龙胆泻肝汤加减治疗儿童慢性鼻窦炎肝胆湿热证临床研究

Clinical Study on Modified Longdan Xiegan Tang for Chronic Sinusitis in Children with Dampness-heat in Liver and Gallbladder Syndrome

目的:观察龙胆泻肝汤加减治疗儿童慢性鼻窦炎肝胆湿热证的临床疗效。方法:选取慢性鼻窦炎肝胆湿热证患儿120例,按随机数字表法分为观察组和对照组各60例。对照组给予克拉霉素治疗,观察组在对照组基础上给予龙胆泻肝汤加减治疗。观察2组中医证候积分、分泌型免疫球蛋白A (SIgA)水平,评价临床疗效。结果:观察组临床总有效率为91.67%,显著高于对照组的61.67%,差异有统计学意义(P <0.05)。治疗前,2组中医证候积分和SIgA水平比较,差异无统计学意义(P> 0.05)。治疗后,2组中医证候积分较治疗前降低,SIgA水平较治疗前升高;观察组中医证候积分显著低于对照组,SIgA水平显著高于对照组;差异有统计学意义(P <0.05)。Pearson相关系数显示,SIgA水平与中医证候积分呈显著负相关(γ=0.715,P <0.05)。结论:龙胆泻肝汤加减可有效治疗儿童慢性鼻窦炎肝胆湿热证,调控患儿窦口鼻道复合体处分泌物的SIgA水平可能是其作用机制之一。

Objective:To observe the clinical effect of modified Longdan Xiegan tang for chronic sinusitis in children with dampness-heat in liver and gallbladder syndrome. Methods:Selected 120 cases of children with chronic sinusitis severe with dampness-heat in liver and gallbladder syndrome, and divided them into the observation group and the control group randomly, 60 cases in each group. The control group received clarithromycin, while the observation group additionally received modified Longdan Xiegan tang. Observed Chinese medicine syndrome scores,the level of secretory immunoglobulin A(SIgA), and evaluated the clinical effect in both groups. Results: The total effective rate was 91.67% in the observation group,being significantly higher than 61.67% in the control group,difference being significant(P < 0.05). Before treatment,comparing Chinese medicine syndrome scores and the level of SIgA in both groups,there was no significant difference being found(P > 0.05). After treatment,Chinese medicine syndrome scores in both groups were significantly lower than those before treatment,and the level of SIgA was significantly higher than that before treatment;Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group,and the level of SIgA was significantly higher than that in the control group,difference being significant(P < 0.05). According to Pearson correlation coefficient,there existed a significant negative correlation between the level of SIgA and Chinese medicine syndrome scores(r=0.715, P < 0.05).Conclusion:Modified Longdan Xiegan tang can effectively treat chronic sinusitis in children with dampness-heat in liver and gallbladder syndrome. One of its functional mechanism may be regulating the level of SIgA of secretion in ostiomeatal complex of patients.