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目的:探讨清热平喘汤配合推拿对风热闭肺型小儿重症病毒性肺炎的疗效及对炎症因子和免疫功能的影响。方法:选择2014年3月-2015年9月我院收拾的96例小儿重症病毒性肺炎患者作为研究对象,按照随机数字表法分为治疗组和对照组各48例,对照组给予西医常规治疗,治疗组在对照组的基础上给予清热平喘汤雾化吸入配合推拿和护理干预,观察比较两组患者治疗后的临床疗效和中医证候评分,采用酶联免疫吸附法测定血清IL-6、IL-8及肿瘤坏死因子-α炎症因子,流式细胞仪测定T细胞亚群CD4~+、CD8~+细胞。结果:治疗组的总有效率为83.33%,显著高于对照组的60.42%(P<0.05);治疗后两组患者的症状、体征、舌象、脉象积分均降低,且治疗组优于对照组(P<0.05);治疗后两组的血清IL-6、IL-8、肿瘤坏死因子-α炎症因子均低于治疗前,且治疗组低于对照组(P<0.05);治疗后,两组的T细胞CD4~+、CD8~+均高于治疗前,且治疗组高于对照组(P<0.05)。结论:清热平喘汤配合推拿疗法和护理干预治疗小儿重症病毒性肺炎,可通过减轻炎症反应,调节机体免疫功能,提高临床疗效,降低中医证候积分。
Objective: To investigate the effect of Qingre Pingchuan Decoction combined with massage on inflamed and closed children with severe pneumonia and its effect on inflammatory factors and immune function. Methods: A total of 96 pediatric severe pneumonia patients who were treated in our hospital from March 2014 to September 2015 were selected as the study subjects, divided into treatment group (48 cases) and control group (48 cases) according to the random number table method. The control group , The treatment group on the basis of the control group was given Qingre Pingchuan Tang aerosol inhalation combined with nursing and nursing interventions were observed and compared the clinical efficacy and TCM syndromes after treatment in both groups were measured by enzyme-linked immunosorbent assay serum IL-6 , IL-8 and tumor necrosis factor-αinflammatory cytokines were detected by flow cytometry. T cell subsets CD4 ~ + and CD8 ~ + cells were detected by flow cytometry. Results: The total effective rate of the treatment group was 83.33%, which was significantly higher than that of the control group (60.42%, P <0.05). The symptoms, signs, tongue and pulse integral of the two groups were decreased after treatment, (P <0.05). After treatment, the serum levels of IL-6, IL-8 and TNF-α in the two groups were lower than those before treatment and lower in the treatment group than those in the control group (P <0.05) The CD4 ~ +, CD8 ~ + of T cells in both groups were higher than before treatment, and the treatment group was higher than the control group (P <0.05). Conclusion: Qingre Pingchuan Decoction combined with massage therapy and nursing intervention in the treatment of severe pneumonia in children can reduce the inflammatory reaction, regulate the immune function, improve the clinical curative effect and reduce the TCM syndrome score.