华盖散加减联合奥司他韦治疗小儿流感病毒性肺炎风寒闭肺证临床研究
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Clinical Study on Modified Huagai Powder Combined with Oseltamivir for Children with Influenza Viral Pneumonia with Wind-Cold Obstructing Lung Syndrome
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    摘要:

    目的:观察华盖散加减联合奥司他韦治疗小儿流感病毒性肺炎风寒闭肺证的临床疗效。方法:选取200 例流感病毒性肺炎风寒闭肺证患儿,采用随机数字表法分为观察组和对照组,每组100 例。对照组给予磷酸奥司他韦颗粒治疗,观察组在对照组基础上给予华盖散加减治疗,2 组均连续治疗7 d。比较2 组临床疗效及主要症状、体征缓解时间,比较2 组治疗前后潮气呼吸肺功能、外周血T 淋巴细胞亚群指标及血清炎症因子水平,记录不良反应。结果:观察组总有效率为96.00%,高于对照组的86.00% (P<0.05)。观察组退热时间及喘促、咳嗽、肺部啰音缓解时间均短于对照组(P<0.05)。治疗后,2 组潮气量(Vt)、达峰时间比(TPTEF/TE) 及达峰容积比(VPEF/VE) 均较治疗前改善(P<0.05);观察组上述潮气呼吸肺功能指标改善情况均优于对照组(P<0.05)。治疗后,2 组外周血CD4+水平均较治疗前升高(P<0.05),CD4+/CD8+均较治疗前增大(P<0.05),CD8+水平均较治疗前降低(P<0.05);观察组外周血CD4+水平高于对照组(P<0.05),CD4+/CD8+大于对照组(P<0.05),CD8+水平低于对照组(P<0.05)。治疗后,2 组血清白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、C-反应蛋白(CRP)水平均较治疗前降低(P<0.05),观察组IL-6、TNF-α、CRP 水平均低于对照组(P<0.05)。观察组不良反应发生率为11.00%,与对照组的13.00%比较,差异无统计学意义(P>0.05)。结论:华盖散加减联合奥司他韦治疗小儿流感病毒性肺炎风寒闭肺证,可有效缓解患儿的症状及体征,保护肺功能,其作用机制可能与正性调控T 淋巴细胞亚群、下调炎症因子表达水平有关。

    Abstract:

    Abstract: Objective: To observe the clinical effect of modified Huagai powder combined with oseltamivir for children with influenza viral pneumonia with wind- cold obstructing lung syndrome. Methods: A total of 200 cases of children with influenza viral pneumonia with wind-cold obstructing lung syndrome were selected and divided into the observation group and the control group according to the random number table method, 100 cases in each group. The control group was given phosphate oseltamivir granules, and the observation group was additionally given modified Huagai powder based on the treatment of the control group. Both groups were continuously treated for seven days. The clinical effect and the remission time of main symptoms and signs were compared between the two groups. Before and after treatment,tidal breathing lung function,indexes of T-lymphocyte subsets in peripheral blood,and levels of inflammatory factors in serum were compared between the two groups. The incidence of adverse reactions was recorded. Results:The total effective rate was 96.00% in the observation group,higher than that of 86.00% in the control group(P<0.05);the fever subsidence time as well as the remission time of tachypnea,cough,and the lung rales in the observation group was shorter than that in the control group (P<0.05). After treatment,tidal volume(Vt),the ratio of time to peak tidal expiratory flow to total expiratory time (TPTEF/TE), and the ratio of volume at peak tidal expiratory flow to expiratory tidal volume(VPEF/VE) in the two groups were improved when compared with those before treatment(P<0.05);the improvement of the indexes of tidal breathing lung function above in the observation group was better than that in the control group(P<0.05). After treatment, in the two groups, levels of CD4 + in peripheral blood were increased when compared with those before treatment(P<0.05);CD4 +/CD8 + were enlarged (P<0.05);levels of CD8+ were decreased(P<0.05). After treatment,in the observation group,the level of CD4+ was higher than that in the control group(P<0.05);CD4+/CD8+ was larger(P<0.05);the level of CD8+ in peripheral blood was lower(P< 0.05). After treatment,levels of interleukin(IL)- 6,tumor necrosis factor(TNF)- α,and C- reactive protein(CRP) in serum in the two groups were decreased when compared with those before treatment(P<0.05), and the three levels above in the observation group were lower than those in the control group(P<0.05). The incidence of adverse reactions was 11.00% in the observation group,and 13.00% in the control group;there was no significant difference being found in the comparison of the incidence between the two groups(P>0.05). Conclusion: In the treatment of children with influenza viral pneumonia with wind- cold obstructing lung syndrome, the therapy of modified Huagai powder combined with oseltamivir can effectively relieve their symptoms and signs,and protect the lung function. Its mechanism is probably related to positive regulation of T-lymphocyte subsets and down-regulation of expression level of inflammatory factors.

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沈晓飞,吴莉城,李小红.华盖散加减联合奥司他韦治疗小儿流感病毒性肺炎风寒闭肺证临床研究[J].新中医,2021,53(12):27-31

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  • 在线发布日期: 2021-06-23
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