三伏贴联合健儿康膏方治疗儿童反复上呼吸道感染缓解期50例临床观察

Clinical observation on 50 cases of children with recurrent respiratory tract infections in remission stage treated by Sanfu Tie(三伏贴)combined with Jian'erkang Gaofang(健儿康膏方)

目的观察三伏贴联合健儿康膏方治疗儿童反复上呼吸道感染(RRTIs)缓解期的临床疗效。方法选取2017年6月至2018年6月宿迁市中医院儿科就诊的98例RRTIs缓解期患儿,采用随机数字表法分为治疗组和对照组。对照组48例给予脾氨肽口服冻干粉治疗,治疗组50例给予三伏贴联合健儿康膏方治疗,2组均随访12个月,统计临床疗效,检测治疗前后血清指标值[IgG、IgA、IgM、IgE、白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、CD4^(+)/CD8^(+)、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)]水平、治疗后12个月内发作次数及中医证候总积分。结果治疗组总有效率为88.00%(44/50),高于对照组的70.83%(34/48),2组比较,差异有统计学意义(P<0.05)。治疗前,2组上呼吸道感染发作次数及中医证候总积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上呼吸道感染发作次数及中医证候总积分均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著,差异有统计学意义(P<0.05)。治疗前,2组血清IgG、IgA、IgM及IgE水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组IgG、IgA、IgM水平均明显升高,IgE降低,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高/降低更显著,差异有统计学意义(P<0.05)。治疗前,2组IL-2、IL-4、IL-6、IL-10、CD4^(+)/CD8^(+)、IFN-γ、TNF-α水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组上述指标值均明显升高,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组升高更显著,差异有统计学意义(P<0.05)。结论三伏贴联合健儿康膏方治疗儿童反复上呼吸道感染RRTIs缓解期疗效满意,可以有效改善中医证候总积分,减轻气道慢性炎症,减少上呼吸道感染发作次数,有效平衡机体免疫功能,值得临床推广应用。

Objective To observe the clinical efficacy of Sanfu Tie(三伏贴)combined with Jian’erkang Gaofang(健儿康膏方)in the treatment of children with recurrent respiratory tract infections(RRTIs)in remission stage.Methods From June 2017 to June 2018,98 cases of RRTIs in remission stage consulted in pediatrics department of Suqian Municipal Hospital of TCM were divided into treatment group and control group according to random number table method,with 50 cases in treatment group and 48 cases in control group.The control group was treated with spleen aminopeptide oral lyophilized powder,and the treatment group was treated with Sanfu Tie combined with Jian’erkang Gaofang.A 12-month follow-up was conducted in both groups,and we kept statistics about the clinical efficacy and detected the serum index values levels of[immunoglobulin(Ig)G,IgA,IgM,IgE,interleukin-2(IL-2),IL-4,IL-6,IL-10,CD4^(+)/CD8^(+),serum interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)]before and after treatment,the number of attacks and the total TCM symptom score after treatment for 12 months.Results The total effective rate of the treatment group was 88.00%(44/50),which was higher than 70.83%(34/48)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,there was no significant difference in the number of attacks of upper respiratory tract infection(URTI)and total TCM symptom score between the 2 groups(P>0.05),and they were comparable;After treatment,the number of attacks of URTI and the total TCM symptom score in the 2 groups significantly decreased,and the differences were statistically significant compared with those before treatment in the same group(P<0.05),moreover,the decrease in the treatment group was more significant,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in serum levels of IgG,IgA,IgM and IgE between the 2 groups(P>0.05)and they were comparable.After treatment,the levels of IgG,IgA and IgM of the 2 groups significantly increased,while that of IgE decreased,and the differences were statistically significant compared with those in the same group before treatment(P<0.05),moreover,the treatment group increased or decreased more significantly,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in levels of IL-2,IL-4,IL-6,IL-10,CD4^(+)/CD8^(+),IFN-γand TNF-αbetween the 2 groups(P>0.05),and they were comparable;After treatment,the above-mentioned index values of the 2 groups significantly increased,and the difference was statistically significant compared with those in the same group before treatment(P<0.05),moreover,the treatment group increased more significantly,and the difference was statistically significant(P<0.05).Conclusion It has satisfactory curative effect,can effectively improve the total TCM symptom score,alleviate chronic airway inflammation,reduce the number of attacks of URTI,and effectively balance the body’s immune function to use Sanfu Tie combined with Jian’erkang Gaofang in the treatment of children with RRTIs in remission stage,which is worthy of clinical promotion and application.