【摘要】 目的探讨凉膈散化裁方联合干扰素α-2b治疗小儿疱疹性咽峡炎的临床疗效,及其心肌保护作用。方法采用随机数字表法将120例疱疹性咽峡炎患儿分为对照组和观察组各60例。对照组在常规治疗基础上予干扰素α-2b,1次/d,雾化吸入;观察组在对照组基础上予凉膈散化裁方,0.5~1剂/d,水煎,分3~4次口服。2组均连续治疗5 d。观察2组临床疗效,记录2组患儿发热、疱疹、流涎消退时间及恢复进食时间,于治疗前后观察2组患儿心肌损伤情况,检测炎症指标及心肌酶谱变化,比较不良反应情况。结果治疗组总有效率为96.67%(58/60),对照组为85.00%(51/60),治疗组明显优于对照组(P<0.05)。治疗组退热时间、疱疹消失时间、恢复进食时间、流涎消失时间较对照组明显缩短(P<0.05)。与本组治疗前比较,2组治疗后肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白Ⅰ(cTnⅠ)水平明显降低(P<0.05);2组治疗后比较,治疗组CK-MB、LDH、cTnⅠ水平明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后白细胞计数(WBC)、中性粒细胞计数(GRAN)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平明显降低(P<0.05);2组治疗后比较,治疗组外周血WBC、GRAN、hs-CRP、TNF-α水平明显低于对照组(P<0.05)。对照组不良反应发生率高于治疗组(P<0.05)。结论凉膈散化裁方联合干扰素α-2b可缩短疱疹性咽峡炎患儿临床症状消失时间,保护受损心肌,抑制机体炎性状态,且不良反应小。更多还原

【Abstract】 Objective To explore the clinical efficacy and myocardial protection of modified Lianggesan Decoction combined with interferon α-2 b for the treatment of infantile herpetic angina pharyngitis. Methods Totally 120 children with infantile herpetic angina were selected and divided into the control group(60 cases) and the treatment group(60 cases) according to the random number table method. Interferon α-2 b was given to the control group on the basis of routine treatment, once a day, atomization inhalation; Patients in the treatment group were treated with modified Lianggesan Decoction on the basis of the control group, half or one dosage per day, decoction, three or four times a day, orally, for 5 d. The clinical efficacy of both groups was observed. Fever, herpes, salivate fading away and recovery time of food intake were recorded. Myocardial injury of children before and after treatment was observed, and relevant inflammatory markers and myocardial enzyme were detected. Adverse reactions in the two groups were compared. Results The total effective rate was 96.67%(58/60) in the treatment group and 85.00%(51/60) in the control group, and the treatment group was significantly higher than the control group(P<0.05). Fever, herpes disappearance time, salivate fading away and recovery time of food intake in the treatment group were significantly shorter than the control group(P<0.05). Compared with before treatment, the levels of creatine kinase isoenzyme(CK-MB), lactate dehydrogenase(LDH) and cardiac troponin Ⅰ(cTnⅠ) were significantly lower in the two groups(P<0.05). The levels of CK-MB, LDH and cTnⅠ in the treatment group were significantly lower than those in the control group(P<0.05). Compared with before treatment, the levels of leukocyte count(WBC), neutrophil count(GRAN), high-sensitivity C-reactive protein(hs-CRP) and tumor necrosis factor-α(TNF-α) in the peripheral blood were significantly reduced in both groups(P<0.05). The levels of WBC, GRAN, hs-CRP and TNF-α in the peripheral blood of the treatment group were significantly lower than those in the control group(P<0.05). The incidence of adverse reactions in the control group was higher than that in the treatment group(P<0.05). Conclusion Modified Lianggesan Decoction combined with interferon α-2 b can shorten the time for clinical symptoms to disappear in children with herpetic angina, protect the damaged myocardium, inhibit the inflammatory state of the body, and have fewer side effects.更多还原