热毒清抗人巨细胞病毒作用的临床及实验研究

作者	单位
邢玮	XING Wei, WEN Liangzhen, DONG Jihua, et al (Pathology Department of Tongji Medical University, Wuhan (430030
闻良珍	XING Wei, WEN Liangzhen, DONG Jihua, et al (Pathology Department of Tongji Medical University, Wuhan (430030
董继华	XING Wei, WEN Liangzhen, DONG Jihua, et al (Pathology Department of Tongji Medical University, Wuhan (430030
江汉珍	XING Wei, WEN Liangzhen, DONG Jihua, et al (Pathology Department of Tongji Medical University, Wuhan (430030
李鸣真	XING Wei, WEN Liangzhen, DONG Jihua, et al (Pathology Department of Tongji Medical University, Wuhan (430030

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中文摘要:

探讨中药热毒清抗人巨细胞病毒（ＨＣＭＶ）的临床疗效及体外抗病毒作用。方法：临床检测ＨＣＭＶ抗体，对其中诊断为ＨＣＭＶ活动性感染者１４例采用热毒清口服治疗，疗程１８～３０天；同时应用ＥＬＩＳＡ、ＰＣＲ和贝利婴幼儿发育量表等方法评价其临床疗效。体外实验研究采用病变抑制法在人胚肺（ＨＥＬ）细胞培养上测定热毒清对ＨＣＭＶ　ＡＤ１６９毒株的抑制作用。结果：１４例孕前或孕期活动性感染者，服药１８～３０天后，ＨＣＭＶ－ＩｇＭ全部转阴（１４／１４），血ＨＣＭＶ　ＤＮＡ大部分转阴（７／１０），尿和宫颈分泌物排毒被抑制（４／４，１／１）。其中５例孕前或孕期治疗后分娩足月正常新生儿，２例为无症状排毒新生儿，３例未感染。体外实验研究结果：热毒清的最大无毒浓度（ＴＤ０）为２０μｇ／Ｌ，最小有效浓度（ＭＴＣ）为５μｇ／Ｌ，治疗指数（ＴＩ）为４。表明热毒清具有抗ＨＣＭＶ作用，随药物浓度增高作用增强。结论：中药热毒清是抗ＨＣＭＶ安全、有效的药物，为临床治疗ＨＣＭＶ活动性感染尤其是孕期感染提供了有效的参考。

英文摘要:

To investigate the therapeutic efficacy of traditional Chinese medicine Reduqing (RDQ) against human cytomegalovirus (HCMV) in clinical and its antiviral activity in vitro. Methods: In clinical practice, HCMV antibody was detected to determine if the case was activity infected with HCMV. Fourteen patients were found and treated with RDQ. The drug was orally administered one dose, three times a day, for 18-30 days as one therapeutic course. And the efficacy was evaluated by ELISA, PCR and other methods. The in vitro inbitory activity of RDQ against HCMV AD169 was carried out on human embryo lung fibroblasts (HEL) by cytopathic effect inhibition method. Ganciclovir (GCV) was used for positive control. Results: Fourteen pre-or during pregnant women with HCMV infection were treated with RDQ. Alter 18-30 days of treatment, all of them showed HCMV-IgM negative conversion, HCMV DNA negative conversion in 7/10 cases, and virus excretion by urine and cervix secretion was inhibited in 4/4 and 1/1 case. Five women gave birth to 5 normal newborns at term after treatment, among them 2 were asymptomatic virus carrier, the other 3 were uninfected. Experimental study in vitro showed that the maximal tolerance dosage (TD0) of RDQ was 20μg/L, the minimal therapeutic concentration (MTC) was 5μg/L, 50% inhibitory concentration (IC50) was 5μg/L and the thera peutic index (TI) was 4. It suggested that RDQ had anti-HCMV activity in vitro and the effect increased with its concentration. Conclusion: RDQ is a safe, valuable drug for inhibiting HCMV infection especially dursing pregnancy.

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