中药汤对病毒性肺炎患儿血清免疫蛋白、T淋巴细胞亚群和炎症因子的影响
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摘要
目的探讨自拟中药汤对病毒性肺炎血清免疫蛋白、 T淋巴细胞亚群和炎症因子的影响。方法选取我院2015年1月-2016年1月期间收治的74例病毒性肺炎患儿作为研究对象,按照随机的方法分为观察组和对照组,各37例。对照组患儿采用西医常规治疗,观察组在对照组的基础上实施自拟中药汤治疗,包括麻黄、厚朴、陈皮、柴胡等,分别观察2组患儿的临床疗效、治疗前后中医证候积分及血清免疫蛋白、T淋巴细胞亚群和炎症因子改善情况。结果观察组总有效率为90.00%,明显优于对照组的76.66%(P <0.05);2组患者治疗后的症状、体征、舌象和脉象积分比较存在统计学意义(P <0.05),其中观察组患者的改善情况更为明显(P <0.05);治疗后,观察组患儿的IgA和IgG、IgM等血清免疫蛋白水平明显高于治疗前和对照组(P <0.05),而IgE水平却低于对照组和治疗前(P <0.05);2组患儿的T淋巴细胞亚群水平改善情况优于治疗前,且观察组显著于对照组(P <0.05);2组治疗后的IL-6、IL-8、TNF-α等炎症因子水平与治疗前比较观察组优于对照组(P <0.05)。结论自拟中药汤治疗可提高临床疗效,可有效调节患儿的免疫功能,减少炎症反应,有助于促进患儿预后康复。
Objective To investigate the effect of self-made decoction on serum immune protein, T lymphocyte subsets and inflammatory factors in viral pneumonia. Methods 74 cases of viral pneumonia in our hospital from January 2015 to January 2016 were selected as the research subjects. According to the random methods, the patients were divided into the observation group(n = 37) and the control group(n = 37). The control group was treated with western medicine, and the observation group was treated with Chinese herbal decoction on the basis of the control group. The clinical efficacy, serum immune protein, TCM syndrome scores before and after treatment, T lymphocyte subsets and inflammatory factors in two groups were measured objectively. Results The total effective rate of the observation group was 90.00%, which was significantly better than 76.66% of the control group(P<0.05). There was significant difference in symptoms, signs, tongue and pulse scores between the two groups after treatment(P<0.05),and the improvement of the patients in the observation group was more obvious(P <0.05). Before treatment, the serum immunoglobulin levels, such as IgA, IgG and IgM, were significantly higher in the observation group than before and in the control group(P <0.05), but the level of IgE was lower than that in the control group and before the treatment(P<0.05). The improvement of T lymphocyte subsets in the two groups was better than that before treatment, and the observation group was significantly higher than that in the control group(P <0.05). The levels of inflammatory factors such as IL-6, IL-8, TNF-α after treatment in the two groups were better than those in the control group(P <0.05). Conclusion Self-made traditional Chinese medicine decoction can improve the clinical efficacy, can effectively regulate the immune function of children, reduce inflammatory reaction, and help to promote therehabilitation of children.
Objective To investigate the effect of self-made decoction on serum immune protein, T lymphocyte subsets and inflammatory factors in viral pneumonia. Methods 74 cases of viral pneumonia in our hospital from January 2015 to January 2016 were selected as the research subjects. According to the random methods, the patients were divided into the observation group(n = 37) and the control group(n = 37). The control group was treated with western medicine, and the observation group was treated with Chinese herbal decoction on the basis of the control group. The clinical efficacy, serum immune protein, TCM syndrome scores before and after treatment, T lymphocyte subsets and inflammatory factors in two groups were measured objectively. Results The total effective rate of the observation group was 90.00%, which was significantly better than 76.66% of the control group(P<0.05). There was significant difference in symptoms, signs, tongue and pulse scores between the two groups after treatment(P<0.05),and the improvement of the patients in the observation group was more obvious(P <0.05). Before treatment, the serum immunoglobulin levels, such as IgA, IgG and IgM, were significantly higher in the observation group than before and in the control group(P <0.05), but the level of IgE was lower than that in the control group and before the treatment(P<0.05). The improvement of T lymphocyte subsets in the two groups was better than that before treatment, and the observation group was significantly higher than that in the control group(P <0.05). The levels of inflammatory factors such as IL-6, IL-8, TNF-α after treatment in the two groups were better than those in the control group(P <0.05). Conclusion Self-made traditional Chinese medicine decoction can improve the clinical efficacy, can effectively regulate the immune function of children, reduce inflammatory reaction, and help to promote therehabilitation of children.
