清瘟败毒饮加减联合阿昔洛韦注射液治疗小儿EB病毒感染传染性单核细胞增多症的疗效观察及对患儿免疫功能的影响  

Qingwen Baidu decoction with acyclovir on infectious mononucleosis caused by Epstein-Barr virus and immune function

作　　者：崔佳丽[1] 张巨平 崔翠[3] 乔磊 CUI Jiali;ZHANG Juping;CUI Cui;QIAO Lei(Department of Pediatrics,Handan Central Hospital,Handan,Hebei 056002;Department of Thoracic Surgery,Shexian Hospital,Shexian,Hebei 056400;Department of Ophthalmology,Handan Central Hospital,Handan,Hebei 056002;Department of TCM,Handan Central Hospital,,Handan,Hebei 056002)

机构地区：[1]河北省邯郸市中心医院儿科,河北邯郸056002 [2]河北省涉县医院胸外科,河北涉县056400 [3]河北省邯郸市中心医院眼科,河北邯郸056002 [4]河北省邯郸市中心医院中医科,河北邯郸056002

出　　处：《河北中医》2022年第10期1665-1669,1711,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省卫生健康委员会科研课题(编号:20150460)。

摘　　要：目的观察清瘟败毒饮加减联合联合阿昔洛韦注射液治疗小儿EB病毒(EBV)感染传染性单核细胞增多症(IM)的临床疗效及对患儿免疫功能的影响。方法将97例EBV感染IM患儿按照随机数字表法分为2组,在均予西医常规治疗的基础上,对照组49例予阿昔洛韦注射液治疗,治疗组48例予清瘟败毒饮加减联合阿昔洛韦注射液治疗,2组均治疗2周,治疗结束后随访4周。比较2组治疗后临床症状、体征缓解时间,包括发热、咽颊炎、淋巴结肿大、肝肿大、脾肿大及眼睑水肿,比较2组治疗前后及随访第4周免疫指标变化情况,包括免疫球蛋白(Ig)A、IgM、IgG水平和T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)及自然杀伤(NK)细胞水平,比较2组治疗前后及随访第4周EBV-DNA和抗EBV衣壳抗原IgM(EBV-VCA-IgM)阴性情况。结果治疗组总有效率91.7%(44/48),对照组总有效率79.6%(39/49),治疗组总有效率高于对照组(P<0.05)。治疗组治疗后发热、咽颊炎、淋巴结肿大、肝肿大、脾肿大及眼睑水肿缓解所需时间均短于对照组(P<0.05)。与本组治疗前比较,2组治疗后及随访4周IgA、IgM、IgG水平均下降(P<0.05),且治疗组治疗后及随访4周IgA、IgM、IgG水平均低于对照组同期(P<0.05)。与本组治疗前比较,2组治疗后及随访4周CD3^(+)、CD8^(+)水平均下降(P<0.05),CD4^(+)及CD4^(+)/CD8^(+)及NK细胞水平均升高(P<0.05),且治疗组治疗后及随访4周CD3^(+)、CD8^(+)水平均低于对照组同期(P<0.05),CD4^(+)及CD4^(+)/CD8^(+)及NK细胞水平均高于对照组同期(P<0.05)。与本组治疗前比较,2组治疗后及随访4周EVB-DNA及EBV-VCA-lgM阴性率均升高(P<0.05),且治疗组治疗后及随访第4周EVB-DNA及EBV-VCA-lgM阴性率均高于对照组同期(P<0.05)。结论清瘟败毒饮加减联合阿昔洛韦注射液治疗小儿EBV感染IM疗效确切,可有效促进患儿症状、体征消退,改善患儿体液免疫和细胞免疫紊乱情况,修复EBV造�Objective To investigate the clinical efficacy of Qingwen Baidu decoction in the treatment of infectious mononucleosis(IM)caused by Epstein-Barr virus(EBV)in children and its influence on immune function.Methods EBV-infected children with IM(n=97)were randomly assigned into 2 groups.Based on conventional Western medicine,the treatment group(n=48)was treated with modified Qingwen Baidu Decoction+acyclovir injection,and the control group(n=49)with the latter only,2-week treatment and 4-week followed-up were carried out.The clinical symptoms and symptom relief time including(fever,pharyngitis,lymphadenopathy,hepatomegaly,splenomegaly and eyelid edema)were compared.At the pre-post-treatment and the 4th week,the immune indexes including immunoglobulin(Ig)A,IgM,IgG levels and CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)of T-lymphocyte subsetsand,natural killer(NK)cell levels,the negative EBV-DNA and EBV serum IgM viral capsid antibodies(EBV-IgM-VCA)were measured.Results The total effective rate in the treatment group was significantly higher than that in the control group(91.7%[44/48]vs 79.6%[39/49];[P<0.05],respectively).The shortened symptom relief time in the treatment group was superior to those in the control group(P<0.05).The levels of IgA,IgM and IgG in the two groups significantly decreased at post-treatment and the 4th week(P<0.05),in concurrent control,but superior in treatment group(P<0.05).The level of significant decreased CD3^(+)and CD8^(+)and significant increased CD4^(+),NK and CD4^(+)/CD8^(+)were found in both groups at post-treatment and the 4th week(all P<0.05),the treatment group was superior to the control group for those indexes(all P<0.05).Conclusion The combined effects of Qingwen Baidu decoction+acyclovir on EBV-infected children with IM are significant,which can effectively promote clinical symptoms and shortened symptom relief time,improve immune function and immunity disorder,repair immune injury,with stable efficacy.

关 键 词：EB病毒 传染性单核细胞增多症 儿童 清瘟败毒饮 阿昔洛韦 

分 类 号：R272.5[医药卫生—中医儿科学]