甘露消毒丹加减联合干扰素治疗小儿手足口病湿热蕴毒的疗效及对血清炎症细胞因子和免疫指标的影响

Curative effect of modified Ganlu Xiaodu micropill combined with interferon in treatment of children with hand-foot-and-mouth disease of damp-heat accumulation toxin syndrome and the impact on serum inflammatory factors and immune indexes

目的探讨甘露消毒丹加减联合干扰素治疗小儿手足口病湿热蕴毒的疗效及对其血清炎症细胞因子和免疫指标的影响,为临床诊治提供参考依据。方法选取在台州市中医院收治的湿热蕴毒型手足口病患儿共计240例,采用随机数表法将患儿分为观察组123例,对照组117例。对照组给予对症治疗同时雾化吸入干扰素-α2b注射液2次/d。观察组在对照组治疗基础上,口服汤剂甘露消毒丹加减,7 d为1个疗程,1个疗程后观察比较两组患儿临床疗效、症状体征消失时间、血清炎症细胞因子水平及免疫指标。结果观察组和对照组总有效率分别为91.0%、81.2%,差异有统计学意义(P<0.05)。观察组在发热消退时间(3.40±1.08)d,皮疹消退时间(4.83±1.27)d均显著短于对照组,差异有统计学意义(均P<0.05)。治疗后,观察组患儿血清炎症细胞因子IL-2,IL-10,TNF-α水平普遍低于对照组,差异有统计学意义(均P<0.01),血清免疫指标Ig A,IgG较对照组下降明显,差异有统计学意义(均P<0.01)。结论甘露消毒丹加减联合干扰素治疗小儿手足口病湿热蕴毒治疗疗效显著,减轻炎症反应,提高免疫水平。

Objective To explore the curative effect of modified Ganlu Xiaodu micropill combined with interferon in treatment of children with hand-foot-and-mouth disease of damp-heat accumulation toxin syndrome and the impact on serum inflammatory factors and immune indexes,provide a reference basis for clinical diagnosis and treatment.Methods A total of 240 children with hand-foot-and-mouth disease of damp-heat accumulation toxin syndrome treated in Taizhou Hospital of Traditional Chinese Medicine were selected and divided into observation group(123 cases)and control group(117 cases)according to random number table.The children in control group were treated by symptomatic treatment and aerosol inhalation of interferon-α2 b injection,twice per day.The children in observation group were treated by oral administration of modified Ganlu Xiaodu micropill based on control group,one course included 7 days.After one course,the clinical effects,disappearance time of symptoms and signs,levels of serum inflammatory factors and immune indexes in the two groups were observed and compared.Results The total effective rates in observation group and control group were 91.0%and 81.2%,respectively,there was statistically significant difference between the two groups(P<0.05).The remission time of fever and rash in observation group were(3.40±1.08)days and(4.83±1.27)days,respectively,which were statistically significantly shorter than those in control group(P<0.05).After treatment,the levels of serum inflammatory factors(IL-2,IL-10,TNF-α)and serum immune indexes(Ig A and Ig G)in observation group were statistically significantly lower than those in control group(P<0.01).Conclusion The curative effect of modified Ganlu Xiaodu micropill combined with interferon in treatment of children with hand-foot-and-mouth disease of damp-heat accumulation toxin syndrome is significant,the therapy can relieve inflammatory response and improve immune level.