验(RCT)。对纳入研究的方法学质量进行评价,应用RevMan5.10软件对数据进行Meta分析。结果:共纳入15项RCT,包括1617名患者。Meta分析结果显示,与对照组比较,标准桃金娘油治疗慢性支气管炎和COPD能够显著提高治疗总有效率[RR=1.24,95%CI(1.15,1.35),P<0.00001];改善血气分析,提高氧分压(PaO2)[MD=7.55,95%CI(4.60,10.50),P<0.00001],降低二氧化碳分压(PaCO2)[MD=-5.46,95%CI(-6.69,-4.24),P<0.00001];改善肺功能,提高每秒用力呼气容积(FEV1%)[MD=7.27,95%C(I5.98,8.56),P<0.00001];改善临床症状体征;减少急性发作次数[RR=0.58,95%C(I0.42,0.79),P<0.05],差异均有统计学意义。在不良反应发生率方面,与对照组比较差异无统计学意义。结论:标准桃金娘油治疗慢性支气管炎和COPD有效,安全性好。但由于纳入研究质量不统一,本结论尚需要更多大样本、高质量RCT予以证实。     

标准桃金娘油联用布地奈德治疗分泌性中耳炎疗效

目的：观察应用标准桃金娘油（吉诺通）口服及布地奈德喷鼻治疗分泌性中耳炎的疗效。方法：75例（89耳）分泌性中耳炎患者随机分为对照组（35例,42耳）和治疗组（40例,47耳）,对照组给予常规用药治疗;治疗组在常规用药治疗上加服吉诺通,布地奈德喷鼻。治疗两周后,对比两组的治疗效果。结果：治疗组显效34耳（72．3％）,有效7耳（14．9％）,总有效41耳（87．23％）;对照组显效24耳（57．1％）,有效5耳（11．9％）,总有效29耳（69．0％）,两组比较有统计学差异,P〈0．05。结论：加服标准桃金娘油和布地奈德喷鼻治疗分泌性中耳炎疗效比常规用药治疗更有效．     

仙璐贝滴剂治疗儿童鼻窦炎的安全性和有效性观察

目的观察仙璐贝滴剂治疗儿童鼻窦炎的安全性和有效性。方法142例患儿随机分为治疗组、对照1组、对照2组,分别口服仙璐贝滴剂、盐酸氨溴索片、标准桃金娘油肠溶胶囊,均连服7d后观察3组临床疗效及不良反应发生情况。结果治疗组、对照1组、对照2组的总有效率分别为90.91%、72.50%、72.22%,治疗组的临床疗效较对照1组、对照2组有显著改善(P<0.05);不良反应发生率分别为4.5%、5.0%、5.6%,3组均无显著性差异(P>0.05)。结论仙璐贝滴剂治疗儿童鼻窦炎的临床疗效优于盐酸氨溴索片和标准桃金娘油肠溶胶囊,在安全性方面与后二者相当。     

桃金娘油辅助治疗C型鼓室导抗图的分泌性中耳炎

目的 :观察桃金娘油辅助治疗C型鼓室导抗图的分泌性中耳炎的疗效。方法 :将 92例 (112耳 )该病的病人随机分为 2组。治疗组 5 0例 (5 8耳 ) [男性 2 8例 ,女性 2 2例 ,年龄 (38±s 6 )a]在咽鼓管扩张再通鼓室注药 (地塞米松 +糜蛋白酶 )术的基础上 ,应用桃金娘油胶囊 30 0mg(儿童用 12 0mg) ,po ,tid× 15d。对照组 4 2例 (5 4耳 ) [男性 2 2例 ,女性 2 0例 ,年龄 (39± 5 )a]用三磷腺苷 (adeno sinetriphosphate)片 4 0mg(儿童用 2 0mg) ,po ,tid× 15d。结果 :治疗组的听力 ,耳鸣 ,耳堵塞感 ,鼓室图峰压值 ,随访 0 .5a的疗效稳定性均明显优于对照组 (P <0 .0 1) ,未见不良反应。结论 :桃金娘油是治疗C型鼓室导抗图的分泌性中耳炎有效、安全的辅助治疗药     

Standardized myrtol attenuates lipopolysaccharide induced acute lung injury in mice

Context: Standardized myrtol, an essential oil containing primarily cineole, limonene and α-pinene, has been used for treating nasosinusitis, bronchitis and chronic obstructive pulmonary disease (COPD).

Objective: To investigate the effects of standardized myrtol in a model of acute lung injury (ALI) induced by lipopolysaccharides (LPS).

Materials and methods: Male BALB/c mice were treated with standardized myrtol for 1.5?h prior to exposure of atomized LPS. Six hours after LPS challenge, lung injury was determined by the neutrophil recruitment, cytokine levels and total protein concentration in the bronchoalveolar lavage fluid (BALF) and myeloperoxidase (MPO) activity in the lung tissue. Additionally, pathological changes and NF-κB activation in the lung were examined by haematoxylin and eosin staining and western blot, respectively.

Results: In LPS-challenged mice, standardized myrtol at a dose of 1200?mg/kg significantly inhibited the neutrophile counts (from 820.97?±?142.44 to 280.42?±?65.45, 10³/mL), protein concentration (from 0.331?±?0.02 to 0.183?±?0.01, mg/mL) and inflammatory cytokines level (TNF-α: from 6072.70?±?748.40 to 2317.70?±?500.14, ng/mL; IL-6: from 1184.85?±?143.58 to 509.57?±?133.03, ng/mL) in BALF. Standardized myrtol also attenuated LPS-induced MPO activity (from 0.82?±?0.04 to 0.48?±?0.06, U/g) and pathological changes (lung injury score: from 11.67?±?0.33 to 7.83?±?0.79) in the lung. Further study demonstrated that standardized myrtol prevented LPS-induced NF-κB activation in lung tissues.

