中西医结合治疗小儿反复上呼吸道感染

目的:探讨中西医结合疗法对小儿反复呼吸道感染(RRTI)的临床疗效及对T细胞亚群及免疫球蛋白的影响.方法:90例RRTI患儿随机分为观察组和对照组各45例.发作期两组均采用常规西医处理,缓解期对照组采用转移因子口服液,10 mL/次,1次/d,口服.观察组采用黄芪生脉饮,10 mL/次,2次/d,口服；参苓白术散,1剂/d,常规水煎分2次口服.两组疗程均为8周,并进行6个月随访观察.观察肺脾气虚证积分,检测治疗前后T细胞亚群和免疫球蛋白.结果:观察组总有效率(97.77％)优于对照组(66.66％)(P＜0.01)；观察组CD3+,CD4+,CD8+及CD4+/CD8+改善优于对照组(P ＜0.05,P＜0.01)；观察组治疗后IgG和IgA上升较对照组显著(P＜0.01)；观察组各症状积分及肺脾气虚证总积分均明显低于对照组(P＜0.01).结论:发作期采用西药治疗,缓解期采用黄芪生脉饮和参苓白术散可有效改善患儿体质,提高患者免疫力,减轻临床症状,能有效治疗小儿反复呼吸道感染.

A Clinical Research on Treatment of Infant Recurrent Respiratory Infection with Combination of Traditional Chinese Medicine and Western Medicine

Objective:To investigate the effect of treatment of infant recurrent respiratory infection (RRTI) with combination of traditional Chinese medicine and Western medicine. Method: Ninety RRTI patients were randomly divided into observation group and control group (n=45 each). At attack stage, the two groups were received routine western medicine therapy. At remission stage, control group was orally received transfer factor oral solution, 10 mL once daily, and observation group was orally treated with Huangqi Shengmai yin, 10 mL twice daily and Shenlin Baizhu powder, 1 agent daily (taken half by half). The treatment course of two groups was 8 weeks, and follow-up time lasted 6 months. Score of lung and spleen deficiency syndrome was observed, T-cell subsets and immunoglobulin were tested before and after treatment. Result: The total effective rate of observation group (97.77%) was higher than that of control group (66.66%) with a significant difference (P<0.01). The improvement of CD3⁺,CD4⁺,CD8⁺ and CD4⁺/CD8⁺ in observation group were better than those in control group (P<0.05, P<0.01). After treatment, IgG and IgA in observation group were increased significantly than those in control group (P<0.01). The syndrome score of lung and spleen deficiency in observation group were significantly lower than those in control group (P<0.01). Conclusion: Western medicine therapy, used at attack stage, combined with Huangqi Shengmai yin and Shenlin Baizhu powder, used at remission stage can improve physical condition of infected children, promote patient immunity, reduce clinical symptom and treat infant recurrent respiratory infection effectively.