小儿急性上呼吸道感染的流行病学特征及中药洗浴辅助疗效分析

Epidemiological characteristics of acute upper respiratory tract infection in children and analysis of the efficacy of traditional Chinese Medicine bath

目的分析本地区小儿急性上呼吸道感染的流行特征,探讨中药洗浴辅助治疗小儿急性上呼吸道感染发热的疗效观察。方法选取2019年1月-2021年12月因急性上呼吸感染于就诊的患儿625例。采集患儿咽拭子标本,采用核酸提取试剂盒提取病毒核酸,采用实时荧光定量PCR方法进行呼吸道病毒检测。选取儿童组(3~14岁)发热患儿100例,按照就诊顺序随机分为治疗组与对照组。治疗组患儿基础治疗外加中药药液洗浴治疗,对照组则采用基础治疗外加温水洗浴,对比两组患儿治疗前及治疗后24、48、72 h体温情况。结果625份咽拭子中病毒阳性318份,262份为单一病毒感染,56份为两种病毒混合感染。单一阳性感染标本,主要为甲型流感病毒(16.80%)和呼吸道合胞病毒A型(7.20%)阳性。混合感染标本,主要为甲型流感病毒+呼吸道合胞病毒A型阳性(2.24%)。男性患儿组阳性率50.54%,女性患儿组阳性率51.37%,差异无统计学意义。将患儿按照年龄分组,幼儿组(1~3岁)、婴儿组(28 d~1岁)、儿童组(3~14岁)的阳性率分别为70.22%、40.22%和39.82%。甲型流感病毒在幼儿组的检出率最高,阳性率为28.00%,其次为婴儿组(13.97%),最低为儿童组(7.69%)。将患儿按照发病季节划分,冬季病毒总检出率最高为70.57%,春季次之为48.59%,秋季为30.33%,夏季最低为26.04%。甲型流感病毒与呼吸道合胞病毒A型的检出率在冬季组最高。治疗前两组患儿平均体温对比差异无统计学意义(P>0.05)。治疗后两组患儿治疗后24 h、48 h体温差异无统计学意义,72 h差异有统计学意义(P<0.05)。结论本地区患儿急性上呼吸道感染主要以甲型流感病毒和呼吸道合胞病毒A型为主的单一病毒感染,多发于幼儿组(1~3岁),冬季为高发季节。发热患儿经中药洗浴辅助治疗后,疗效显著。

Objective The epidemic characteristics of acute upper respiratory infection in children were analyzed in this area,and The efficacy of traditional Chinese medicine bath as an adjunctive treatment for fever in children with acute upper respiratory tract infection were explored.Methods From January 2019 to December 2021,625 children with acute upper respiratory infection were selected.Pharyngeal swab samples of all children were collected,viral nucleic acid was extracted by nucleic acid extraction kit,and respiratory virus was detected by real-time fluorescent quantitative PCR.100 children with fever in children group(3-14 years old)were randomly divided into treatment group and control group according to the order of visit.The children in the treatment group were treated with basic treatment plus traditional Chinese medicine bath,while the children in the control group were treated with basic treatment plus warm water bath.The body temperatures of the children in the two groups were compared before treatment and 24,48 and 72 hours after treatment.Result Among the 625 throat swabs tested,318 were virus positive,262 were single virus infections,and 56 were mixed infections of two viruses.The single positive infection samples were mainly influenza A virus(16.80%)and respiratory syncytial virus type A(7.20%).The mixed infection samples were mainly influenza A virus+respiratory syncytial virus type a positive(2.24%).The positive rate of male children group was 50.54%,and that of female children group was 51.37%.There was no statistical difference between the two groups.According to the age of children,the positive rates of children group(1-3 years old),infant group(28 days to 1 year old)and children group(3-14 years old)were 70.22%,40.22%and 39.82%respectively.The detection rate of influenza A virus in the young children group was the highest,with a positive rate of 28.00%,followed by the infant group(13.97%),and the lowest was the children group(7.69%).According to the season of onset,the total detection rate of virus in children was 70.57%in winter,48.59%in spring,30.33%in autumn and 26.04%in summer.The detection rate of influenza A virus and respiratory syncytial virus type A was the highest in winter group.Before treatment,there was no significant difference in the average body temperature between the two groups(P>0.05).After treatment,there was no statistically significant difference in body temperature between the two groups at 24 h and 48 h after treatment,but there was statistically significant difference at 72 h after treatment(P<0.05).Conclusion The acute upper respiratory tract infection of children in this area is mainly a single virus infection dominated by influenza A virus and respiratory syncytial virus type A,which mostly occurs in the young children group(1-3 years old).Winter is the high incidence season.The curative effect of Chinese medicine bath for children with fever is remarkable.