普济消毒饮加减辅助治疗小儿疱疹性咽峡炎里热内蕴证41例临床观察

Clinical observation on 41 cases of pediatric herpetic angina with internal heat syndrome treated by modified Puji Xiaodu Yin (普济消毒饮)as adjuvant therapy

目的 观察普济消毒饮加减辅助治疗小儿疱疹性咽峡炎里热内蕴证的临床疗效。方法 选取2019年2月至2021年1月浙江大学金华医院传统医学中心收治的疱疹性咽峡炎里热内蕴证患儿82例,按照随机数字表法分为对照组和治疗组,各41例。对照组给予利巴韦林喷剂、维生素C等对症治疗,治疗组在对照组治疗方法的基础上予普济消毒饮加减治疗。2组均7 d为1个疗程,治疗1个疗程后统计临床疗效。结果对照组总有效率为75.61%(31/41),治疗组为95.12%(39/41),2组比较,差异有统计学意义(P<0.01)。治疗组体温恢复正常时间、疱疹消失时间和食欲恢复正常时间均短于对照组,2组比较,差异有统计学意义(P<0.01)。治疗前,2组CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后,2组CD4^(+)、CD4^(+)/CD8^(+)水平明显升高,CD8^(+)水平明显下降,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组升高或下降更显著(P<0.05)。结论 普济消毒饮加减辅助治疗小儿疱疹性咽峡炎里热内蕴证,能明显改善患儿临床症状、体征,提高机体免疫功能,疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of modified Puji Xiaodu Yin(普济消毒饮) in adjuvant treatment for pediatric herpetic angina with intrinsic heat syndrome. Methods From February 2019 to January 2021, a total of 82 children with intrinsic heat syndrome of herpetic angina admitted into the Traditional Medicine Center of Jinhua Hospital of Zhejiang University were selected and divided into control group and treatment group according to random number table method with 41 cases each. The control group was given routine Western medicine treatment such as ribavirin spray and vitamin C, and the treatment group was given modified Puji Xiaodu Yin on the basis of the treatment of the control group.In both groups, 7 days were taken as a course of treatment, and the clinical efficacy was calculated after one course of treatment. Results The total effective rate was 75.61% (31/41) in the control group and 95.12% (39/41) in the treatment group,and the difference was statistically significant(P<0.01). The body temperature recovery time, herpes disappearance time and appetite recovery time in the treatment group were shorter than those in the control group, the difference being significant (P<0.01). Before treatment, there was no significant difference being found in the comparison of the levels of CD4^(+), CD8^(+) and CD4^(+) / CD8^(+) between the two groups(P>0.05), which was comparable.After treatment,the levels of CD4^(+) and CD4^(+)/CD8^(+) in the two groups were increased significantly, and the level of CD8^(+) was decreased significantly, compared with those in the same group before treatment, differences being significant(P<0.05), and the increase or decrease in the treatment group was more significant(P<0.05). Conclusion It can improve the clinical symptoms and immunity of children patients significantly to use modified Puji Dudu Yin in the adjuvant treatment of herpetic angina with internal heat syndrome,which is worthy of clinical application.