自拟流感方治疗儿童乙型流行性感冒的疗效及作用机制研究  

Efficacy and mechanism of self-designed influenza formula in the treatment of influenza B in children

作　　者：金海燕[1] 许斌斌 詹璐[1] Jin Haiyan;Xu Binbin;Zhan Lu(Department of Pediatrics,Zhejiang Integrated Traditional Chinese and Western Medicine Hospital(Hangzhou Red Cross Hospital),Hangzhou 310000,Zhejiang,China)

机构地区：[1]浙江省中西医结合医院(杭州市红十字会医院)儿科,浙江杭州310000

出　　处：《中国中西医结合急救杂志》2023年第1期22-25,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省中医药科技计划项目(2019ZB091)。

摘　　要：目的观察自拟流感方对儿童乙型流行性感冒(乙流)的疗效及其作用机制。方法采用前瞻性随机对照研究方法,选择2019年1月至2020年2月就诊于浙江省中西医结合医院儿科门诊的60例表寒里热型乙流患儿。按随机数字表法,并取得患儿监护人知情同意后将患儿分为观察组及对照组,每组30例。两组均予基础对症支持治疗,观察组口服自拟流感方方剂,对照组口服奥司他韦,均治疗5 d。观察两组患儿治疗前后临床症状并计算中医症状积分,判定患儿临床疗效;同时采用酶联免疫吸附试验(ELISA)检测血清白细胞介素-6(IL-6)、γ-干扰素(IFN-γ)及超氧化物歧化酶(SOD)水平。结果60例乙流患儿中因病情加用其他药物退出2例、失访脱落1例,共获得有效病例57例,其中观察组28例,对照组29例。两组患儿在性别、年龄方面差异均无统计学意义,具有可比性。两组治疗后中医证候积分均较治疗前明显降低,且观察组治疗后中医证候积分明显低于对照组(分:1.93±1.15比3.90±2.87,P<0.01)。观察组总有效率明显高于对照组〔96.4%(27/28)比72.4%(21/29),χ^(2)=6.179,P=0.013〕。两组治疗前血清IL-6、IFN-γ及SOD水平差异均无统计学意义;两组治疗后IL-6、IFN-γ水平均明显下降,且观察组治疗后血清IL-6及IFN-γ较对照组下降更明显〔IL-6(ng/L):0.69±0.06比1.14±0.20,IFN-γ(ng/L):5.56±0.87比9.08±1.64,均P<0.01〕。观察组治疗后SOD水平较治疗前明显升高,而对照组无明显变化;观察组治疗后SOD明显高于对照组(ng/L:37.27±20.76比29.14±10.93,P<0.01)。结论自拟流感方能有效治疗儿童乙流,改善临床症状,其作用机制可能通过减低IL-6、IFN-γ炎性因子水平,提升SOD活性减轻细胞氧化损伤来发挥作用的。Objective To observe the therapeutic effect and mechanism of self-designed influenza formula in children with influenza B.Methods A prospective randomized controlled study was conducted.Sixty children infected with influenza B virus and with superficial cold and li-fever admitted to the pediatric outpatient department of Zhejiang Integrated Traditional Chinese and Western Medicine Hospital from January 2019 to February 2020 were enrolled.After obtaining consent of their guardians,children were randomly divided into observation group and control group using random number table method,with 30 cases in each group.Both groups were given basic symptomatic supportive treatment.The observation group was given self-designed influenza formula,and the control group was given oseltamivir orally.Both groups were treated for 5 days.The clinical symptoms of the two groups were observed before and after treatment and the traditional Chinese and Western(TCM)symptom score was calculated to determine the clinical efficacy of the children.Serum levels of interleukin-6(IL-6),interferon-γ(IFN-γ)and superoxide dismutase(SOD)were detected by enzyme linked immunosorbent assay(ELISA).Results Among the 60 cases,2 cases were withdrawn due to additional use of other drugs and 1 case was lost to follow-up.A total of 57 effective cases were obtained,including 28 cases in the observation group and 29 cases in the control group.There were no significant differences in gender and age between the two groups,which was comparable.After treatment,the TCM syndrome score in both groups were significantly lower than those before treatment,and the TCM syndrome score in the observation group was significantly lower than that in the control group(1.93±1.15 vs.3.90±2.87,P<0.01).The total effective rate of the observation group was significantly higher than that of the control group[96.4%(27/28)vs.72.4%(21/29),χ^(2)=6.179,P=0.013].There was no significant difference in serum IL-6,IFN-γand SOD levels between the two groups before treatment.After treatm

关 键 词：流感方 流行性感冒 乙型 邪犯肺卫 白细胞介素-6 Γ-干扰素 超氧化物歧化酶 

分 类 号：R725.1[医药卫生—儿科]