清解合剂联合更昔洛韦治疗儿童EBV感染传染性单核细胞增多症(热毒炽盛型)临床疗效及对免疫功能的影响  

Clinical efficacy of Qingjie Mixture combined with ganciclovir in treatment of children with infectious mononucleosis(blazing heat-toxin type)caused by Epstein-Barr virus infection and its influence on immune function

作　　者：吉慧 史艳平[1] 李霞[1] 田纪凤 JI Hui;SHI Yan-ping;LI Xia;TIAN Ji-feng(Department of Integrative Medicine,Xi'an Children's Hospital,Xi'an 710003)

机构地区：[1]陕西省西安市儿童医院中西医结合科,陕西西安710003

出　　处：《湖北中医药大学学报》2024年第1期25-28,共4页Journal of Hubei University of Chinese Medicine

基　　金：陕西省西安市卫生健康委员会中医药科研项目(项目编号:SZL202012)。

摘　　要：目的观察EB病毒(EBV)感染传染性单核细胞增多症(IM)(热毒炽盛型)患儿治疗应用清解合剂加更昔洛韦临床疗效。方法将我院收治的80例EBV感染IM(热毒炽盛型)患儿随机分为对照组与研究组各40例。对照组给予更昔洛韦治疗,研究组在对照组治疗基础上给予清解合剂治疗。比较两组患儿临床疗效,治疗前后症状体征积分及EB病毒-脱氧核糖核酸(EBV-DNA)水平,肝功能,T淋巴细胞亚群(CD4^(+)、CD4^(+)/CD8^(+)、CD8^(+)、异型淋巴细胞比例),血清炎症指标及不良反应发生率。结果治疗后,研究组治疗总有效率显著高于对照组(P<0.05);两组发热、咽峡炎、浅表淋巴结肿大、肝脏肿大、脾脏肿大评分均低于治疗前,研究组发热、咽峡炎、浅表淋巴结肿大、肝脏肿大、脾脏肿大评分均低于对照组(P<0.05);两组EBV-DNA水平及谷草转氨酶和谷丙转氨酶均低于治疗前,研究组EBV-DNA水平及谷草转氨酶和谷丙转氨酶均低于对照组(P<0.05);两组CD4^(+)和CD4^(+)/CD8^(+)百分比均高于治疗前,CD8^(+)和异型淋巴细胞比例均低于治疗前,研究组CD4^(+)和CD4^(+)/CD8^(+)百分比均高于对照组,CD8^(+)和异型淋巴细胞比例均低于对照组(P<0.05);两组白介素-4(IL-4)、干扰素-γ(IFN-γ)、颗粒酶B和穿孔素指标水平均低于治疗前;研究组IL-4、IFN-γ、颗粒酶B和穿孔素指标水平均低于对照组(P<0.05);两组不良反应发生率比较无统计学意义(P>0.05)。结论EBV感染IM(热毒炽盛型)患儿采用清解合剂联合更昔洛韦治疗可以明显改善免疫功能,临床疗效及安全性较好。Objective To observe the efficacy of Qingjie Mixture combined with ganciclovir in treatment of children with infectious mononucleosis(IM)(blazing heat-toxin type)caused by Epstein-Barr virus(EBV)infection.Methods Eighty cases of EBV-infected IM(blazing heat-toxin type)children were randomly divided into control group and research group,40cases in each group.Control group was treated with ganciclovir,and research group was treated with Qingjie Mixture on the basis of control group.The clinical efficacy,symptoms and signs score,EBV deoxyribonucleic acid(EBV-DNA)level,liver function,T lymphocyte subsets(CD4^(+),CD4^(+)/CD8^(+),CD8^(+),atypical lymphocyte ratio),serum inflammatory indicators and the incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate of research group was significantly higher than that in control group(P<0.05);the scores of fever,angina,superficial lymphadenopathy,hepatomegaly,splenomegaly in both groups were lower than those before treatment,and were lower in research group than those in control group(P<0.05);the EBV-DNA levels,scores of aspartate aminotransferase and alanine aminotransferase in both groups were lower than those before treatment,and were lower in research group than those in control group(P<0.05);the percentages of CD4^(+)and CD4^(+)/CD8^(+)in both groups were higher than those before treatment,and were higher in research group than those in control group,while the percentages of CD8^(+)and atypical lymphocytes were lower than those before treatment,and were lower in research group than those in control group(P<0.05);the levels of interleukin-4(IL-4),interferon-(IFN-γ),granzyme B and perforin in both groups were lower than those before treatment,and were lower in research group than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Qingjie Mixture combined with ganciclovir can significantly improve the immunologic function

关 键 词：EB病毒 传染性单核细胞增多症 热毒炽盛型 儿童 清解合剂 更昔洛韦 免疫功能 

分 类 号：R272.5[医药卫生—中医儿科学]