中西医结合治疗儿童疱疹性咽峡炎40例临床观察

目的观察中西医结合治疗儿童疱疹性咽峡炎的临床疗效。方法选取2017年1月至2019年7月嘉兴市第二医院耳鼻咽喉科收治的疱疹性咽峡炎患儿80例,按随机数字表法分为治疗组和对照组,各40例。对照组给予西医常规对症治疗,治疗组在对照组治疗方法的基础上加用清肺利咽汤治疗。2组均5 d为1个疗程,连续治疗1个疗程后统计临床疗效、临床症状消失时间、血清炎症因子降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6(IL-6)]和T淋巴细胞亚群CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺水平。结果治疗组总有效率为95.0%(38/40),显著高于对照组的75.0%(30/40),2组比较,差异有统计学意义(P<0.05)。治疗组疱疹消退时间、发热消退时间及咽痛消失时间均短于对照组,2组比较,差异有统计学意义(P<0.01)。治疗前,2组血清炎症因子PCT、IL-6、CRP水平比较,差异均无统计学意义(P>0.05),具有可比性;治疗后,2组PCT、IL-6及CRP水平均较同组治疗前降低(P<0.05),且治疗组降低更显著,差异有统计学意义(P<0.05)。治疗前,2组T淋巴细胞亚群CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺水平比较,差异均无统计学意义(P>0.05),具有可比性;治疗后,2组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平较同组治疗前升高(P<0.05),CD8⁺水平降低(P<0.05),且治疗组升高/降低更显著,差异有统计学意义(P<0.05)。结论中西医结合治疗儿童疱疹性咽峡炎能有效提高临床疗效,不仅可促进临床症状消失,而且有助于减轻炎症反应,提高患儿的机体免疫力,值得临床推广应用。

Clinical observation on 40 cases of children with herpangina treated by combined traditional Chinese and Western medicine

Objective To observe the clinical efficacy of combined traditional Chinese and Western medicine in the treatment of children with herpangina.Methods From January 2017 to July 2019,80 children with herpangina admitted into otolaryngology department of Jiaxing Municipal The Second Hospital were divided into treatment group and control group according to random number table method, with 40 cases in each.The control group was given routine Western medicine symptomatic treatment,on this basis,the treatment group was added with Qingfei Liyan Tang(清肺利咽汤).Five days constituted 1 course of treatment for the 2 groups,we kept statistics about the clinical efficacy,the disappearance time of clinical symptoms,the levels of serum inflammatory factorsprocalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6)] and T lymphocyte subsets CD3⁺,CD4⁺,CD8⁺ and CD4⁺/CD8⁺.Results The total effective rate of the treatment group was 95.0%(38/40),which was significantly higher than 75.0%(30/40) of the control group,and the difference was statistically significant between the 2 groups(P<0.05).The extinction time of herpes,fever and sore throat in the treatment group were shorter than those in the control group,and the difference was statistically significant between the 2 groups(P<0.01).Before treatment,the difference was not statistically significant in the levels of serum inflammatory factors PCT,IL-6 and CRP(P>0.05),and they were comparable.After treatment,the levels of PCT,IL-6 and CRP in the 2 groups decreased compared with those in the same group before treatment(P<0.05),moreover,the treatment group decreased more significantly,and the difference was statistically significant(P<0.05). Before treatment, the difference was not statistically significant in the levels of T lymphocyte subsets CD3⁺,CD4⁺,CD8⁺ and CD4⁺/CD8⁺ between the 2 groups(P>0.05),and they were comparable.After treatment, the levels of CD3⁺,CD4⁺and CD4⁺/CD8⁺ increased in the 2 groups compared with those in the same group before treatment(P<0.05),the level of CD8⁺ decreased(P<0.05),moreover,the treatment group increased/decreased more significantly, and the difference was statistically significant(P<0.05).Conclusion It can effectively improve clinical efficacy for combined traditional Chinese and Western medicine in the treatment of children with herpangina,which can not only promote the disappearance of clinical symptoms, but also help to reduce the inflammatory reactions and improve the body immunity of children.It deserves clinical promotion and application.