解毒化浊方联合针刺宽喉法治疗小儿急性化脓性扁桃体炎的疗效观察

Observation on the Curative Effect of Jiedu Huazhuo Recipe(解毒化浊方)Combined with Wide Throat Acupuncture Method in the Treatment of Acute Suppurative Tonsillitis in Children

目的:观察解毒化浊方联合针刺宽喉法治疗小儿急性化脓性扁桃体炎的疗效及对免疫功能、炎症因子的影响。方法:将86例急性化脓性扁桃体炎患儿采用随机数字表法分为对照组和治疗组,每组43例。对照组采用常规西药治疗;治疗组在对照组基础上采用解毒化浊方联合针刺宽喉法治疗。观察患儿脓性分泌物、扁桃体肿大、咽痛及发热消退时间;观察治疗前后患儿中医证候评分变化;检测患儿治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)水平及外周血白细胞计数(WBC)变化;检测治疗前后CD4^(+)、CD3^(+)及CD8^(+)水平变化。结果:治疗组总有效率为93.02%(40/43),对照组总有效率为74.42%(32/43);两组疗效比较,差异有统计学意义(P<0.05)。治疗组患儿脓性分泌物、扁桃体肿大、咽痛及发热消退时间均低于对照组(P<0.05)。治疗后两组患儿中医证候评分均低于治疗前(P<0.05),且治疗后治疗组患儿中医证候评分明显低于对照组(P<0.05)。治疗后两组患儿TNF-α、IL-6、IL-8、hs-CRP水平及WBC均明显下降,且治疗组患儿治疗后TNF-α、IL-6、IL-8、hs-CRP水平及WBC均低于对照组(P<0.05)。治疗后两组患儿CD4^(+)、CD3^(+)水平均明显升高(P<0.05),且治疗组患儿治疗后CD4^(+)、CD3^(+)均高于对照组(P<0.05);治疗后两组患儿CD8^(+)水平均明显下降(P<0.05),且治疗组患儿治疗后CD8^(+)水平低于对照组(P<0.05)。结论:解毒化浊方联合针刺宽喉法治疗小儿急性化脓性扁桃体炎疗效确切,可有效改善发热、咽痛、扁桃体肿大、脓性分泌物及中医证候。其疗效机制可能与降低TNF-α、IL-6、IL-8、hs-CRP、CD8^(+)水平及WBC,升高CD4^(+)、CD3^(+)水平有关。

Objective:To observe the curative effect of Jiedu Huazhuo Recipe combined with wide throat acupuncture method in the treatment of acute suppurative tonsillitis in children and its influence on immune function and inflammatory factors.Methods:A total of 86 children with acute suppurative tonsillitis were randomly divided into control group and treatment group by random number table method,with 43 cases in each group.The control group was treated with conventional western medicine,and the treatment group was treated with Jiedu Huazhuo Recipe combined with wide throat acupuncture method on the basis of the control group.The time of purulent secretion,tonsil enlargement,pharyngeal pain and fever subsided was observed.The changes of TCM syndrome scores were observed before and after treatment.Detection of the serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),high-sensitivity C-reactive protein(hs-CRP)levels and the white blood cells(WBC)in peripheral blood before and after treatment in children.The levels of CD4^(+),CD3^(+)and CD8^(+)were detected before and after treatment.Results:The total effective rate was 93.02%(40/43)in the treatment group and 74.42%(32/43)in the control group.There was significant difference between the two groups(P<0.05).The regression time of purulent secretion,tonsil enlargement,pharyngeal pain and fever in the treatment group was lower than that in the control group(P<0.05).After treatment,the TCM syndrome scores of the two groups were lower than those before treatment(P<0.05),and the TCM syndrome score of the treatment group was significantly lower than that of the control group(P<0.05).After treatment,the levels of TNF-α,IL-6,IL-8,hs-CRP and WBC in the two groups were significantly decreased,and the levels of TNF-α,IL-6,IL-8,hs-CRP and WBC in the treatment group were lower than those in the control group(P<0.05).After treatment,the levels of CD4^(+)and CD3^(+)in the two groups were significantly increased(P<0.05),and the levels of CD4^(+)and CD3^(+)in the treatment group were higher than those in the control group(P<0.05).After treatment,the level of CD8^(+)in the two groups decreased significantly(P<0.05),and the level of CD8^(+)in the treatment group was lower than that in the control group(P<0.05).Conclusion:Jiedu Huazhuo Recipe combined with wide throat acupuncture method is effective in treating acute suppurative tonsillitis in children,which can effectively improve fever,sore throat,tonsil enlargement,purulent secretions and TCM syndromes.The mechanism may be related to decreasing the levels of TNF-α,IL-6,IL-8,hs-CRP,CD8^(+),WBC and increasing the levels of CD4^(+),CD3^(+).