联合炎琥宁注射液治疗小儿病毒性肺炎的临床效果及对细胞免疫、炎性因子的影响

目的探讨联合炎琥宁注射液治疗小儿病毒性肺炎的临床疗效及对细胞免疫、炎性因子的影响。方法选择2018年1月—2019年5月收治的小儿病毒性肺炎160例,按照治疗方法的不同,分为对照组与观察组,每组各80例。两组均予止咳、平喘、保持呼吸道通畅等对症处理,同时给予利巴韦林治疗,在此基础上,观察组加用炎琥宁注射液治疗。两组均治疗5 d。记录治疗前、治疗后炎性因子相关指标白细胞介素-6(interleukin-6,IL-6)、超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)]、细胞免疫相关指标CD4+/CD8+、辅助性T淋巴细胞(T helper cells,Th)1/Th2、Th17/调节性T淋巴细胞(regulatory T cell,Treg)]水平及中医症候(咳嗽、喘促、咳痰痰鸣)评分,评估治疗后临床疗效,记录不良反应发生情况。结果与对照组比较,观察组治疗后IL-6、hs-CRP、Th17/Treg水平及咳嗽、喘促、咳痰痰鸣评分降低,CD4+/CD8+、Th1/Th2水平升高,差异有统计学意义(P<0.05或P<0.01);与本组治疗前比较,两组治疗后IL-6、hs-CRP、Th17/Treg水平及咳嗽、喘促、咳痰痰鸣评分下降,CD4+/CD8+、Th1/Th2水平上升,差异有统计学意义(P<0.05)。观察组、对照组治疗总有效率分别为93.75%(75/80)、85.00%(68/80),比较差异有统计学意义(χ2=3.359,P=0.003)。观察组2例出现轻度肝功能损伤,对照组1例出现轻度肝功能损伤,给予对症处理后恢复正常;两组均出现1例轻度凝血酶原时间延长,未予处理,1周后恢复正常。结论联合中药炎琥宁注射液治疗可以显著提高小儿病毒性肺炎的临床疗效,作用机制可能与炎琥宁注射液下调机体炎性反应、改善细胞免疫功能有关。

Clinical Efficacy of Combined Yanhuning Injection Therapy in Infantile Viral Pneumonia and Its Effect on Cellular Immunity and Inflammatory Factors

Objective To investigate the clinical efficacy of combined Yanhuning injection therapy in children with viral pneumonia and to analyze its effect on cellular immunity and inflammatory factors.Methods A total of 160 children with viral pneumonia who were treated from January 2018 to May 2019 were selected.According to the different treatment methods,they were divided into the control group and the observation group,with 80 patients in each group.The two groups were given ribavirin as well as symptomatic treatment for cough,asthma and the obstruction of the respiratory tract.On this basis,the observation group was given Yanhuning injection.The two groups were treated for 5 days.The inflammatory factor related indicatorsinterleukin-6(IL-6)and hypersensitive C-reactive protein(hs-CRP)],cellular immune function related indicatorsCD4/CD8,helper T-lymphocytes(Th)1/Th2,Th17/regulatory T cell(Treg)]and TCM syndrome scores(cough,wheezing,expectoration,gurgling with sputum)before and after treatment were recorded,clinical efficacy after treatment was evaluated and the occurrence of adverse reactions was recorded.Results Compared with the control group,the levels of IL-6,hs-CRP,and Th17/Treg and scores of cough,wheezing,sputum and gurgling with sputum were significantly decreased in the observation group after treatment,while the levels of CD4+/CD8+and Th1/Th2 were significantly increased(P<0.05 or P<0.01).Compared with those before treatment,the levels of IL-6,hs-CRP,Th17/Treg and scores of cough,wheezing,sputum and gurgling with sputum were significantly decreased,whereas the levels of CD4+/CD8+and Th1/Th2 were significantly increased after treatment(P<0.05).The total effective rates of treatment in the observation group and control group were 93.75%(75/80)and 85.00%(68/80),respectively,and the difference was statistically significant(χ2=3.359,P=0.003).There were 2 cases of mild liver injury in the observation group,and 1 case of mild liver injury in the control group,which became normal after symptomatic treatment.One case in each group showed mild prolonged prothrombin time,which became normal 1 week afterwards without treatment.Conclusion Combined Yanhuning injection therapy can significantly improve the clinical efficacy of children with viral pneumonia,and its mechanism may be related to Yanhuning injection's down-regulation of inflammatory response and improvement of cellular immunity.