从抑制炎性因子和提高免疫功能方面探究小儿热速清颗粒治疗小儿疱疹性咽峡炎的机制

曾丽琳

摘 要 目的：观察小儿热速清颗粒治疗小儿疱疹性咽峡炎对炎性因子和免疫功能的影响。方法：收治疱疹性咽峡炎患儿72例，随机分为两组，各36例。对照组应用清开灵注射液治疗，观察组采取清开灵注射液联合小儿热速清颗粒进行治疗。比较两组治疗总有效率、治疗前及治疗5 d的白细胞介素一10（IL一10）、人干扰素（IFN一r）、1gA、1gG、1gM水平、不良反应总发生率。结果：观察组治疗总有效率94.44%，显著高于对照组的77.78%，差异有统计学意义（P

关键词 小儿疱疹性咽峡炎;小儿热速清颗粒;炎性因子;免疫能力

Study on the mechanism of pediatric resuqing granllles jll tlle treatrnent of cllildren witg herpangina from inhibition ofinflammatory faCtorS and enhancement of immune fhnctionZeng Lilin

Depanment of Pediatrics，the Second People's Hospita1 of Deyang City 618000

Abstract objective：To observe the effect of pediatric resuqing granules on inflammatory factors and immune function in thetreatment of children with herpangina.Methods：72 cases with herpangina were selected，they were randomly divided into me twogroups with 36 cases in each group.The control group was treated with Qingkailing injection，while the observation group wastreated with Qingkailing injection combined with pediatric resuqing granule.The total effective rate，the levels of IL一10，IFN一y，IgA，IgG，IgM before treatment and 5 days of aner treatment and the total incidence of adverse reactions were compared betweentwo groups.Resuhs：The total effective rate of the observation group was 94.44%，which was significantly higher than 77.78%in thecontrol group，the difference was statically significant（P<0.05）.Aner treatment，the levels of semm IL一10，IgG，IgA and IgM inboth gmups were significantly higher than those before treatmem，and the levels of IFN一y were significamly lower than thosebefbre treatment（P<0.05）.After treatment，the serum levels of IL一10，IgG，IgA and IgM in the observation group were significantlyhigher than those in the comrol group，and the levels of IFN—gamma were significantly lower than those in the contml group（P<0.05）.Conclusion：The pediatric resuqing granules in the treatment of children with herpangina can effectively inhibit inflammatorycytokines，improve immunity，the treatment has been strengthened，safe and reliable.

Key words

Children with herpangina;Pediatric resuqing granules;Inflammatory factors;Immune

疱疹性咽峡炎为感染性咽峡炎，多由柯萨奇病毒、埃可病毒30型引起，主要表现为咽痛、咽部灰白色疱疹。据报道[l]，该病多见于夏秋季，以1-7岁儿童高发，传染性强。目前该病尚无特异性治疗方案，以抗病毒治疗为主。利巴韦林具有良好抗病毒效果，但不良反应明显，寻找治疗疱疹性咽峡炎的有效治疗方法意义重大。清开灵注射液以往主要用于治疗肺炎、呼吸道感染、病毒性肝炎等病，在呼吸内科、消化内科中应用广泛。但近年研究发现[2]，该药对部分疱疹性咽峡炎患儿的治疗效果并不理想。小儿热速清颗粒可清热、利咽、解毒，常用于发热头痛、咽喉红肿等的治疗[3]。收治疱疹性咽峡炎患儿72例，从抑制炎性因子、增强免疫方面分析小儿热速清颗粒治疗小儿疱疹性咽峡炎的机制，现报告如下。

资料与方法

2016年3月-2017年10月收治疱疹性咽峡炎患儿72例，按随机数字表分为两组，各36例。观察组男20例，女16例;年龄1 - IO岁，平均（4.32±1.22）岁;病程1-8d，平均（3.01±1.4l）d;體温38.2 - 40.2℃，平均（39.00±0.55）℃。对照组男17例，女19例;年龄1-9岁，平均（4.53±1.34）岁;病程1-7d，平均（3.41±1.28）d;体温38.0 - 40.1℃，平均（39.08±0.49）℃。两组基线资料差异无统计学意义（P>0.05），具有可比性。 纳入标准：①符合《儿科学》中疱疹性咽峡炎诊断标准[4]：均伴发热，查咽可见明显充血，咽峡部可见直径2-4 mm黄白色疱疹，多少不等;②年龄1- 10岁;③研究获医院伦理委员批准，患者签署知情同意书。