阿莫西林克拉维酸钾联合脂溶性维生素治疗儿童急性化脓性扁桃体炎临床效果

Clinical Effect of Potassium Amoxicillin Clavulanate Combined with Fat-soluble Vitamin in the Treatment of Acute Suppurative Tonsillitis in Children

目的:研究阿莫西林克拉维酸钾(ACP)联合脂溶性维生素(FSV)治疗儿童急性化脓性扁桃体炎(PAST)的效果。方法:选取厦门市第五医院2021年3月至2022年3月期间收治的72例PAST患儿,采用随机数字表法将患儿分为B组和A组,各36例。B组患儿采用FSV治疗,A组患儿采用ACP联合FSV治疗。比较两组患儿的临床疗效、临床症状消失时间、治疗前后免疫功能指标、血清炎症因子水平、不良反应。结果:A组患儿治疗总有效率为94.44 %,高于B组的72.22 %,差异具有统计学意义(P<0.05)。A组患儿的咽痛消失时间、退热时间、扁桃体肿大改善时间、脓性分泌物消失时间短于B组,差异具有统计学意义(P<0.05)。治疗后两组患儿的CD3^(+)、CD4^(+)水平、CD4^(+)/CD8^(+)比值较治疗前升高,且治疗后A组患儿的CD3^(+)、CD4^(+)水平、CD4^(+)/CD8^(+)比值高于B组,差异具有统计学意义(P<0.05)。治疗后两组患儿的血清可溶性白细胞介素-2受体(SIL-2R)、白细胞介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)水平较治疗前降低,且治疗后A组患儿的血清SIL-2R、IL-6、IL-8、TNF-α水平低于B组,差异具有统计学意义(P<0.05)。两组患儿不良反应发生率比较,差异无统计学意义(P>0.05)。结论:ACP联合FSV治疗儿童PAST可缓解临床症状,增强免疫功能,调节炎症反应,安全可行。

Objective To investigate the efficacy of amoxicillin and clavulanate potassium(ACP)combined with fat-soluble vitamin(FSV)in the treatment of children with pediatric acute suppurative tonsillitis(PAST).Methods A total of 72 PAST children admitted to Xiamen Fifth Hospital from March 2021 to March 2022 were selected and divided into group B and group A by random number table method,with 36 cases in each group.Children in group B were treated with FSV,and children in group A were treated with ACP combined with FSV.The clinical efficacy,disappearance time of clinical symptoms,immune function indexes before and after treatment,serum levels of inflammatory factors,and adverse reactions were compared between the two groups.Results The total effective rate of group A was 94.44%,which was higher than that of group B(72.22%),and the difference was statistically significant(P<0.05).The disappearance time of pharyngeal pain,antipyretic time,improvement time of tonsil enlargement and disappearance time of purulent secretions in group A were shorter than those in group B,and the differences were statistically significant(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),the ratio of CD4^(+)/CD8^(+)in the two groups were higher than those before treatment,and the levels of CD3^(+),CD4^(+),the ratio of CD4^(+)/CD8^(+)in the group A were higher than those in the group B,and the differences were statistically significant(P<0.05).After treatment,the serum levels of soluble interleukin-2 receptor(SIL-2R),interleukin-6(IL-6),IL-8 and tumor necrosis factor-α(TNF-α)in the two groups were lower than those before treatment,and the serum levels of SIL-2R,IL-6,IL-8 and TNF-αin the group A were lower than those in the group B,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion ACP combined with FSV in the treatment of PAST in children can alleviates clinical symptoms,enhances immune function,and regulates inflammatory response,which is safe and feasible.