咳可灵合剂联合热毒宁注射液治疗小儿病毒性肺炎的临床研究

Clinical Study on Kekeling Mixture and Reduning Injection in the Treatment of Infantile Viral Pneumonia

目的:观察咳可灵合剂联合热毒宁注射液治疗小儿病毒性肺炎的临床疗效及对免疫功能的影响。方法:选取2017年6月至2018年9月张家港市中医医院收治的病毒性肺炎患儿68例作为研究对象,按照随机数字表法分为观察组和对照组,每组34例。观察组给予咳可灵合剂和热毒宁注射液,对照组给予盐酸氨溴索口服溶液和利巴韦林注射液,观察2组患儿治疗前后发热、咳嗽、痰壅、喘息、肺部听诊及X线胸部正位片变化,及治疗前后患儿外周血IL-6及T淋巴细胞亚群变化情况。结果:2组患者治疗后发热、咳嗽、痰壅、喘息、肺部听诊及胸部X线均较治疗前好转,且观察组喘息症状治疗后较对照组缓解更明显,观察组治疗后总积分较对照组降低更明显,差异有统计学意义(P<0.05)。2组患儿治疗后IL-6、CD8^+均较治疗前降低、CD3^+、CD4^+、CD4^+/CD8^+均较治疗前升高,其中观察组治疗后CD3^+、CD4^+/CD8^+升高较对照组更明显,且观察组降低CD8^+更明显,差异有统计学意义(P<0.05),观察组疗效均较对照组高差异有统计学意义(P<0.05)。结论:咳可灵合剂联合热毒宁注射液治疗小儿病毒性肺炎痰热闭肺证临床疗效确切,能明显改善患儿症状及体征指标,且能有效纠正患儿免疫功能紊乱情况,安全性好,值得临床推广应用。

Objective: To observe the clinical efficacy of Kekeling Mixture combined with Reduning Injection in the treatment of viral pneumonia in children and its effects on immune functions. Methods: A total of 68 children with viral pneumonia in Zhangjiagang Hospital of TCM from June 2017 to September 2018 were randomly divided into an observation group and a control group according to the random number table,with 34 cases in each group.The observation group was given Kekeling Mixture and Reduning Injection,and the control group was given ambroxol hydrochloride oral solution and ribavirin injection.The changes of fever,cough,expectoration,wheezing,lung auscultation and X-ray chest anterior film were observed before and after treatment.And changes in peripheral blood IL-6 and T lymphocyte subsets in children before and after treatment were also observed. Results: After treatment,fever,cough,expectoration,wheezing,lung auscultation and chest X-ray were better than before treatment.Moreover,the improvement of wheezing symptom in the observation group was more obvious than the control group after treatment,and the total score after treatment in the observation group was significantly lower than that of the control group( P >0.05).The levels of IL-6 and CD8^+ in the 2 groups were decreased than those before treatment,and CD3^+,CD4^+ and CD4^+/CD8^+ were increased than those before treatment.The increase of CD3^+ and CD4^+/CD8^+ in the observation group was more obvious than that in the control group.The observation group reduced CD8^+ more obviously,and the difference was statistically significant( P <0.05).The difference of the curative effect between the observation group and the control group was statistically significant( P <0.05). Conclusion: Kekeling Mixture combined with Reduning Injection is effective in the treatment of children with viral pneumonia and heat-blocking lung syndrome.It can significantly improve the symptoms and signs of children,and can effectively correct the immune dysfunction in children.It is safe and worthy of clinical promotion and application.