五积散加味敷脐治疗儿童慢性荨麻疹75例

Curative effect of modified Wuji powder for navel compressing on children with chronic urticaria

目的探究五积散加味敷脐治疗儿童慢性荨麻疹的疗效。方法选择2016年2月至2019年12月开封市儿童医院收治的156例儿童慢性荨麻疹病人作为研究对象,采用随机数字表法将病儿分为观察组及对照组。对照组病儿给予盐酸西替利嗪滴剂口服,观察组在对照组基础上给予五积散加味敷脐。于治疗前后进行荨麻疹症状严重程度评分,测定免疫球蛋白(Ig)E、白细胞介素-4(IL-4)、干扰素γ(INF-γ)水平及T细胞亚群比例,评估疗效及安全性,随访统计复发情况。结果观察组及对照组分别有3例、2例病人失访,共75例、76例病儿被纳入研究,观察组及对照组病儿总体治疗有效率分别为90.67%、85.53%,组间比较差异无统计学意义(P>0.05)。治疗后观察组病儿瘙痒程度、持续时间等方面评分显著低于对照组(P<0.05)。治疗后观察组总IgE水平显著低于对照组(P<0.05),INF-γ水平、CD4^(+)T淋巴细胞亚群比例及CD4^(+)/CD8^(+)值显著高于对照组(P<0.05)。观察组及对照组停药2周后复发率分别为6.67%(2/30)、31.82%(7/22),组间比较差异有统计学意义(χ^(2)=5.61,P=0.018)。结论五积散加味敷脐联合盐酸西替利嗪滴剂可显著改善儿童慢性荨麻疹临床症状,相较于盐酸西替利嗪滴剂单药治疗可降低复发率,其机制可能与调控机体T淋巴细胞亚群平衡及炎性因子水平相关。

Objective To explore the curative effect of modified Wuji powder for navel compressing on children with chronic urticaria.Methods A total of 156 children with chronic urticaria who were admitted to Kaifeng Children's Hospital from February 2016 to December 2019 were enrolled as the research subjects.They were divided into observation group and control group by random number table method.The control group was given cetirizine hydrochloride drops,while the observation group was additionally given modified Wuji powder for navel compressing.Before and after treatment,the severity of urticaria symptoms was scored.The levels of immunoglobulin(Ig)E,interleukin-4(IL-4)andγ-interferon(INF-γ),and the proportions of T cell subsets were measured.The curative effect and safety were evaluated.The recurrence was statistically analyzed by follow-up.Results There were 3 and 2 cases lost in follow-up in the observation group and the control group,respectively.Finally,there were 75 cases and 76 cases included in the two groups.The overall treatment response rates in the observation group and the control group were 90.67%and 85.53%,respectively(P>0.05).After treatment,the scores of itching degree and duration in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the total level of IgE in observation group was significantly lower than that in the control group(P<0.05),while INF-γlevel,the proportion of CD4^(+)T lymphocyte subset and CD4^(+)/CD8^(+)were significantly higher than those in the control group(P<0.05).The recurrence rates in the observation group and the control group were 6.67%(2/30)and 31.82%(7/22)at 2 weeks after drug withdrawal(χ^(2)=5.61,P=0.018).Conclusions Modified Wuji powder for navel compressing combined with cetirizine hydrochloride drops can significantly improve clinical symptoms in children with chronic urticaria.Compared with cetirizine hydrochloride drops alone,it can reduce the recurrence rate.The mechanism may be regulating the balance of T lymphocyte subsets and levels of inflammatory factors in the body.