还尔金防治支气管哮喘患儿反复呼吸道感染的临床研究

Clinical study of huanerjin's effect on repeated respiratory tract infection in bronchial asthma children

目的探讨还尔金防治支气管哮喘(简称哮喘)并反复呼吸道感染(RRTI)的疗效及机制。方法在常规方法治疗哮喘的基础上,随机选取120例哮喘并RRTI的患儿(其中男81例,女39例,≤3岁31例,3～7岁67例,>7岁22例。病程≤1年41例,1～3年72例,>3年7例。反复上呼吸道感染49例,反复下呼吸道感染71例)按3∶1顺序分为还尔金治疗组(≤3岁,5g/次,2次/d;3～5岁,5g/次,3次/d;>5岁,10g/次,2次/d),和黄芪颗粒对照组(分别为2g/次,2次/d;2g/次,3次/d;4g/次,2次/d)均连服3个月。二组在年龄、性别、病程及病情等方面有可比性。由专人定期随访、观察、记录上或下呼吸道感染次数、病情、治疗情况及咳喘、发热、出汗、便秘、食欲等1年。对其中治疗组30例在治疗前和治疗后查免疫功能。结果还尔金组显效率74.44%,总有效率94.44%,显著优于黄芪颗粒组(分别为56.67%和90.00%,P<0.05)。治疗组30例治前IgG、IgA、CD3+、CD4+、CD8+均较正常儿显著下降(P值均<0.05),治疗后较治疗前显著升高(P值均<0.05),与正常儿童差异无统计学意义。CD4+/CD8+无明显变化,IgM治后明显下降(P<0.01),与正常儿童差异无统计学意义。治疗组一疗程后便秘消失,食欲明显好转,黄芪颗粒无此变化。治疗组少数出现大便次数增多,1周左右恢复,未见其他不良反应。结论还尔金防治哮喘并RRTI的疗效明显优于黄芪颗粒。其机制可能是通过调节免疫功能紊乱,使之趋于平衡有关。还尔金安全、有效、服用方便、依从性好,值得推广应用。

Objective To study effects and mechanism of huanerjin treatment on children bronchial asthma（asthma） and recurrent respiratory tract infection （RRTI）. Methods Random selection of 120 children with asthma and RRTI after routine asthma treatment,including male 81cases,female 39 cases. G3 years old 31 cases,3-7 years old 67 cases,〉7 years old 22 cases. Treatment 〈1 year 41 cases,1-3 years 72 cases and 〉 3 years 7 cases. Repeated upper respiratory tract infection 49 cases and repeated lower respiratory tract infection 71 cases. Patients were divided into 2 groups with comparable age, sex, diseaseprocess,state of an illness and so on. Group A with 90 children were treated with huanerjin （〈3 years old 5 g bid,3-5 years old 5 g tid and 〉7 years 10 g bid. Group B with 30 children were treated with huangqikeli as control （2 g bid,2 g tid and 4 g hid respectively）. Patients were followed up for one year to record lower or upper respiratory tract infection, including lower respiratory tract infection or the frequency of illness, treatment and Kechuan, fever, sweating, constipation, loss of appetite and so on. In group A, 30 patients were tested for immune function before and after treatment. Results Effectiveness and total effective rate in group A （huanerjin treated） were 74.44% and 94.44% respectively,which are significantly higher than that of the control group （56.67% and 90.00% respectively, P 〈0.05）. IgG,IgA,CD3,CD4,and CD8 readings of the 30 children selected from group A were significantly lower than normal children before treatment （ P 〈 0.05）. After treatment, these readings were comparable with normal children, significantly higher than that before treatment （ P 〈0.05）. IgM reading was significantly higher than normal children before treatment （ P 〈0.05）, but after treatment, it drops to normal level, significantly higher than that before treatment （ P 〈0.05）. CD4/CD8 showed no significant change. In group A,after a course of medical treatment, constipation disappeared obviously improved appetite, while no such observation in the control group. A few patients in group A showed increased frequencies and recovered in about one week. No other side effects were observed in group A. Conclusions Effects of huanerjin on children asthma with RRTI significantly higher than that of the huangqikeli. The immunological readings suggested that huanerjin may restore the immune system disorder of these patients to normal. Huanerjin is safe,effective,easy to take and compliance, and is worth popularizing.