四生汤加减联合西药治疗气阴两虚型小儿反复呼吸道感染的疗效观察

Effect of Modified Sisheng Decoction Combined with Western Medicine on the Treatment of Recurrent Respiratory Tract Infection in Children with Deficiency of Both Qi and Yin

目的探讨四生汤加减联合西药治疗气阴两虚型小儿反复呼吸道感染(Recurrent Respiratory Tract Infection,RRTI)的临床疗效。方法选取2018年10月—2020年10月期间新乡医学院第一附属医院收治的100例气阴两虚型反复呼吸道感染(RRTI)患儿,按随机数字表法将其分为对照组和治疗组,每组各50例。对照组采用西医常规药物治疗,治疗组在对照组基础上加用四生汤加减治疗。治疗4周后,观察比较两组患儿临床疗效、不良反应发生率,治疗前后中医症状评分、血清炎症因子[白细胞介素4(Interleukin 4,IL-4)、白细胞介素10(Interleukin 10,IL-10)]、血清免疫球蛋白[免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG),免疫球蛋白M(Immunoglobin M,IgM)]、血清维生素[维生素A(Vitamin A,VitA)、维生素E(Vitamin E,VitE)]水平。结果治疗后治疗组临床总有效率91.49%(43/47)明显高于对照组79.17%(38/48),差异有统计学意义(P<0.05)。治疗后两组患儿神疲乏力,食欲不振,腹胀,久咳不止,手足心发热,口干舌燥,小便黄/大便干结评分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组中医症状评分均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患儿血清IL-4、IL-10水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清IL-4、IL-10水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患儿血清IgA、IgG、IgM水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组患儿血清IgA、IgG、IgM水平均较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患儿血清VitA、VitE水平均较治疗前升高,差异有统计学意义(P<0.05);且治疗组血清VitA、VitE水平均较对照组明显升高,差异有统计学意义(P<0.05)。治疗期间,两组患儿不良反应发生率分别为29.17%和27.66%,两组比较,差异无统计学意义(P>0.05)。结论四生汤加减治疗气阴两虚型RRTI临床疗效确切,其主要机制在于益气养阴,补气而不伤阴,滋阴而不碍气,以及其具备抗炎,调节免疫、改善胃肠道功能。

Objective To explore the clinical effect of the modified Sisheng Decoction combined with western medicine on the treatment of recurrent respiratory tract infection(RRTI)in children with deficiency of both qi and yin.Methods A total of 100 children with RRTI of qi-yin deficiency admitted in the First Affiliated Hospital of Xinxiang Medical College from October 2018 to October 2020 were included and divided into a control group and a treatment group by random number table,with 50 cases in each group.The control group was treated with conventional western medicine,and the treatment group was treated with the modified Sisheng Decoction combined with western medicine.After 4 weeks of treatment,this paper observed and compared the clinical efficacy,incidence of adverse reactions,traditional Chinese medicine(TCM)syndrome scores,and the levels of serum inflammatory factors[interleukin 4(IL-4)and interleukin 10(IL-10)],serum immunoglobulins[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin(IgM),and serum vitamins vitamin A(VitA)and vitamin E(VitE)].Results The total clinical effective rate in the treatment group was 91.49%(43/47),which was higher than that in the control group[79.17%(38/48),P<0.05].After treatment,children with RRTI in both groups had significantly lower scores of fatigue,inappetence,abdominal distension,prolonged cough,fever in the hands and feet,dry mouth and tongue,and yellow urine/dry stools than before treatment(P<0.05).The TCM syndrome scores of the treatment group were significant lower than those of the control group(P<0.05).After treatment,the levels of serum IL-4 and IL-10 in the two groups were lower than before treatment(P<0.05),and the levels of serum IL-4 and IL-10 in the treatment group were lower than those in the control group(P<0.05).The levels of serum IgA,IgG,and IgM in the two groups were higher than before treatment(P<0.05),and the levels of serum IgA,IgG,and IgM in the treatment group were higher than those in the control group(P<0.05).The levels of serum VitA and VitE in the two groups were higher than before treatment(P<0.05),and the levels of serum VitA and VitE in the treatment group were higher than those in the control group(P<0.05).During treatment,the incidence of adverse reactions in the two groups was 29.17%and 27.66%,respectively,whereas there was no statistical significance between the two groups(P>0.05).Conclusion The modified Sisheng Decoction has an obvious clinical effect on the treatment of RRTI with deficiency of both qi and yin.The main mechanism is to replenish qi without injuring yin and nourish yin without hindering qi,and it has pharmacological effects such as anti-inflammation,immunity regulation,and improvement of gastrointestinal function.