槐杞黄颗粒联合利巴韦林、亿活治疗轮状病毒感染性腹泻并心肌损害的临床价值
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摘要
目的观察在轮状病毒感染性腹泻并心肌损害患儿中,应用槐杞黄颗粒联合利巴韦林、亿活的方案对其临床疗效、心肌酶水平及炎症因子的影响.方法回顾性分析2013-10/2016-10期间,我院收治的210例轮状病毒感染性腹泻并心肌损害患儿的临床资料,其中100例患儿给予利巴韦林、亿活进行治疗,将其作为对照组,110例患儿给予槐杞黄颗粒联合利巴韦林、亿活治疗,将其作为观察组.然后将两组患儿的临床疗效、心肌酶水平及炎症因子水平等指标进行比较.结果经过治疗后,观察组患儿的治疗总有效率为94.55%,明显高于对照组的83%,差异有统计学意义;在治疗前,两组患儿的CK、CK-MB、LDH、AST水平无明显差异,无统计学意义(P>0.05);在治疗后,观察组患儿的CK、CK-MB、LDH、AST水平分别为138.05±22.56、17.06±4.61、131.39±20.39、25.25±5.21,明显低于对照组的199.76±22.35、29.22±4.58、251.89±31.46、43.28±6.37,差异均具有统计学意义(P<0.05);在治疗前,两组患儿的IL-6、IL-10、TNF-α水平无明显差异,无统计学意义(P>0.05);在治疗后,观察组患儿的IL-6、IL-10、TNF-α水平分别为92.06±12.61、9.25±2.16、2.05±0.35,明显低于对照组的133.22±15.58、20.08±3.22、3.12±0.41,差异均具有统计学意义(P<0.05).结论在轮状病毒感染性腹泻并心肌损害患儿中应用槐杞黄颗粒联合利巴韦林、亿活的治疗方案,能够显著提高临床疗效,有效降低其炎性反应,保护心肌免受损伤.
AIM To observe the clinical efficacy of Huaiqihuang granules combined with ribavirin and Saccharomyces boulardii sachets in treating children with rotavirus-induced diarrhea and myocardial damage and the impact on the levels of myocardial enzyme and inflammatory cytokines.METHODS The clinical data of 210 children with rotavirus-induced diarrhea and myocardial damage admitted to our hospital from October 2013 to October 2016 were retrospectively analyzed. Among them, 100 cases were given ribavirin combined with Saccharomyces boulardii sachets(control group), and 110 cases were given Huaiqihuang granules combined with ribavirin and Saccharomyces boulardii sachets(observation group). Clinical efficacy, myocardial enzyme levels, and the levels of inflammatory cytokines were compared between the two groups.RESULTS After treatment, the total effective rate was significantly higher in the observation group than in the control group(94.55% vs 83%, P < 0.05). Before treatment, there was no significant difference in CK, CK-MB, LDH, or AST levels between the two groups(P > 0.05). After treatment, the levels of CK, CK-MB, LDH, and AST were significantly lower in the observation group than in the control group(138.05 ± 22.56 vs 199.76 ± 22.35, 17.06 ± 4.61 vs 29.22 ± 4.58, 131.39 ± 20.39 vs 251.89 ± 31.46, 25.25 ± 5.21 vs 43.28 ± 6.37, P < 0.05). Before treatment, there was no significant difference in the levels of IL-6, IL-10, or TNF-α between the two groups(P > 0.05). After treatment, the levels of IL-6, IL-10, and TNF-α in the observation group were significantly lower than those in the control group(92.06 ± 12.61 vs 133.22 ± 15.58, 9.25 ± 2.16 vs 20.08 ± 3.22, 2.05 ± 0.35 vs 3.12 ± 0.41, P < 0.05).CONCLUSION Huaiqihuang granules combined with ribavirin and Saccharomyces boulardii sachets in children with rotavirus-induced diarrhea and myocardial damage can significantly improve the clinical curative effect, reduce the inflammatory reaction, and protect the myocardium from injury.
