健脾饮对学龄前儿童反复呼吸道感染的治疗作用

Therapeutic Effect of Jianpi Yin for Repeated Respiratory Tract Infection in Preschool Children

【目的】探讨健脾饮(由白术、黄芪、鸡内金、黄精、橘红组成)对学龄前儿童反复呼吸道感染(RRTI)的治疗作用及其对T细胞亚群的影响。【方法】采用简单随机法将100例RRTI患儿随机分为两组,在感染间歇期治疗组50例用健脾饮治疗,对照组50例用卡介苗多糖、核酸注射液治疗。两组均治疗6个月,并随访1年,观察两组总疗效,统计两组患儿年平均发病次数和每次患病天数,分别检测两组治疗前后T细胞亚群指标,并与50例正常组进行对照分析。【结果】治疗组近期控制23例,显效18例,有效7例,无效2例,总有效率为96.0%;对照组近期控制22例,显效15例,有效10例,无效3例,总有效率为94.0%。统计结果显示,两组疗效相仿(P>0.05);但治疗组在减少年平均发病次数和每次患病天数方面优于对照组(P<0.05或P<0.01)。临床观察发现,RRTI患儿血清CD3、CD4水平及CD4与CD8比值低于正常儿,CD8水平高于正常儿(P<0.05或P<0.01)。治疗组经健脾饮治疗后血清CD4水平提高,CD8水平下降,CD4与CD8比值增高(与治疗前比较,P<0.05),与对照组比较也均有显著性差异(P<0.05),并基本达到正常组水平(P>0.05)。【结论】健脾饮能有效减少RRTI患儿年平均发病次数和每次发病天数,这可能与其改善RRTI患儿的T细胞亚群指标,提高RRTI患儿的细胞免疫功能有关。

[Objective] To observe the effect of Jianpi Yin （JY, a spleen-strengthening prescription mainly composed of Rhizoma Atractylodis Macrocephalae, Radix Astragali, Endothelium Corneum Gigeriae Galli, Rhizoma Polygonati, Exocarpium Citri Rubrum） on repeated respiratory tract infection （RRTI） in preschool children and to investigate the effect of JY on subgroups of T lymphocytes. [ Methods ] One hundred preschool children with RRTI were equally randomized into groups A and B. During the intermission period of infection, group A was treated with JY and group B with BCG-PSN （bacillus calmette-guerin vaccine polysaccharide nucleic acid） injection. The two groups were treated for 6 months and followed up for one year. After treatment, mean yearly incidence of RRTI and duration of each onset were examined to evaluate the therapeutic effect in the two groups, and parameters of T lymphocytes subgroups were detected and compared with those in 50 healthy controls （group C） before and after treatment. [Results] In group A, 23 were short-term cured, 18 markedly effective, 7 effective and 2 ineffective and the total effective rate was 96.00%, and 22, 15, 10, 3 and 94.00% in group B respectively. The difference of therapeutic effect was insignificant between the two groups （ P 〉 0.05）. However, the effect on decreasing mean yearly incidence of RRTI and duration of each onset in group A was superior to that in group B （ P 〈 0.05 or P 〈 0.01 ）. Serum levels of CD3 and CD4 and CD4/CDs ratio in RRTI children were lower, and serum CDs level higher than those in the healthy （ P 〈 0.05 or P 〈 0.01 ）. After treatment, serum CD4 level and CD4/CDs ratio increased and CDs decreased in group A （ P 〈 0.05 as compared with those before treatment and those in group B）, and were similar to those in the healthy （ P 〉 0.05）. [Conclusion] JY can reduce the mean yearly incidence of RRTI and duration of each onset in preschool children with RRTI, and its mechanism may be related to the regualtion of cellular immune function by improving the parameters of subgroups of T lymphocytes.