| Objective: Qing Re Jie Du Tablets include internal dose and the fumigation, had the role of antibacterial, antibiral and antipyretic, anti-inflammatory and regulation of immune system. Clinically, it were used to treatment with erysipelas. By studying bacteriostasis of Qing Re Jie Du Tablets in vivo and vitro, mechanism and the clinical effects, we will got a comprehensive and comprehension about the effect of Qing Re Jie Du Tablets. And the study will provide sufficient theoretical basis for clinical use.Method:1. For exploring the bacteriostasis of Qing Re Jie Du Tablets in vitro,we used paper spreading method and the test tube dilution method,carried on the inhibition zone diamerter and MIC,by the β-hemolytic streptococcus。golden yellow staphylococcus and colibacillus.2. The erysipelas of rats’ model were induced by β-hemolytic streptococcus. The rats were randomly divider into 8 groups: model group,amoxicillin group,Wu Shen Tang high dose group,Wu Shen Tang low dose group, internal Qing Re Jie Du Tablets high dose group,internal Qing Re Jie Du Tablets low dose group, internal Qing Re Jie Du Tablets high dose+ fumigation,internal Qing Re Jie Du Tablets low dose+ fumigation. The third day after the model gavage,once a day, for 7 days. Every day the rats’ conditiong and body weight were rocord. At the 2,3,5,7,9 day, the diameter of swelling were measured. Seven days after administration, elisa was used to measure the expression of NO、TNF-α、IL-1βin serum. The histological and pathological changes in the inflammatory site was explored by light microscope and the extent of damage was measured by semi-quantitative score method.3.The 84 patients of limb erysipelas were randomly divided into treatment group and control group; treatment group take the internal Qing Re Jie Du Tablets and fumigation, while the control group intravenous drip of penicillin sodium; after four weeks treatment, observed local symptoms, detected blood WBC, ESR and CRP level.Result:1.The MIC of internal Qing Re Jie Du Tablets with standard and clinical β-hemolytic streptococcus was 85.94mg/ml, the inhibition zone diamerter with standard strains was 19.76mm; The MIC of fumigation with standard and clinical β-hemolytic streptococcus was 121.88mg/ml, with standard and clinical golden yellow staphylococcus was 121.88mg/ml and the the inhibition zone diamerter with standard strains was 20.01mm; The MIC of internal Qing Re Jie Du Tablets with standard golden yellow staphylococcus was 171.88mg/ml, while the MIC with the clinical stsains was 343.75mg/ml; Internal and fumigation of Qing Re Jie Du Tablets had certain bacteriostasis with standard and clinical colibacillus, the MIC were between 343.75 and 687.50mg/ml.2. ① Weight: Since the third day, the weight velocity of the rats treating with β-hemolytic streptococcus were lower than the rats in control group. The weight velocity of rats in Wu Shen Tang high dose group, Wu Shen Tang low dose group, internal Qing Re Jie Du Tablets high dose+ fumigation and internal Qing Re Jie Du Tablets low dose+ fumigation were higher than the rats in model group.② Diameter of swelling: Since the second day, there was no significant difference with the diameter of swelling between each group; Since the third day, the diameter of swelling of the rats treating with β-hemolytic streptococcus was greater than the rats in control group and the difference was significant(P<0.05); The diameter of swelling of the rats in Wu Shen Tang high dose group, Wu Shen Tang low dose group, internal Qing Re Jie Du Tablets high dose group, internal Qing Re Jie Du Tablets low dose group, internal Qing Re Jie Du Tablets high dose+ fumigation, internal Qing Re Jie Du Tablets low dose+ fumigation were reduced. In the 7th and 9th day, the difference were significant(P<0.05).③NO: Compared with control group, the serum NO in model group were higher(P<0.05). Compared with model group, the serum NO in Wu Shen Tang high dose group, Wu Shen Tang low dose group, internal Qing Re Jie Du Tablets high dose group, internal Qing Re Jie Du Tablets low dose group, internal Qing Re Jie Du Tablets high dose+ fumigation and internal Qing Re Jie Du Tablets low dose+ fumigation were lower, the difference in Wu Shen Tang high dose group, Wu Shen Tang low dose group and internal Qing Re Jie Du Tablets high dose+ fumigation were significant(P<0.05).④ TNF-α: Compared with control group, the serum TNF-α in model group were higher(P<0.01); Compared with model group, the serum TNF-α in Wu Shen Tang high dose group and internal Qing Re Jie Du Tablets low dose+ fumigation were lower(P<0.05), the serum TNF-α in internal Qing Re Jie Du Tablets high dose+ fumigation were highly reduced(P<0.01), the serum TNF-α in Wu Shen Tang low dose group, internal Qing Re Jie Du Tablets high dose group, internal Qing Re Jie Du Tablets low dose group were reduced.⑤ IL-1β: The serum IL-1β in model group were higher(P<0.01), compared with control group; Compared with model group, the serum IL-1β in Wu Shen Tang high dose group, Wu Shen Tang low dose group, internal Qing Re Jie Du Tablets high dose group, internal Qing Re Jie Du Tablets low dose group, internal Qing Re Jie Du Tablets high dose+ fumigation, internal Qing Re Jie Du Tablets low dose+ fumigation were reduced with no significant difference.⑥ Semi-quantitative score: Compared with model group, the score in Wu Shen Tang high dose group, Wu Shen Tang low dose group, internal Qing Re Jie Du Tablets low dose group and internal Qing Re Jie Du Tablets low dose+ fumigation were significantly reduced(P<0.05), the score in internal Qing Re Jie Du Tablets high dose group and internal Qing Re Jie Du Tablets high dose+ fumigation were rduced with no significant difference.3. The total effective rate was 95%, compared with the control group, the rate had a significant diuretic effect(P<0.05). After treatment, syndrome score, ESR, WBC, CRP decreased significantly(P<0.01); Compared with the control group, syndrome score and CRP of treatment group were decreased significantly(P<0.01), ESR was decreased significantly(P<0.05), while WBC decreased with no signigicant difference.Conclusion: Internal Qing Re Jie Du Tablets and fumigation had anti-bacterial effects on standard and clinical β-hemolytic streptococcus in vitro and vivo, at the same time the effects were significantly in clinical; When internal Qing Re Jie Du Tablets used in combination with fumigation, the effect superior than Wu Shen Tang. The mechanism may related to reducing NO、TNF-α、IL-1βin serum, inflammation and swelling. |
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