甘露消毒丹加减辅助治疗儿童传染性单核细胞增多症湿热证30例临床观察

Clinical observation on 30 cases of infectious mononucleosis in children with damp-heat syndrome treated by modified Ganlu Xiaodu Dan(甘露消毒丹) as adjuvant therapy

目的观察甘露消毒丹加减辅助治疗儿童传染性单核细胞增多症(IM)湿热证的临床疗效。方法选取2017年9月至2018年12月西南医科大学附属中医医院儿科确诊的IM湿热证患儿60例,按随机数字表法分为治疗组和对照组,各30例。对照组给予肌肉注射干扰素治疗,治疗组在对照组治疗方法的基础上口服中药汤剂甘露消毒丹加减治疗。2组均连续治疗5 d后,观察临床疗效、治疗前后中医证候积分和实验室指标值恢复正常时间。结果治疗组总有效率为93.3%(28/30),显著高于对照组的73.3%(22/30),2组比较,差异有统计学意义(P<0.05)。治疗组在退热时间和咽痛、颈部淋巴结肿大缓解时间方面均显著短于对照组,2组比较,差异有统计学意义(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义,具有可比性(P>0.05);治疗后,2组中医证候积分较同组治疗前均显著下降(P<0.05),且治疗组下降更显著(P<0.05)。治疗组异型淋巴细胞(ALY)、WBC和T淋巴细胞亚群恢复正常时间均显著短于对照组,2组比较,差异有统计学意义(P<0.05)。结论甘露消毒丹加减辅助治疗儿童IM湿热证疗效满意,不仅可明显缩短发热、咽痛和颈部淋巴结肿大消失或缓解时间,而且可显著降低中医证候积分,值得临床推广应用。

Objective To observe the clinical efficacy of modified Ganlu Xiaodu Dan(甘露消毒丹) in the treatment of infectious mononucleosis(IM) in children with damp-heat syndrome.Methods Sixty IM in children with damp-heat syndrome confirmly diagnosed in pediatrics department of Hospital of TCM Affiliated to Southwest Medical University from September 2017 to December 2018 were chosen and divided into treatment group and control group according to random number table method, with 30 children in each.The control group was given intramuscular injection of interferon therapy,on this basis,the treatment group was given oral administration of Chinese materia medica decoction modified Ganlu Xiaodu Dan.After the 2 groups were both given consecutive treatment for 5 days,the clinical efficacy,TCM symptom score before and after treatment and the laboratory index value returning to normal time were observed.Results The total effective rate of the treatment group was 93.3%(28/30),which was significantly higher than 73.3%(22/30) of the control group,and the difference between the 2 groups was statistically significant(P<0.05).The time of abating fever,and the remission time of sore-throat and the swelling of cervical lymph node was significantly shorter than that of the control group,and the difference between the 2 groups was statistically significant(P<0.05).Before treatment,the difference was not statistically significant in TCM symptom score between the 2 groups(P>0.05),and they were comparable.After treatment,TCM symptom score of the 2 groups all significantly decreased compared with the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly(P<0.05).In the treatment group,the time of returning to normal for abnormal lymphocyte(ALY), white blood cell(WBC) and T lymphocyte subsets was significantly shorter than that of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Conclusion It has satisfactory curative effects to use modified Ganlu Xiaodu Dan in adjuvant treatment of IM in children with damp-heat syndrome,which not only can significantly shorten the disappearance time or remission time of fever,sore-throat and the swelling of cervical lymph node,but also can significantly decrease TCM symptom score.It deserves clinical promotion and application.