Discussion and conclusion: Together, these data suggest that standardized myrtol has the potential to protect against LPS-induced airway inflammation in a model of ALI.     

Efficacy and tolerability of myrtol standardized in acute bronchitis. A multi-centre, randomised, double-blind, placebo-controlled parallel group clinical trial vs. cefuroxime and ambroxol

Myrtol standardized (Gelomyrtol forte) is a phytotherapeutic extract (distillate) consisting mainly of three monoterpenes: (+)alpha-pinene, d-limonene and 1,8-cineole. OBJECTIVE: This study describes and compares the efficacy, safety and tolerability of a 2-week treatment with myrtol stand. (4 x 300 mg, day 1-14), cefuroxime (CAS 55268-75-2) (2 x 250 mg daily for day 1-6), ambroxol (CAS 18683-91-5) (3 x 30 mg for day 1-3, 2 x 30 mg for days 4-14) and matched placebo in acute bronchitis. PATIENTS: 676 male and female outpatients, aged > or = 18 years, with acute bronchitis of recent onset (within last 5 days), with an FEV1 > 75% of the normal EGKS-value and without evidence or suspicion of chronic pulmonary disease or any further confounding illness were included in the study. INTERVENTION: Patients were randomly assigned to a 2-week treatment course with either myrtol stand. (N = 170), cefuroxime (N = 171), ambroxol (N = 163) or placebo (N = 172) in a double-blind, placebo-matched, parallel-group fashion. Evaluations were at baseline (visit 1), after 1 and 2 weeks of treatment (visits 2 and 3) and at 2 weeks after conclusion of the treatments (visit 4). CRITERIA: Responder- and non-responder rates (primary), signs (abnormal auscultation), symptoms (daily diary data on nightly cough, coughing fits during the day, sputum consistence and general well-being; visit data on bronchial hyperreactivity and absence/presence of associated symptoms), FEV1, overall efficacy, absence of relapse, safety and tolerability (adverse events, laboratory screens, vital signs and physical examination). Criteria were evaluated for the intention-to-treat data-set (ITT) and the 'efficacy evaluable' sample (EAP), i.e. excluding patients with missing values (incl. discontinued non-responders and drop-outs for other reasons) at the time of assessment. RESULTS: The signs and symptoms of acute bronchitis regressed readily in all treatment groups, but regression was slower and less complete in the patients treated with placebo. In patients treated with placebo, the acute bronchitis was considered to have deteriorated to such an extent that discontinuation was indicated ('non-responder') in 36 patients (ITT: 20.9%, 95% CI: 15.1 to 27.8% and EAP: 21.3%, CI: 15.4 to 28.3%) after 1 week (visit 2) and in 19 further patients (ITT: 11.0%, CI: 6.8 to 16.7%; EAP: 14.8%, CI: 9.2 to 22.2%) after 1 further week (visit 3). In contrast, in the group of patients treated with myrtol stand. the non-responder rates at visits 2 and 3 were only 5.3% (ITT, CI: 2.4 to 9.8%; EAP: 5.4%, CI: 2.5 to 10.0%) and 1.2% (ITT, CI: 0.1 to 4.2%; EAP: 1.3%, CI: 0.2 to 4.7%); the responder rates at visit 2 were statistically significantly higher (p < 0.001) for myrtol stand. (ITT: 92.9%, CI: 88.0 to 96.3) compared to placebo (ITT: 77.3%, CI: 70.3 to 83.4), and similar to those for cefuroxime (ITT: 92.4%, CI: 87.4 to 95.9) and ambroxol (ITT: 89.6%, CI: 83.8 to 93.8%). The superiority of the active treatments vs. placebo with little difference among the treatments was confirmed for all further criteria of evaluation. There was no evidence of bronchoconstriction or relapse in any treatment group for the patients continuing treatment (i.e. for those who were not discontinued because of non-response). The treatments were safe and comparably well tolerated. CONCLUSION: Compared to placebo, treatment with myrtol stand. was well tolerated but evidently superior in terms of efficacy, resulting in a more rapid and more complete recovery; although well comparable with the other active treatments, myrtol stand. tended to be superior to cefuroxime and ambroxol for several ancillary criteria. Myrtol stand. is a well-evidenced alternative to antibiotics for acute bronchitis without specified infective agent, without the risk to promote the development of bacterial resistance.     

标准桃金娘油肠溶胶囊致过敏反应

1例52岁女性患者,因贲门息肉入院。因左肺下叶炎性病变,给予盐酸氨溴索注射液30 mg滴斗入,注射用头孢美唑钠2 g静滴。治疗7 d后,患者仍痰多且黏稠不易咳出,给予标准桃金娘油肠溶胶囊300 mg,服药后1 h患者出现胸闷、气短、恶心,胸腹部、腰背部及双侧大腿间出现片状皮疹伴瘙痒等急性过敏反应的症状,立即给予持续低流量吸氧,盐酸异丙嗪注射液25 mg肌注,氯雷他定分散片10 mg口服,30 min后症状缓解。停用标准桃金娘油肠溶胶囊后未再出现类似反应。