论文部分内容阅读
目的探讨热毒净治疗儿童传染性单核细胞增多症的临床疗效及其安全性。方法将2013年1月1日至2015年12月31日首都医科大学附属北京友谊医院儿科病房收治的传染性单核细胞增多症患儿共113例纳入本研究,热毒净组86例,非热毒净组27例。观察两组的临床症状(发热),体征(皮疹、淋巴结肿大、咽峡炎、肝脾肿大)及实验室检查指标(外周血异型淋巴细胞比例、外周血白细胞计数、外周血淋巴细胞比例、肝功能、外周血T细胞亚群CD4~+、CD8~+及CD4~+/CD8~+值、外周血EBV-DNA),不良反应情况。比较两组临床疗效及其安全性,并对结果进行统计学分析。结果热毒净组86例,显效41例,有效40例,无效5例;非热毒净组27例,显效8例,有效14例,无效5例;热毒净组总有效率显著高于非热毒净组(94.2%vs.81.5%,P<0.05)。热毒净组热退时间、咽峡炎消失时间、颈部淋巴结肿大消退时间、肝脾肿大消退时间明显短于非热毒净组(P<0.05)。热毒净组治疗后的外周血异型淋巴细胞比例、外周血白细胞计数、外周血淋巴细胞比例与非热毒净组治疗后的指标比较,差异无统计学意义(P>0.05);治疗后两组患儿的证候总积分比治疗前均明显降低(P=0.000),且热毒净组临床症状总积分的改善明显优于非热毒净组(P=0.046)。热毒净组治疗后肝功能、外周血T细胞亚群CD4~+、CD8~+及CD4~+/CD8~+值与非热毒净组治疗后的指标比较,差异均有统计学意义(P<0.05);热毒净组治疗后外周血EBV-DNA阴性率明显高于非热毒净组(81.4%vs.63.0%,P<0.05)。两组患儿实验室检查结果(血、尿、便、肾功能)、胃肠道反应均未出现明显异常改变。结论热毒净口服液能够提高儿童传染性单核细胞增多症的治疗效果,安全性较高,可进一步推广。
Objective To investigate the clinical efficacy and safety of Tachiken in the treatment of children’s infectious mononucleosis. Methods From January 1, 2013 to December 31, 2015, 113 children with infectious mononucleosis admitted to the Pediatric Ward of Beijing Friendship Hospital affiliated to Capital Medical University were enrolled in this study. 86 cases Heat toxic net group of 27 cases. The clinical symptoms (fever), signs (rash, swollen lymph nodes, angina, hepatosplenomegaly) and laboratory tests (peripheral blood atypical lymphocyte proportion, peripheral blood leukocyte count, peripheral blood lymphocyte proportion , Liver function, CD4 ~ +, CD8 ~ + and CD4 ~ + / CD8 ~ + in peripheral blood T cell subsets, EBV-DNA in peripheral blood) and adverse reactions. The clinical efficacy and safety of the two groups were compared, and the results were statistically analyzed. Results Toxic net group of 86 cases, markedly effective in 41 cases, effective in 40 cases, 5 cases of ineffective; non-heat toxic net group of 27 cases, 8 cases markedly effective in 14 cases, 5 cases ineffective; heat toxicity net group was significantly higher than the total effective rate Non-heat toxicity net group (94.2% vs.81.5%, P <0.05). Heat net group heat back time, disappearance of angina, cervical lymph node regression time, hepatosplenomegaly regression time was significantly shorter than non-heat toxicity net group (P <0.05). There was no significant difference in the ratio of peripheral blood lymphocyte, peripheral blood leukocyte count, peripheral blood lymphocyte ratio and non-heat toxicity net group after treatment (P> 0.05) The total score of syndromes of children in the treatment group was significantly lower than that before treatment (P = 0.000), and the improvement of clinical symptom scores in the treatment group was significantly better than that in the non-heat toxicity therapy group (P = 0.046). Compared with the untreated group after treatment, the difference was statistically significant (P <0.05), and the differences were statistically significant (P <0.05) P <0.05). The negative rate of EBV-DNA in peripheral blood was significantly higher in the treatment group than in the untreated group (81.4% vs.63.0%, P <0.05). Two groups of children with laboratory test results (blood, urine, urine, renal function), gastrointestinal reactions showed no significant abnormal changes. Conclusion RTCD can improve the therapeutic effect of infectious mononucleosis in children with high safety and can be further popularized.