连花清瘟颗粒联合帕拉米韦对儿童病毒性急性上呼吸道感染的疗效及免疫功能影响

Efficacy and immune function of Lianhua qingfei granules combined with paramivir on viral acute upper respiratory tract infection in children

目的探究对儿童病毒性急性上呼吸道感染(ARI)采取连花清瘟颗粒联合帕拉米韦治疗的疗效及对患儿免疫功能的影响。方法选取2019年1月至2022年1月于合肥市第二人民医院儿科就诊的126例病毒性ARI患儿为研究对象。采用简单随机抽样法,将其分别纳入研究组、对照组及空白对照组,均为42例。对研究组患儿采取帕拉米韦联合连花清瘟颗粒治疗,对照组采取帕拉米韦治疗,空白对照组仅进行常规对症治疗。对3组患儿均在治疗第5天时,进行临床症状缓解时间、疗效与血清CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)值,血清免疫球蛋白(Ig)M、IgG与IgA水平,以及治疗相关不良反应进行统计学分析。3组患儿性别及年龄构成比、病毒性ARI病程及严重程度等临床资料比较,差异均无统计学意义(P>0.05)。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》。监护人对患儿的诊治方案等均知情同意,并签署临床研究知情同意书。结果①研究组患儿体温开始下降时间、体温恢复至正常所需时间、咽喉肿痛及肺啰音消失时间,均显著短于对照组及空白对照组患儿,并且差异均有统计学意义(P<0.05)。②治疗第5天时,3组组内比较,患儿的血清CD4^(+)水平与CD4^(+)/CD8^(+)值,以及血清IgM、IgG以及IgA水平,均较治疗前显著升高,但是血清CD8^(+)水平较治疗前显著降低,并且差异均有统计学意义(P<0.05)。③治疗第5天时,3组组间比较,研究组患儿血清CD4^(+)水平与CD4^(+)/CD8^(+)值,以及血清IgM、IgG、IgA水平,均显著高于对照组及空白对照组、而血清CD8^(+)水平,则显著低于对照组及空白对照组患儿,并且差异亦均有统计学意义(P<0.05)。④3组患儿治疗相关不良反应发生率均较低,3组总体比较,差异无统计学意义(P>0.05)。结论连花清瘟颗粒与帕拉米韦联合治疗儿童病毒性ARI,有助于提高临床疗效,可以显著改善患儿的发热等症状,有效改善免疫功能,并且安全性良好。

Objective To explore therapeutic effects and immune function of lianhua qingwen granules combined with peramivir on viral acute upper respiratory tract infection(ARI)in children.Methods A total of 126 children with viral ARI admitted in Department of Pediatrics of the Second People′s Hospital of Hefei City from January 2019 to January 2022 were selected in this study.By simple random sampling method,they were divided into research group(n=42),control group(n=42)and blank control group(n=42),respectively.Regime of research group was treated by peramivir combined with lianhua qingwen granules,control group was treated with peramivir,and blank control group was treated with conventional symptomatic treatment.Clinical symptom remission time,clinical efficacy,levels of serum CD4^(+),CD8^(+)values and CD4^(+)/CD8^(+),levels of serum immunoglobulin(Ig)M,IgG and IgA,and incidence of treatment-related adverse reactions were statistically analyzed among 3 groups before and on the 5th day atter treatment by different regimes.The procedure followed in this study is in line with the Helsinki Declaration of the World Medical Association as amended in 2013.Written informed consent was obtained from all research participants.There were no statistically significant differences in clinical data such as gender and age composition ratio,course and severity of viral ARI of children among 3 groups(P>0.05).Results①The time for body temperature to drop,the time for body temperature to return to normal,the time for sore throat to disappear,and the time for pulmonary rales to disappear in research group were all significantly shorter than those in control group and blank control group,and the differences were statistically significant(P<0.05).②On the 5th day of treatment,compared within the group,the serum CD4^(+)level and CD4^(+)/CD8^(+)value,as well as the serum IgM,IgG and IgA levels in 3 groups were significantly higher than those before the treatment,but the serum CD8^(+)level was significantly lower than that before the treatment,and all the differences were statistically significant(P<0.05).③On the 5th day of treatment,among serum CD4^(+)level and CD4^(+)/CD8^(+)value,as well as serum IgM,IgG and IgA levels in research group were significant higher than those in control group and blank control group,while serum CD8^(+)level was significantly lower than those in control group and blank control group,and the above differences were also statistically significant(P<0.05).④The incidences of treatment-related adverse reactions in 3 groups were all low,and there was no statistically significant difference among 3 groups(P>0.05).Conclusions The combination of lianhua qingwen granule combined with peramivir in treatment of viral ARI in children is helpful to improve clinical efficacy,significantly improve symptoms such as fever,and effectively improve their immune function,and have good safety.