升降散合栀子豉汤加减联合母乳治疗小儿急性化脓性扁桃体炎疗效及对免疫、炎症因子水平的影响  

Clinical effect of Shengjiang powder combined with Zhizichi decoction combined with breast milk in the treatment of acute suppurative tonsillitis in children and its effects on immune regulation and inflammatory factors

作　　者：顾晓慧 吴晓萍 张蕾 GU Xiaohui;WU Xiaoping;ZHANG Lei(Department of Neonatology,Zhangjiagang Hospital of Traditional Chinese Medicine,Zhangjiagang,Jiangsu 215600)

机构地区：[1]江苏省张家港市中医医院新生儿科,江苏张家港215600

出　　处：《河北中医》2020年第2期197-201,296,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：2017年度张家港市科技支撑计划(农业、社会发展)、软科学计划项目(编号:ZKS1725)。

摘　　要：目的观察升降散合栀子豉汤加减联合母乳治疗小儿急性化脓性扁桃体炎的临床疗效及对患儿免疫、炎症因子水平的影响。方法将110例急性化脓性扁桃体炎患儿按随机数字表法分为2组。对照组55例采用常规对症治疗;治疗组55例在对照组基础上予升降散合栀子豉汤加减口服联合母乳。2组均治疗5 d。比较2组治疗前后中医证候评分、免疫功能相关指标[免疫球蛋白A(IgA)、IgG、IgM]及炎症指标[肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白细胞介素2(IL-2)、IL-6、IL-17],比较主要症状改善时间,并统计疗效及不良反应发生情况。结果治疗组总有效率90.91%(50/55),对照组总有效率76.36%(42/55),治疗组疗效优于对照组(P<0.05)。治疗后2组各项中医证候评分均降低(P<0.05),且治疗后治疗组各项中医证候评分均低于对照组(P<0.05)。治疗组体温恢复正常时间、扁桃体缩小时间、脓性分泌物消失时间均短于对照组(P<0.05)。治疗后2组IgA、IgG、IgM均升高(P<0.05),且治疗后治疗组IgA、IgG、IgM均高于对照组(P<0.05)。治疗后2组TNF-α、CRP、IL-6、IL-17均降低(P<0.05),IL-2均升高(P<0.05),且治疗后治疗组TNF-α、CRP、IL-6、IL-17均低于对照组(P<0.05),IL-2高于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论升降散合栀子豉汤加减联合母乳治疗者利于改善急性化脓性扁桃体炎患儿临床症状,缩短病程,发挥免疫调节作用,减轻炎性反应,安全有效,值得临床推广。Objective To observe the effect of Shengjiang powder combined with Zhizichi decoction combined with breast milk in the treatment of acute suppurative tonsillitis in children and its effects on immune regulation and inflammatory factors.Methods 110 children with acute suppurative tonsillitis were randomly divided into two groups according to the random number table method.55 cases in control group were treated by conventional symptomatic therapy.55 cases in treatment group were treated by Shengjiang powder combined with zhizichi decoction and breast milk on the basis of the control group.Both groups were treated for 5 days.Before and after treatment,the TCM syndrome score,immune function related indexes[Immunoglobulin A(IgA),IgG,IgM]and inflammation indexes[tumor necrosis factorα(TNF-α),C-reactive protein(CRP),interleukin-2(IL-2),IL-6,IL-17]were compared between the two groups,the improvement time of main symptoms was compared,and the curative effect and adverse reactions were counted.Results The total effective rate was 90.91%(50/55)in the treatment group and 76.36%(42/55)in the control group.The therapeutic effect of the treatment group was better than that of the control group(P<0.05).After treatment,the scores of TCM syndromes in the two groups were decreased(P<0.05),and the scores of TCM syndromes in the treatment group were lower than those in the control group(P<0.05).The recovery time of body temperature,the reduction time of tonsil and the disappearance time of purulent secretion in the treatment group were shorter than those in the control group(P<0.05).After treatment,IgA,IgG and IgM in the two groups were all increased(P<0.05),and IgA,IgG and IgM in the treatment group were higher than those in the control group(P<0.05).After treatment,TNF-α,CRP,IL-6 and IL-17 were all decreased in two groups(P<0.05),while IL-2 was increased(P<0.05).After treatment,TNF-α,CRP,IL-6 and IL-17 in the treatment group were lower than those in the control group(P<0.05),and IL-2 was higher than those in the control group(P

关 键 词：升降散 栀子豉汤 扁桃体炎 中药疗法 

分 类 号：R766.181[医药卫生—耳鼻咽喉科]