引文
[1]陈陆双,徐宇坤,由凤鸣,等.中医药防治放射性肺炎方药分析[J].长春中医药大学学报,2014,30(6):1098-1100.
[2]吴方,余陈欢,俞文英,等.基于microRNAs的石荠苧总黄酮抗流感病毒性肺炎作用机制研究[J].中草药,2016,47(7):1149-1154.
[3]赵志勇,韩晶,李贤伟,等.热毒宁注射液联合大剂量丙种球蛋白治疗小儿急性重症病毒性肺炎疗效观察[J].现代中西医结合杂志,2016,25(29):3264-3266.
[4]吴会玲,宋希,申玉英.血必净注射液联合人免疫球蛋白治疗重症病毒性肺炎的临床研究[J].现代药物与临床,2016,31(11):1725-1728.
[5]VAKIL E,EVANS S E.Viral pneumonia in patients with hematologic malignancy or hematopoietic stem cell transplantation[J].Clinics in Chest Medicine,2017,38(1):97-98.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:54-60.
[7]CAO B,GAO H,ZHOU B,et al.Adjuvant corticosteroid treatment in adults with influenza a(H7N9)viral pneumonia[J].Critical Care Medicine,2016,44(6):e318.
[8]汪受传,孙轶秋,卞国本,等.清肺口服液治疗小儿病毒性肺炎痰热闭肺证507例临床研究[J].世界中医药,2016,11(9):1649-1653.
[9]劳慧敏,曹宏,王晓.呼吸道合胞病毒肺炎患儿中医辨证分型与实验室指标的相关性[J].吉林中医药,2015,35(10):1037-1040.
[10]郝欧美,王雪峰,魏巍,等.中医内外合治综合方案改善小儿病毒性肺炎中医证候的多中心随机对照研究[J].中华中医药杂志,2017,32(11):5216-5220.
[11]李吉红,邓焰,兰德联,等.利巴韦林注射液联合清开灵注射液治疗小儿病毒性肺炎的临床研究[J].中国临床药理学杂志,2017,33(3):262-264.
[12]覃黎葵.银翘散对呼吸道合胞病毒感染小鼠呼吸系统模型的作用研究[D].广州:广州中医药大学,2016.
[13]刘琪,王建国,马彦平,等.疏风宣肺解毒方药对流感病毒性肺炎小鼠Janus激酶信号转导与转录激活因子通路的影响[J].中国中西医结合急救杂志,2016,23(5):449-452.
[14]王晓敏,蔡建新,徐和祥,等.小儿宣肺止咳颗粒治疗小儿急性支气管炎的理论发微[J].世界中医药,2016,11(5):917-918.
[15]李雄海,王晓琴,梁骑.感染性肺炎患儿炎症反应及免疫功能相关指标水平变化及意义[J].海南医学院学报,2017,23(22):3146-3149.
[16]刘琪,顾立刚,卢娜娜,等.疏风宣肺、解表清里方药对流感病毒性肺炎小鼠辅助性T细胞1/2平衡调节的研究[J].中国中西医结合急救杂志,2013,26(1):1-4.
[17]胡涛,林琳,吴蕾,等.成人病毒性肺炎的中医证治与机制研究进展[J].天津中医药,2015,32(3):189-192.
[18]李丽华,黄秋芳,代文琼,等.不同剂量重组人干扰素α_2b注射液雾化吸入治疗小儿病毒性肺炎临床疗效的对比研究[J].实用心脑肺血管病杂志,2017,25(8):86-89.