AIM To observe the clinical efficacy of Huaiqihuang granules combined with ribavirin and Saccharomyces boulardii sachets in treating children with rotavirus-induced diarrhea and myocardial damage and the impact on the levels of myocardial enzyme and inflammatory cytokines.METHODS The clinical data of 210 children with rotavirus-induced diarrhea and myocardial damage admitted to our hospital from October 2013 to October 2016 were retrospectively analyzed. Among them, 100 cases were given ribavirin combined with Saccharomyces boulardii sachets(control group), and 110 cases were given Huaiqihuang granules combined with ribavirin and Saccharomyces boulardii sachets(observation group). Clinical efficacy, myocardial enzyme levels, and the levels of inflammatory cytokines were compared between the two groups.RESULTS After treatment, the total effective rate was significantly higher in the observation group than in the control group(94.55% vs 83%, P < 0.05). Before treatment, there was no significant difference in CK, CK-MB, LDH, or AST levels between the two groups(P > 0.05). After treatment, the levels of CK, CK-MB, LDH, and AST were significantly lower in the observation group than in the control group(138.05 ± 22.56 vs 199.76 ± 22.35, 17.06 ± 4.61 vs 29.22 ± 4.58, 131.39 ± 20.39 vs 251.89 ± 31.46, 25.25 ± 5.21 vs 43.28 ± 6.37, P < 0.05). Before treatment, there was no significant difference in the levels of IL-6, IL-10, or TNF-α between the two groups(P > 0.05). After treatment, the levels of IL-6, IL-10, and TNF-α in the observation group were significantly lower than those in the control group(92.06 ± 12.61 vs 133.22 ± 15.58, 9.25 ± 2.16 vs 20.08 ± 3.22, 2.05 ± 0.35 vs 3.12 ± 0.41, P < 0.05).CONCLUSION Huaiqihuang granules combined with ribavirin and Saccharomyces boulardii sachets in children with rotavirus-induced diarrhea and myocardial damage can significantly improve the clinical curative effect, reduce the inflammatory reaction, and protect the myocardium from injury.
引文
1 赵嘉咏,申晓靖,张白帆,苏佳,段晶晶,王喜,夏胜利.河南省2008年至2015年5岁以下儿童病毒性腹泻病原谱及流行病学分析.中华传染病杂志2016;34:738-742[DOI:10.3760/cma.j.issn.1000-6680.2016.12.008]
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5 岑小玲,李晓,刘全.1,6-二磷酸果糖治疗轮状病毒肠炎伴心肌损害的疗效观察.深圳中西医结合杂志2016;26:28-30[DOI:10 .16458/j.cnki.1007-0893.2016.04.013]
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14 卫丽,白涛敏,高颖,白玉,韩伟.婴幼儿轮状病毒肠炎60例肠道外损害分析.陕西医学杂志2017;46:1174-1175,1192[DOI:10 .3969/j.issn.1000-7377.2017.09.008]
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18 陈思如.PCT、CRP、hs-CRP在急性轮状病毒肠炎伴心肌损害中的表达.现代临床医学2017;43:185-186,188[DOI:10 .11851/j.issn.1673-1557.2017.03.009]
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26 Acquistapace G,Rossi M,Garbi M,Cosci P,Canetta C,Manelli A,Ricevuti G.Acute metformin intoxication:2012experience of Emergency Departement of Lodi,Italy.Clin Chem Lab Med 2014;52:1489-1497[PMID:24940713]
