中药协同治疗小儿肺炎合并全身炎症反应综合征的机制研究  

Study of traditional Chinese medicine combined with regular therapy in the treatment of pneumonia with systemic inflammatory response syndrome in children

作　　者：余峰[1] 崔敏娴[1] 黄金城[1] 熊江波[1] 姚冬莉[1] 林飞进[1] 

机构地区：[1]杭州市中医院儿科,浙江杭州310006

出　　处：《中国中西医结合急救杂志》2006年第5期276-278,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省杭州市科技计划项目(99A20)

摘　　要：目的:探讨中药协同治疗小儿肺炎合并全身炎症反应综合征(S IRS)的机制。方法:64例肺炎患儿被随机分为3组,51例合并S IRS,26例在常规治疗基础上加中药辨证施治(治疗组),25例未加中药治疗(对照Ⅰ组);另13例未合并S IRS者作为对照Ⅱ组,予常规治疗。监测各组治疗前后血清肿瘤坏死因子α(TNFα)、白细胞介素6(IL 6)和IL 8的动态变化;同步测定血中C反应蛋白(CRP)和白细胞(W BC)总数。对肺炎合并S IRS患儿于治疗5 d后进行临床症状、体征评分。结果:治疗组和对照Ⅰ组患儿治疗前血清TNFα、IL 6和IL 8均明显高于对照Ⅱ组(P均<0.01),而治疗组与对照Ⅰ组间各指标差异均无显著性。治疗后各组血清TNFα水平比较差异均无显著性;而治疗组IL 6则显著低于对照Ⅰ组,IL 8显著低于对照Ⅰ组和对照Ⅱ组。治疗前治疗组与对照Ⅰ组血CRP水平均高于对照Ⅱ组,治疗后治疗组则低于对照Ⅰ组和对照Ⅱ组(P<0.05或P<0.01)。W BC总数在各组间差异均无显著性。两组患儿发热和咳嗽咯痰情况差异有显著性(P均<0.05)。结论:在小儿肺炎合并S IRS中,中药协同治疗可下调机体炎性细胞因子水平,阻断疾病的进一步发展,促进临床症状的恢复。Objective： To explore the mechanism of traditional Chinese medicine （TCM） combined with regular therapy in the treatment of pneumonia with systemic inflammatory response syndrome （SIRS/ in children. Methods： Sixty-four children with pneumonia including 51 cases with SIRS complication were randomly divided into three groups： treatment group （regular therapy＋TCM, n=261, control group I （regular therapy only, n=25） and the control groups Ⅱ （13 pneumonia children without SIRS receiving routine treatment） . The dynamic changes of tumor necrosis factor -α （TNF -α）, interleukin - 6 （IL - 6） and IL - 8 were measured before and after treatment in all children. Serum C - reactive protein （CRP） and total white blood cell （WBC） count were measured simultaneously. Clinical symptom and sign scores were performed 5 days after treatment in children with pneumonia and SIRS complication. Results： Before treatment, serum TNF -a, IL -6,IL -8 and CRP concentrations were significantly higher in treatment group and control group Ⅰ than control group Ⅱ （all P 〈 0. 01）. But all the indexes were of no significant differences in treatment group and control group Ⅰ before treatment and the concentration of TNF -α were of no significant difference in all groups after treatment. The concentration of IL - 6 was significantly lower in treatment group than control group Ⅰ . The concentration of IL -8 was significantly lower in treatment group than control group Ⅰ and control group Ⅱ . The serum CRP was higher in treatment group and control group Ⅰthan control groupⅡ before treatment,but it was lower in treatment group than controul group Ⅰ and control group Ⅱ after treatment with significant difference （P〈0. 05 or P〈0.01）. Total WBC was of no significant difference among three groups, but there were of significant difference in fever, cough and stethocatharsis between two groups （all P〈0.05）. Conclusion： Traditional Chinese medicine combined with regular the

关 键 词：肺炎 全身炎症反应综合征 炎症细胞因子 中医药疗法 

分 类 号：R272[医药卫生—中医儿科学]