西替利嗪糖浆联合除湿止痒汤治疗小儿湿疹的疗效及其对炎性因子和免疫球蛋白的影响

Efficacy of Cetirizine Syrup Combined with Chushizhiyang Decoction in Treating Children’s Eczema and Influence on Inflammatory Factors and Immunoglobulin

目的探讨西替利嗪糖浆联合除湿止痒汤治疗小儿湿疹的疗效,以及对患儿炎性因子和免疫球蛋白的影响。方法选取2018年2月—2019年10月期间青海省中医院收治的湿疹患儿216例,根据随机数字表法分为对照组108例和观察组108例。对照组给予盐酸西替利嗪糖浆治疗,观察组在对照组基础上加以除湿止痒汤治疗,两组均连续治疗2周。观察两组临床疗效、两组湿疹面积和严重度指数(EASI)评分,检测血清炎性因子[干扰素-γ(IFN-γ)、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)及白细胞介素-10(IL-10)]和免疫球蛋白[免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)]水平。随访6个月,观察两组患儿复发情况。结果治疗后观察组总有效率89.81%(97/108)高于对照组75.93%(82/108),两组比较,差异有统计学意义(χ^(2)=7.338,P=0.007,P<0.05)。治疗后两组患儿EASI评分、瘙痒严重程度评分均低于治疗前(P<0.05),且观察组患儿治疗后EASI评分、瘙痒严重程度评分均低于对照组(P<0.05)。治疗后两组患儿血清IFN-γ水平均高于治疗前(P<0.05),且观察组患儿治疗后血清IFN-γ水平高于对照组(P<0.05);治疗后两组患儿血清IL-2、IL-4、IL-10水平均低于治疗前(P<0.05),且观察组患儿治疗后血清IL-2、IL-4、IL-10水平均低于对照组(P<0.05)。治疗后两组患儿血清免疫球蛋白Ig A、Ig G、Ig M水平均低于治疗前(P<0.05),且观察组患儿治疗后血清免疫球蛋白Ig A、Ig G、Ig M水平均低于对照组(P<0.05)。治疗后随访6个月,观察组复发率为9.26%(10/108),低于对照组的20.37%(22/108),两组比较,差异有统计学意义(P<0.05)。结论西替利嗪糖浆联合除湿止痒汤治疗小儿湿疹可显著改善患儿临床症状,调节血清炎性因子及免疫球蛋白水平,缓解机体炎症和过敏反应,减少湿疹复发率,疗效显著,值得临床推广应用。

Objective To explore the curative effect of cetirizine syrup combined with Chushizhiyang Decoction in the treatment of children with eczema,and the influence on inflammatory factors and immunoglobulins.Methods A total of 216 children with eczema admitted to Qinghai Provincial Hospital of Traditional Chinese Medicine from February2018 to October 2019 were selected and divided into 108 cases in the control group and 108 cases in the observation group according to the random number table method.The control group was treated with cetirizine hydrochloride syrup,and the observation group was treated with Chushizhiyang Decoction on the basis of the control group.Both groups were treated for2 weeks.The clinical efficacy,eczema area and severity index(EASI),serum inflammatory factors,and immunoglobulin levels were compared between the two groups.Follow-up 6 months later,observe the recurrence of the two groups.Results After treatment,the total effective rate of the observation group was 89.81%(97/108)higher than that of the control group75.93%(82/108).The difference between the two groups was statistically significant(χ^(2)=7.338,P=0.007,P<0.05).After treatment,the EASI score and pruritus severity score of the two groups of children were lower than before treatment(P<0.05),and the EASI score and pruritus severity score of the observation group were lower than those of the control group(P<0.05).After treatment,the serum IFN-γlevels of the two groups of children were higher than before treatment(P<0.05),and the serum IFN-γlevels of the observation group were higher than those of the control group after treatment(P<0.05);the two groups of children after treatment Serum IL-2,IL-4,and IL-10 levels were lower than before treatment(P<0.05),and serum IL-2,IL-4,and IL-10 levels after treatment in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of serum immunoglobulins Ig A,Ig G,and Ig M of the two groups of children were lower than before treatment(P<0.05),and the levels of serum immunoglobulins Ig A,Ig G,and Ig M of the observation group were lower than those of the control group after treatment(P<0.05).Follow-up for 6 months after treatment,the recurrence rate in the observation group was 9.26%(10/108),which was lower than 20.37%(22/108)in the control group.The difference between the two groups was statistically significant(P<0.05).Conclusion Cetirizine syrup combined with Chushizhiyang Decoction can significantly improve the clinical symptoms of children with eczema,regulate serum inflammatory factors and immunoglobulin levels,relieve inflammation and allergic reactions,and reduce the recurrence rate of eczema.It has significant efficacy and is worthy of clinical application.