曾麗琳

摘 要 目的：觀察小兒熱速清顆粒治療小兒皰疹性咽峽炎對炎性因子和免疫功能的影響。方法：收治皰疹性咽峽炎患兒72例，隨機(jī)分為兩組，各36例。對照組應(yīng)用清開靈注射液治療，觀察組采取清開靈注射液聯(lián)合小兒熱速清顆粒進(jìn)行治療。比較兩組治療總有效率、治療前及治療5 d的白細(xì)胞介素一10（IL一10）、人干擾素（IFN一r）、1gA、1gG、1gM水平、不良反應(yīng)總發(fā)生率。結(jié)果：觀察組治療總有效率94.44%，顯著高于對照組的77.78%，差異有統(tǒng)計(jì)學(xué)意義（P

關(guān)鍵詞 小兒皰疹性咽峽炎;小兒熱速清顆粒;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

皰疹性咽峽炎為感染性咽峽炎，多由柯薩奇病毒、?？刹《?0型引起，主要表現(xiàn)為咽痛、咽部灰白色皰疹。據(jù)報(bào)道[l]，該病多見于夏秋季，以1-7歲兒童高發(fā)，傳染性強(qiáng)。目前該病尚無特異性治療方案，以抗病毒治療為主。利巴韋林具有良好抗病毒效果，但不良反應(yīng)明顯，尋找治療皰疹性咽峽炎的有效治療方法意義重大。清開靈注射液以往主要用于治療肺炎、呼吸道感染、病毒性肝炎等病，在呼吸內(nèi)科、消化內(nèi)科中應(yīng)用廣泛。但近年研究發(fā)現(xiàn)[2]，該藥對部分皰疹性咽峽炎患兒的治療效果并不理想。小兒熱速清顆?？汕鍩帷⒗?、解毒，常用于發(fā)熱頭痛、咽喉紅腫等的治療[3]。收治皰疹性咽峽炎患兒72例，從抑制炎性因子、增強(qiáng)免疫方面分析小兒熱速清顆粒治療小兒皰疹性咽峽炎的機(jī)制，現(xiàn)報(bào)告如下。

資料與方法

2016年3月-2017年10月收治皰疹性咽峽炎患兒72例，按隨機(jī)數(shù)字表分為兩組，各36例。觀察組男20例，女16例;年齡1 - IO歲，平均（4.32±1.22）歲;病程1-8d，平均（3.01±1.4l）d;體溫38.2 - 40.2℃，平均（39.00±0.55）℃。對照組男17例，女19例;年齡1-9歲，平均（4.53±1.34）歲;病程1-7d，平均（3.41±1.28）d;體溫38.0 - 40.1℃，平均（39.08±0.49）℃。兩組基線資料差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。 納入標(biāo)準(zhǔn)：①符合《兒科學(xué)》中皰疹性咽峽炎診斷標(biāo)準(zhǔn)[4]：均伴發(fā)熱，查咽可見明顯充血，咽峽部可見直徑2-4 mm黃白色皰疹，多少不等;②年齡1- 10歲;③研究獲醫(yī)院倫理委員批準(zhǔn)，患者簽署知情同意書。