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目的:观察参芪固肺汤联合匹多莫德治疗肺脾两虚证小儿反复发作呼吸道感染(RRTI)的临床疗效及对患儿免疫功能的影响。方法:将110例患儿随机分为2组各55例,对照组(脱落6例)急性感染期给予抗生素、抗病毒、退热、止咳、补液等对症治疗;并予匹多莫德口服溶液治疗,适当补充维生素和锌等微量元素。观察组(脱落7例)在对照组的基础加用参芪固肺汤内服。疗程12周,并进行24周随访,检测治疗前后血清免疫球蛋白(Ig A、IgG、Ig M)和T淋巴细胞亚群变化(CD3~+、CD4~+和CD8~+)水平;记录随访期内呼吸道感染次数、平均病程和病情程度。结果:总有效率观察组为97.92%,对照组为83.67%,2组比较,差异有统计学意义(P<0.05)。治疗后2组患者CD3~+、CD4~+、CD4~+/CD8~+均升高(P<0.01),CD8~+降低(P<0.01);且观察组上述指标改善均优于对照组(P<0.01)。治疗后2组IgG,IgA,IgM水平均较治疗前升高(P<0.01),且观察组IgG,IgA,IgM水平高于对照组(P<0.01)。随访24周,观察组平均发作次数和平均病程小于对照组、病情程度评分低于对照组,差异均有统计学意义(P<0.01)。结论:参芪固肺汤联合匹多莫德治疗肺脾两虚型RRTI,近远期疗效显著,可减少RRTI的发作次数。
Objective: To observe the clinical efficacy of Shenqi Gufei Decoction combined with pidotimod in the treatment of recurrent respiratory tract infection (RRTI) in children with pulmonary-spleen deficiency syndrome and its effect on immune function. Methods: One hundred and ten children were randomly divided into two groups (n = 55 each). The control group (n = 6) were given antibiotics, antiviral, antipyretic, antitussive and rehydration symptomatic treatment during acute infection. Treatment, appropriate vitamin and zinc and other trace elements. Observation group (7 cases of fall off) in the control group plus Shenqi Gufei Tang oral administration. The changes of serum immunoglobulin (Ig A, IgG, Ig M) and T lymphocyte subsets (CD3 +, CD4 + and CD8 +) before and after treatment were recorded after 12 weeks of treatment and 24 weeks follow-up. The number of respiratory infections during the period, the average duration and severity of illness. Results: The total effective rate was 97.92% in the observation group and 83.67% in the control group. There was significant difference between the two groups (P <0.05). After treatment, the levels of CD3 +, CD4 +, CD4 + / CD8 + in both groups were significantly increased (P <0.01) and CD8 + decreased (P <0.01), and the improvement in the observation group was better than that in the control group (P <0.01). The levels of IgG, IgA and IgM in the two groups after treatment were significantly higher than those before treatment (P <0.01), and the levels of IgG, IgA and IgM in the observation group were higher than those in the control group (P <0.01). After 24 weeks of follow-up, the average number of attacks and the average duration of disease in the observation group were less than those in the control group, and the severity of illness was lower than that in the control group (P <0.01). Conclusion: Shenqi Gufei Decoction combined with pidotimod in the treatment of pulmonary spleen deficiency type RRTI, short-term significant effect, can reduce the RRTI episodes.