【摘要】 目的观察清肺利咽汤联合穴位外敷治疗小儿疱疹性咽峡炎的临床疗效并探讨其作用机制。方法将90例患儿随机分为A、B两组,各45例。A组给予清肺利咽汤口服联合自制溃疡散适量外敷于水突穴、照海穴和足心涌泉穴;B组给予维生素C片联合利巴韦林颗粒口服。5 d为1个疗程。比较两组患儿临床总有效率、症状改善情况、T淋巴细胞亚群、炎性因子及免疫球蛋白水平变化。结果 A组临床总有效率为95.56%,高于B组的73.33%(P<0.05)。A组退热、恢复进食、疱疹消退时间均短于B组(均P<0.05)。治疗5 d后,两组与治疗前比较,白介素-10(IL-10)水平显著升高,人γ干扰素(IFN-γ)水平显著降低(均P<0.05),且A组两因子改善程度优于B组(均P<0.05)。治疗5 d后,A组CD3、CD4和CD4/CD8水平显著高于治疗前,CD8水平显著低于治疗前(均P<0.05),且A组优于B组(均P<0.05)。但B组治疗后各项因子水平与治疗前相近(均P>0.05)。两组治疗前Ig G、Ig A、Ig M等免疫球蛋白水平相近(均P>0.05)。治疗5 d后,A组Ig G、Ig A、Ig M水平显著升高(均P<0.05),且A组各项免疫球蛋白升高程度显著高于B组(P<0.05)。A组1例出现食欲不振,余未见明显不良反应发生;B组4例出现食欲不振,2例出现皮疹,2例出现消化道反应。A组不良反应发生率为2.22%,低于对照组的17.78%(P<0.05)。结论清肺利咽汤联合穴位外敷治疗疱疹性咽峡炎临床疗效确切,可显著改善患儿发热、疱疹等临床症状及体征,不良反应较小,患儿易于接受,其作用可能与其在一定程度上调节患儿机体的免疫功能、改善免疫功能抑制状态、抑制机体炎症反应、增强机体的抗病能力有关。更多还原

【Abstract】 Objective: To observe the clinical effects and mechanism of Qingfei Liyan Decoction combined with external acupoint application on herpangina in children. Methods: 90 cases were randomly divided into group A and group B,45 cases in each. Group A were treated with Qingfei Liyan Decoction,combined with self-made ulcer powder on Shuitu,Zhaohai and Yongquan. Group B were given vitamin C tablets combined with ribavirin particles orally. 5 d was a course of treatment. The general information,clinical total efficiency,symptom improvement,T lymphocyte subsets,inflammatory factors and immunoglobulin levels were compared between the two groups. Results: The total effective rate of group A was 95.56%,significantly higher than 73.33% of group B(P <0.05). The fever,recovery of eating,herpes regression time of group A were significantly shorter than those of group B(P < 0.05). There was no significant difference in the level of IL-10 and IFN-γ between the two groups before treatment(P > 0.05). After 5 days′ treatment,IL-10 levels of the two groups were significantly higher than those before treatment,and the level of IFN-γ was significantly decreased(P < 0.05),and the improvement of the two factors in group A was better than that in group B(P < 0.05). There was no significant difference in the level of CD3,CD4 and CD4/CD8 between the two groups before treatment(P > 0.05). After 5 days′ treatment,the levels of CD3,CD4 and CD4/CD8 in group A were significantly higher than those before treatment(P < 0.05). However,there was no significant difference in group B after treatment(P > 0.05). There was no significant difference in the level of Ig G,Ig A,Ig M and other immunoglobulin between the two groups before treatment(P > 0.05). After 5 days′treatment,the levels of Ig G,Ig A,Ig M and other immunoglobulin in group A were significantly higher than those before treatment with significant difference(P < 0.05),and the level of immunoglobulin of group A was significantly higher than that of group B(P < 0.05). There were 1 cases of anorexia in group A,but there were no obvious adverse reactions;there were 4 cases of anorexia,2 cases of rash,and 2 cases of digestive tract reaction in group B. The incidence of adverse reactions in group A was 2.22%,lower than that of the control group(17.78%)(P <0.05). Conclusion: Qingfei Liyan Decoction combined with external acupoint application on herpangina is effective in improving the clinical symptoms and signs of children with fever and herpes. Adverse reactions are small and children are easy to accept it. It may pay a role by regulating the immune function of children,improving the immune function to suppress the state,inhibiting the body′s inflammatory response,and enhancing the body′s resistance to disease.更多还原