扶正固表汤联合敷贴疗法治疗小儿反复上呼吸道感染的临床观察

目的:观察扶正固表汤联合敷贴疗法治疗小儿反复上呼吸道感染(RRTI)的疗效及对免疫功能和微量元素的影响。方法:将150例患儿按就诊先后以随机数字表法分为对照组和观察组各75例。两组患儿在急性感染期给予抗生素、抗病毒、退热、止咳、补液等对症治疗;并采用匹多莫德口服溶液治疗。对照组给予玉屏风口服液,5~10 m L/次,3次/d,口服。观察组给予扶正固表汤联合敷贴疗法。两组疗程均为16周,再进行32周的随访。记录48周内的发病次数;记录每次发病的天数;记录发病病种;进行肺脾两虚证评分;检测血清免疫球蛋白(Ig)A,IgG,IgM,T淋巴细胞亚群和补体C3及补体C4,检测钙(Ca),铁(Fe),锌(Zn),镁(Mg),铜(Cu)水平。结果:观察组临床疗效总有效率为94.29%,高于对照组的82.09%(P0.05);在48周的观察随访期间,观察组平均发作次数少于对照组,平均病程短于对照组,病情程度轻于对照组(P0.01);治疗后观察组CD3~+,CD4~+和CD4~+/CD8~+均高于对照组,而CD8~+低于对照组(P0.01);治疗后观察组血清IgG,IgA,IgM水平均高于对照组(P0.01);两组患儿C3和C4水平治疗前后变化无统计学意义;治疗后观察组Ca,Fe,Zn,Mg水平均高于对照组(P0.05,P0.01),两组患儿Cu水平的组间比较,差异无统计学意义。结论:扶正固表汤联合敷贴疗法治疗肺脾两虚型RRTI,能提高机体免疫力,调节微量元素水平,能预防RRTI的发作次数和发作程度,近期和远期均有明显疗效。

Effect of Fuzheng Gubiao Decoction Combined with Plastering Therapy in Treating Recurrent Respiratory Tract Infection

Objective: To observe the effect of Fuzheng Gubiao decoction combined with plastering therapy in treating recurrent respiratory tract infection (RRTI) and its influence on immunologic function and trace elements. Method: One hundred and fifty patients were divided into control group (75 cases) and observation group (75 cases) by random number table. Both groups were given antibiotic, antivirus, defervescence, and antitussive treatment and fluid infusion during acute infection period. Both group''s patients took Pidotimod oral solution. Patients in control group received Yupingfeng oral liquid, 5-10 mL/time, 3 times/day. Patients in observation group took Fuzheng Gubiao decoction combined with plastering therapy. Courses of treatment lasted for 16 weeks. And a 32-week following-up was conducted. Onset frequency, days of morbidity and disease type were recorded within 48 weeks. Lung-spleen deficiency syndromes were scored. Levels of serum immunoglobulins IgA, IgG, IgM, T-lymphocyte, complement component C3 and C4, Ca, Fe, Zn, Mg and Cu were detected. Result: The total effective rate in observation group was 94.29%, which was superior to 82.09%in control group (P<0.05). During the 48-week following-up visit, mean onset frequency in observation group were less than that in control group, and mean disease course was shorter than that in control group, disease severity was also lower than that in control group (P<0.01). After treatment, levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ in observation group were higher than those in control group, but level of CD8⁺was lower than that in control group (P<0.01). Levels of IgG, IgA and IgM were higher than those in control group (P<0.01). There were no statistical significant differences in levels of C3, C4 and Cu between the two groups. Levels of Ca, Fe, Zn and Mg in observation group were higher than those in control group (P<0.01). Conclusion: Fuzheng Gubiao decoction combined with plastering therapy can improve immunity, regulate levels of microelements, reduce onset frequency and onset degree of RRTI, with obvious long-term and short-term effects.