桂枝汤加减联合抗生素治疗小儿肠系膜淋巴结炎临床观察

Clinical observation on modified Guizhi Decoction combined with antibiotics in treatment of pediatric mesenteric lymphadenitis

目的观察桂枝汤加减联合抗生素治疗小儿肠系膜淋巴结炎(PML)临床疗效。方法将我院110例PML患者随机分为对照组与观察组各55例。对照组口服抗生素治疗,观察组口服桂枝汤加减联合抗生素治疗。比较两组临床疗效,免疫指标[免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(IgG)],肠系膜淋巴结长径、短径,炎症指标[降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞计数(WBC)],证候积分,舒缩血管指标[降钙素基因相关肽(CGRP)、内皮缩血管肽(ET-1)]。结果治疗后,观察组总有效率高于对照组(P<0.05);两组IgA、IgM、IgG高于治疗前,观察组IgA、IgM、IgG高于对照组(P<0.05);两组肠系膜淋巴结长径、短径低于治疗前,观察组肠系膜淋巴结长径、短径低于对照组(P<0.05);两组PCT、hs-CRP、WBC低于治疗前,观察组PCT、hs-CRP、WBC低于对照组(P<0.05);两组证候积分低于治疗前,观察组证候积分低于对照组(P<0.05);两组CGRP高于治疗前,ET-1低于治疗前,观察组CGRP高于对照组,ET-1低于对照组(P<0.05)。结论桂枝汤加减联合抗生素治疗PML,显著提高临床疗效,提高免疫,缩小肠系膜淋巴结,降低炎症指标,减轻证候积分,调节血管舒缩。

Objective To observe the efficacy of modified Guizhi Decoction combined with antibiotics in treatment of pediatric mesenteric lymphadenitis(PML).Methods A total of 110 PML patients were randomly divided into control group and observation group,with 55 cases in each group.Control group was treated with oral antibiotics,and observation group was treated with modified Guizhi Decoction combined with antibiotics.The clinical efficacy,immune indexes[immunoglobulin A(IgA),immunoglobulin M(IgM),immunoglobulin G(IgG)],mesenteric lymph node long diameter and short diameter,inflammatory indicators[procalcitonin(PCT),hypersensitive C-reactive protein(hs-CRP),white blood cell count(WBC)],syndrome score,vasodilation indexes[calcitonin gene-related peptide(CGRP),endothelial vasoconstrictor peptide(ET-1)]in the two groups were compared.Results After treatment,the total effective rate of observation group was higher than that of control group(P<0.05);IgA,IgM and IgG in both groups were higher than those before treatment,and were higher in observation group than control group(P<0.05);the mesenteric lymph nodes long diameter and short diameter in both groups were lower than those before treatment,and were lower in observation group than control group(P<0.05);PCT,HS-CRP,and WBC in both groups were lower than those before treatment,and were lower in observation group than control group(P<0.05);the pattern scores of both groups were lower than those before treatment,and was lower in observation group than control group(P<0.05);CGRP and ET-1 in both groups were higher than those before treatment,and was higher in observation group than control group,and the ET-1 was lower than that in control group(P<0.05).Conclusion Modified Guizhi Decoction combined with antibiotics can significantly improve the clinical efficacy in treatment of PML,improve immunity,shrink mesenteric lymph nodes,reduce inflammatory indicators,reduce syndrome scores,and regulate vasomotorization.