[19]王晓红,林燕,胡丹,等.奥司他韦联合炎琥宁在小儿病毒性肺炎中的应用[J].河北医学,2017,23(4):535-539.
[20]白涛敏,严晓华,张瑜.金叶败毒颗粒联合热毒宁注射液治疗小儿病毒性肺炎的临床研究[J].现代药物与临床,2017,32(9):1687-1691.
[2]吴方,余陈欢,俞文英,等.基于microRNAs的石荠苧总黄酮抗流感病毒性肺炎作用机制研究[J].中草药,2016,47(7):1149-1154.
[3]赵志勇,韩晶,李贤伟,等.热毒宁注射液联合大剂量丙种球蛋白治疗小儿急性重症病毒性肺炎疗效观察[J].现代中西医结合杂志,2016,25(29):3264-3266.
[4]吴会玲,宋希,申玉英.血必净注射液联合人免疫球蛋白治疗重症病毒性肺炎的临床研究[J].现代药物与临床,2016,31(11):1725-1728.
[5]VAKIL E,EVANS S E.Viral pneumonia in patients with hematologic malignancy or hematopoietic stem cell transplantation[J].Clinics in Chest Medicine,2017,38(1):97-98.
[6]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:54-60.
[7]CAO B,GAO H,ZHOU B,et al.Adjuvant corticosteroid treatment in adults with influenza a(H7N9)viral pneumonia[J].Critical Care Medicine,2016,44(6):e318.
[8]汪受传,孙轶秋,卞国本,等.清肺口服液治疗小儿病毒性肺炎痰热闭肺证507例临床研究[J].世界中医药,2016,11(9):1649-1653.
[9]劳慧敏,曹宏,王晓.呼吸道合胞病毒肺炎患儿中医辨证分型与实验室指标的相关性[J].吉林中医药,2015,35(10):1037-1040.
[10]郝欧美,王雪峰,魏巍,等.中医内外合治综合方案改善小儿病毒性肺炎中医证候的多中心随机对照研究[J].中华中医药杂志,2017,32(11):5216-5220.
[11]李吉红,邓焰,兰德联,等.利巴韦林注射液联合清开灵注射液治疗小儿病毒性肺炎的临床研究[J].中国临床药理学杂志,2017,33(3):262-264.
[12]覃黎葵.银翘散对呼吸道合胞病毒感染小鼠呼吸系统模型的作用研究[D].广州:广州中医药大学,2016.
[13]刘琪,王建国,马彦平,等.疏风宣肺解毒方药对流感病毒性肺炎小鼠Janus激酶信号转导与转录激活因子通路的影响[J].中国中西医结合急救杂志,2016,23(5):449-452.
[14]王晓敏,蔡建新,徐和祥,等.小儿宣肺止咳颗粒治疗小儿急性支气管炎的理论发微[J].世界中医药,2016,11(5):917-918.
[15]李雄海,王晓琴,梁骑.感染性肺炎患儿炎症反应及免疫功能相关指标水平变化及意义[J].海南医学院学报,2017,23(22):3146-3149.
[16]刘琪,顾立刚,卢娜娜,等.疏风宣肺、解表清里方药对流感病毒性肺炎小鼠辅助性T细胞1/2平衡调节的研究[J].中国中西医结合急救杂志,2013,26(1):1-4.
[17]胡涛,林琳,吴蕾,等.成人病毒性肺炎的中医证治与机制研究进展[J].天津中医药,2015,32(3):189-192.
[18]李丽华,黄秋芳,代文琼,等.不同剂量重组人干扰素α_2b注射液雾化吸入治疗小儿病毒性肺炎临床疗效的对比研究[J].实用心脑肺血管病杂志,2017,25(8):86-89.
[19]王晓红,林燕,胡丹,等.奥司他韦联合炎琥宁在小儿病毒性肺炎中的应用[J].河北医学,2017,23(4):535-539.
[20]白涛敏,严晓华,张瑜.金叶败毒颗粒联合热毒宁注射液治疗小儿病毒性肺炎的临床研究[J].现代药物与临床,2017,32(9):1687-1691.