肤痒颗粒联合氯雷他定治疗小儿慢性荨麻疹疗效观察及对血清细胞因子的影响

Effect of Fuyang Granule combined with loratadine on serum cytokines in treating chronic urticaria

目的观察肤痒颗粒联合氯雷他定治疗儿童慢性荨麻疹的疗效,并探讨其对血清细胞因子γ-干扰素(IFN-γ)、白细胞介素-10(IL-10)和白细胞介素-18(IL-18)水平的影响。方法选取2010年6月至2012年12月就诊的86例慢性荨麻疹患儿,随机分为2组,联合组给予肤痒颗粒联合氯雷他定治疗,西药组给予氯雷他定治疗,疗程8周,观察2组的临床疗效。治疗前检测IFN-γ、IL-10和IL-18水平,并与对照组20例健康儿童比较,并在治疗8周后复查上述指标。结果治疗8周后,联合组总有效率显著高于西药组(P<0.05),停药1月后,联合组复发率显著低于西药组(P<0.05)。治疗前,联合组和西药组IFN-γ,IL-10和IL-18水平差异无统计意义(P>0.05),但与对照组比较差异有统计意义(P<0.05);治疗后,联合组和西药组IFN-γ、IL-10和IL-18水平与治疗前比较差异均有统计意义(P<0.05),且组间各项指标比较差异亦有统计意义(P<0.05)。联合组和西药组不良反应比较差异无统计意义(P>0.05)。结论儿童慢性荨麻疹发病与机体免疫失衡有关,肤痒颗粒联合氯雷他定可调节患儿机体免疫功能,提高疗效,降低复发率,且耐受性良好。

Objective To observe the effect of Fuyang Granule combined with loratadine in the treatment of pediatric chronic urticaria, and its influence on the serum cytokine interferon gamma （IFN-γ） , interleukin-10 （IL-10） and interleukin-18 （IL-18）. Methods 86 cases of chronic urticaria children from June 2010 to December 2012 were randomly divided into 2 groups, combined group （45 cases） was given Fuyang Granule combined with loratadine, and western medicine group （41 cases ） was given loratadine only for 8 weeks. The clinical curative effect of the two groups was observed. IFN-γ, IL-10 and IL-18 level were detected before and after treatment, and compared with those of 20 healthy children in the control group. Results After treatment, the clinical curative effect in combined group was significantly higher than that in western medicine group （ P〈0.05 ） ; 1 month after treatment, the recurrence rate in combined group was significantly lower than that in western medicine group （P〈 0.05）. Before treatment, IFN-γ, IL-10 and IL-18 levels between combined group and medicine group（ P〉0.05） , but there were significant difference for the two groups to be compared with that of the control group （ P〈0.05 ） ; and the differences of IFN-γ, IL-10 and IL-18 levels in the two groups after treatment were statistically significant compared with that before treatment （P〈0.05） , and the differences between the two groups were statistically significant （P〈0.05） ; There was no statistical significance in the side effect between combined group and western medicine group （ P〉0. 05 ）. Conclusion The pathogenesis of pediatric chronic urticaria may be associated with immune imbalance. Fuyang Granule combined with loratadine can regulate immune function, improve the curative effect, and reduce the recurrence rate, and it＇s well tolerated.