保元汤对婴幼儿室间隔缺损修补术后细胞免疫及肺感染的影响

目的:探讨保元汤婴幼儿室间隔缺损修补术后调节细胞免疫的能力及防治肺感染的作用。方法:将85例婴幼儿室间隔缺损患儿随机分为两组,对照组42例,按常规手术和术后处理,治疗组43例,在常规手术和术后处理的同时,手术前7d起口服纯中药保元汤煎剂,所有患儿于手术前8d及术后3d取静脉血10mL(肝素抗凝)分别做T淋巴细胞集落培养和流式细胞仪T淋巴细胞亚群测定,同时观察术后发生肺感染情况。结果:(1)对照组18患儿发生肺感染,其中支气管炎10例,肺炎6例,呼吸衰竭2例,治疗组9例患儿发生肺感染,其中支气管炎7例,肺炎2例,其构成比有高度显著差异(P<0.01);(2)术后对照组患儿的TL-CFU降低,前后值为186.5VS 165.4,治疗组患儿的TL-CFU明显升高,前后值为198.9VS 276.8;术后治疗组较对照组升高明显(P<0.001);(3)对照组患儿术后的CD4+/CD8+比值高化不大,其值分别为1.32VS 1.31。(4)治疗组患儿CD4+/CD8+比值上升,其值分别为1.31VS 1.71,治疗组患儿的CD4+/CD8+,治疗组升高较对照组明显(P<0.05)。结论:保元汤煎剂口服可有效提高患儿外因血TL-CFU和CD4+/CD8+比值,增强其细胞免疫功能,可有效减少肺感染的发生率和减轻病情的严重程度。

Effect of Baoyuan decoction on cellular immune function after mending surgery for ventricular septal defect of infants and preventive effect on pulmonary infection

Objective: To discuss the effect of Baoyuan decoction on cellular immune function after mending surgery for ventricular septal defect of infants and preventive effect on pulmonary infection.Methods:A total of 85 infants with ventricular septal defect into two groups randomly.Forty-two infants in control group were treated by conventional treatment,and 43 infants in treatment group were treated with Baoyuan decoction 7 days before surgery.10 mL venous blood was extracted on 8 days before surgery and 3 day after surgery.T lymphocytes colony was cultured,and T lymphocytes subsets was detected by flow cytometry.Besides,incidence of pulmonary infection was observed after operation.Result:In control group,18 infants had pulmonary infection,including 10 bronchitis,6 pneumonia,2 respiratory failure.In treatment group,9 infants had pulmonary infection,including 7 bronchitis,2 pneumonia.There was significant difference in constituent ratio(P<0.01).In control group,TL-CFU was decreased after treatment(186.5 vs.165.4).In treatment group,value of TL-CFU was increased(198.9 vs.276.8).The level of TL-CFU was significantly higher in treatment group after treatment(P<0.001).In control group,CD4+/CD8+ was elevated(1.32 vs.1.31).While in treatment group,the change of CD4+/CD8+ was significant(1.31 vs.1.71).The change was more significant(P<0.05).Conclusion Baoyuan decoction can increase the level of TL-CFU and CD4+/CD8+ effectively,and improve the cellular immune function.Also it can reduce the incidence of pulmonary infection and alleviate patient’s condition.