27 张书琳.槐耳及其复方制剂槐杞黄颗粒的研究进展.医学综述2015;21:114-116[DOI:10.3969/j.issn.1006-2084.2015.01.045]
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2 王鹏,原新慧,林谦,沈一燚,卢燕,全瑶,金玉,程卫霞.南京2011-2013年婴幼儿腹泻轮状病毒分子流行病学研究.中华实验和临床病毒学杂志2015;29:207-209[DOI:10.3760/cma.j.issn.1003-9279.2015.03.005]
3 张海琼,莫胜福,蒋渝采,韦兴高,覃麦.腹泻患儿轮状病毒与腺病毒抗原检测结果分析.中华医院感染学杂志2016;26:2602-2603,2630[DOI:10.11816/cn.ni.2016-151352]
4 马德强,王道静,王梅春.轮状病毒感染患儿的临床特征及相关因素分析.中华医院感染学杂志2017;27:4016-4019[DOI:10 .11816/cn.ni.2017-170384]
5 岑小玲,李晓,刘全.1,6-二磷酸果糖治疗轮状病毒肠炎伴心肌损害的疗效观察.深圳中西医结合杂志2016;26:28-30[DOI:10 .16458/j.cnki.1007-0893.2016.04.013]
6 毛中华.益生菌与免疫球蛋白口服辅助治疗儿童轮状病毒性肠炎的疗效对比分析.中国肛肠病杂志2017;37:33-35[DOI:10 .3969/j.issn.1000-1174.2017.04.017]
7 梁忠培,杨力,邓昌枢,董红琴,李同欢,王宇.参苓白术散加减辅助推拿辩证治疗小儿急性轮状病毒感染性腹泻的临床疗效研究.中华医院感染学杂志2017;27:5262-5265[DOI:10 .11816/cn.ni.2017-170928]
8 朱通球,张晓桂,刘勇,孟慧娴,彭友.心肌酶检测评价婴幼儿轮状病毒腹泻并心肌损害.实用预防医学2014;21:811-811,880,881[DOI:10.3969/j.issn.1006-3110.2014.07.041]
9 周文,罗友昌.喜炎平治疗小儿轮状病毒腹泻伴心肌损害58例疗效观察.浙江中医杂志2013;48:619-620[DOI:10.3969/j.issn.0411-8421.2013.08.054]
10 李亚冰.婴幼儿轮状病毒腹泻伴发心肌损害56例回顾性分析.中国中西医结合儿科学2010;02:519-520[DOI:10.3969/j.issn.1674-3865.2010.06.019]
11 夏慧.婴幼儿轮状病毒腹泻引起心肌酶谱变化的临床分析.牡丹江医学院学报2012;33:45-46[DOI:10.3969/j.issn.1001-7550.2012.04.023]
12 何火英.婴幼儿轮状病毒肠炎合并心肌损害的临床分析.实用临床医药杂志2015;19:141-142[DOI:10.7619/jcmp.201505052]
13 孙蕊蕊,刘晓东,栾孟福,李田华,刘茜.儿童轮状病毒性肠炎并发心肌损害的影响因素研究.中国全科医学2015;18:425-427[DOI:10.3969/j.issn.1007-9572.2015.04.017]
14 卫丽,白涛敏,高颖,白玉,韩伟.婴幼儿轮状病毒肠炎60例肠道外损害分析.陕西医学杂志2017;46:1174-1175,1192[DOI:10 .3969/j.issn.1000-7377.2017.09.008]
15 江超雄,杨长青,王慧,白卉,苏建华,许春娣.婴幼儿轮状病毒感染致肠外损害的临床研究.国际儿科学杂志2017;44:205-209[DOI:10.3760/cma.j.issn.1673-4408.2017.03.015]
16 王利君.金双歧联合思密达治疗4 8例小儿腹泻的临床疗效观察.北方药学2018;15:84-85[DOI:10.3969/j.issn.1672-8351.2018.01.072]
17 侯小燕.小儿腹泻致病因素分析和临床治疗作用探讨.医药前沿2018;8:268-269[DOI:10.3969/j.issn.2095-1752.2018.05.227]
18 陈思如.PCT、CRP、hs-CRP在急性轮状病毒肠炎伴心肌损害中的表达.现代临床医学2017;43:185-186,188[DOI:10 .11851/j.issn.1673-1557.2017.03.009]
19 殷朝阳.蒙脱石散保留灌肠联合锌制剂治疗小儿腹泻的效果.检验医学与临床2018;15:254-256[DOI:10.3969/j.issn.1672-9455.2018.02.037]
20 宋翠领,曹锦芬,张晓,李丽,张慧颖.瑞安吉口服液联合煨葛根穴位贴治疗小儿轮状病毒肠炎.吉林中医药2018;38:220-223[DOI:10.13463/j.cnki.jlzyy.2018.02.029]
21 张善凤,邹贵雄.喜炎平配合双歧杆菌与利巴韦林治疗小儿病毒型腹泻的疗效分析.深圳中西医结合杂志2017;27:100-101[DOI:10.16458/j.cnki.1007-0893.2017.14.047]
22 柯旭,李丽华,黎碧婵,崔泽敏,李宏想,周惠嫦,杨燕华,何永盛.中西药结合治疗消化不良性腹泻患儿有效性分析.实用中西医结合临床2015;15:60-61[DOI:10.13638/j.issn.1671-4040.2015.01.037]
23 胡三红,胡海燕,刘飞,殷琰,程升保.布拉氏酵母菌治疗小儿支气管肺炎继发腹泻患儿的临床研究.中华医院感染学杂志2016;26:4061-4063[DOI:10.11816/cn.ni.2016-160313]
24 周本刚,刘梅,汪凯,肖政,张海.国内布拉氏酵母菌增效治疗幽门螺杆菌感染疗效及安全性的Meta分析.中华医院感染学杂志2016;26:4847-4851[DOI:10.11816/cn.ni.2016-161175]
25 Giannopoulos G,Angelidis C,Kouritas VK,Dedeilias P,Filippatos G,Cleman MW,Panagopoulou V,Siasos G,Tousoulis D,Lekakis J,Deftereos S.Usefulness of colchicine to reduce perioperative myocardial damage in patients who underwent on-pump coronary artery bypass grafting.Am J Cardiol 2015;115:1376-1381[PMID:25784519]
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