咽部吹药疗法配合甘露消毒丹加减治疗儿童疱疹性咽峡炎临床研究

Clinical Study on Therapy of Throat Insufflation Combined with Modified GanluXiaodu Pellets for Herpetic Angina in Children

目的:观察咽部吹药疗法联合甘露消毒丹加减治疗疱疹性咽峡炎患儿的临床疗效。方法:选取120例疱疹性咽峡炎患儿为研究对象,采用随机数字表法分为对照组及观察组各60例。2组患儿均于入院后密切观察病情,给予一般及对症支持治疗。观察组给予冰青散用儿童专用工具吹入咽部,并配合甘露消毒丹加减口服。对照组给予重组人干扰素α2b喷雾剂,同时配合口服小儿豉翘清热颗粒治疗。比较2组临床疗效、症状改善时间及不良反应,并比较2组治疗前后中医证候积分、血清炎症和免疫功能指标变化。结果:观察组痊愈率、总有效率分别为41.67%、98.33%,高于对照组15.00%、88.33%(P<0.05)。治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,2组中医证候积分均下降(P<0.05),且观察组低于对照组(P<0.05)。观察组体温恢复时间、纳食恢复时间、睡眠恢复时间、疱疹消失时间、流涎消失时间、消化道症状消失时间均短于对照组(P<0.05)。治疗前,2组血清白细胞计数(WBC)、中性粒细胞计数(NEUT)、C-反应蛋白(CRP)、白细胞介素-6 (IL-6)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清WBC、NEUT、CRP、IL-6水平均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗前,2组血清免疫球蛋白A (IgA)、免疫球蛋白G (IgG)、免疫球蛋白M (IgM)水平比较,差异无统计学意义(P>0.05);治疗后,2组血清IgA、IgG水平升高(P<0.05),IgM水平降低(P<0.05),且观察组血清IgA、IgG水平高于对照组(P<0.05)。治疗前,2组CD4+、CD8+、CD4+/CD8+比较,差异无统计学意义(P>0.05);治疗后,2组CD4+、CD4+/CD8+均升高(P<0.05),CD8+均降低(P<0.05),且观察组CD4+、CD4+/CD8+高于对照组(P<0.05),CD8+低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:咽部吹药疗法配合口服甘露消毒丹加减治疗儿童疱疹性咽峡炎疗效显著,可缩短咽峡部疱疹及溃疡愈合时间,改善食欲和睡眠,促使患儿消化道症状快速消失,调节患儿机体免疫,减轻炎症反应,且安全性较好。

Objective:To observe the clinical effect of therapy of throat insufflation combined with modified Ganlu Xiaodu Pellets on herpetic angina in children.Methods:A total of 120 children with herpetic angina were selected as the study objects and divided into the control group and the observation group according to the random number table method,with 60 cases in each group.The condition of children in the two groups was closely observed,and common and symptomatic treatment was given accordingly.The observation group was given insufflation of Bingqing Powder into the throat with special tool for children combined with oral administration of modified Ganlu Xiaodu Pellets. The control group was treated withtherapy of Recombinant Human Interferon- α2b Spraying Agent combined with Xiao'er Chiqiao QingreGranules. The clinical effects,improvement time of symptoms,incidence of adverse reactions,traditionalChinese medicine (TCM) syndrome scores, and changes of serum inflammatory indicators and immunefunction indexes were compared before and after treatment between the two groups. Results: The curerate and effective rate were 41.67% and 98.33% in the observation group,respectively,higher than thoseof 15.00% and 88.33% in the control group (P<0.05). Before treatment,there was no significant differencebeing found in the comparison of TCM syndrome score between the two groups (P>0.05);aftertreatment,the TCM syndrome scores in both groups were decreased (P<0.05),and the TCM syndromescore in the observation group was lower than that in the control group (P<0.05). The recovery time ofnormal body temperature, food intake and sleep, and disappearance time of herpes, drooling andsymptoms of digestive tract in the observation group were less than those in the control group (P<0.05).Before treatment, there was no significant difference being found in the comparisons of levels of serumwhite blood cell count (WBC), neutrophil count (NEUT), C- reactive protein (CRP) and white blood cellcount- 6(IL- 6) between the two groups (P>0.05);after treatment, the levels of serum WBC, NEUT,CRP and IL-6 in both groups were decreased (P<0.05),and the above four levels in the observation groupwere lower than those in the control group (P<0.05). Before treatment,there was no significant differencebeing found in the comparisons of levels of serum immunoglobulin A(IgA), immunoglobulin G (IgG) andimmunoglobulin M (IgM) between the two groups (P>0.05);after treatment,the levels of serum IgA andIgG in both groups were increased (P<0.05),the IgM levels were decreased,and the levels of serum IgAand IgG in the observation group were higher than those in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparisons of CD4+,CD8+ and CD4+/CD8+ betweenthe two groups (P>0.05);after treatment,the CD4+ and CD4+/CD8+ in the two groups were increased (P<0.05),the CD8+ was decreased (P<0.05);the CD4+ and CD4+/CD8+ in the observation group were higherthan those in the control group (P<0.05),and the CD8+ was lower than that in the control group (P<0.05).There was no significant difference being found in the comparison of incidence of adverse reactionsbetween the two groups (P>0.05). Conclusion:The therapy of throat insufflation combined with modifiedGanlu Xiaodu Pellets has a significant curative effect on herpetic angina in children,which can shorten therecovery time of herpetic herpes, improve the appetite and sleep, accelerate the disappearance ofsymptoms of digestive tract, regulate the immune function of the body, and mitigate the inflammatoryresponses with good safety.