清热化瘀养阴方联合西医常规治疗儿童川崎病的疗效及对患儿免疫功能、炎症反应水平的影响  

Clinical efficacy of Qingre Huayu Yangyin Formula combined with routine Western medicine on immune function and inflammatory response in children with Kawasaki disease

作　　者：冯东灵[1] 苏梅艳 段素娴 张英谦[1] FENG Dongling;SU Meiyan;DUAN Suxian;ZHANG Yingqian(Department of Cardiology,Hebei Children's Hospital,Shijiazhuang,Hebei 050031)

机构地区：[1]河北省儿童医院心内科,河北石家庄050031

出　　处：《河北中医》2024年第7期1083-1086,共4页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的探讨清热化瘀养阴方联合西医常规治疗儿童川崎病的临床疗效,以及其对患儿免疫功能、炎症反应水平的影响。方法选取2020年1月至2022年12月收治的147例川崎病患儿为研究对象,按照随机数字表法分为2组,对照组77例予西医常规治疗,治疗组70例在对照组的基础上联合清热化瘀养阴方治疗。2组均治疗2周后评价疗效,比较2组治疗后退热、手足肿胀消退、黏膜充血消退、皮疹消退及淋巴结肿大消退时间情况,比较2组治疗前后免疫功能指标[包括T淋巴细胞亚群CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、调节T淋巴细胞(Treg)、辅助性T细胞17(Th17)及Th17/Treg]及炎症因子[肿瘤坏死因子α(TNF-ɑ)、C反应蛋白(CRP)及白细胞介素6(IL-6)]水平变化情况,比较2组治疗期间不良反应发生情况。结果治疗组总有效率91.43%(64/70),对照组总有效率77.92%(60/77),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后免疫指标T淋巴细胞亚群CD4^(+)、CD4^(+)/CD8^(+)、Th17、Th17/Treg水平均降低(P<0.05),CD8^(+)、Treg水平均升高(P<0.05),且治疗组治疗后T淋巴细胞亚群CD4^(+)、CD4^(+)/CD8^(+)、Th17、Th17/Treg水平均低于对照组(P<0.05),CD8^(+)、Treg水平均高于对照组(P<0.05)。与本组治疗前比较,2组治疗后炎症因子TNF-ɑ及IL-6水平均降低(P<0.05),CRP水平均升高(P<0.05),且治疗组治疗后TNF-ɑ及IL-6水平均低于对照组(P<0.05),CRP水平高于对照组(P<0.05)。治疗组治疗期间不良反应总发生率20.00%(14/70),对照组治疗期间不良反应总发生率18.18%(14/77),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论清热化瘀养阴方联合西医常规治疗川崎病临床疗效显著,可促进患儿临床症状消退,且无明显不良反应,安全性高,其作用机制可能与调节患儿免疫功能、降低炎症反应水平相关。Objective To explore the clinical efficacy of Qingre Huayu Yangyin Formula combined with routine Western medicine for children with Kawasaki disease(KD),and its influence on immune function and inflammatory response.Methods A total of 147 children with KD in our hospital from January 2020 to December 2022 were enrolled and randomly assigned into the treatment group(n=70)and the control group(n=77).All patients were managed by routine Western medicine,and those in treatment group were additionally treated with Qingre Huayu Yangyin Formula.Treated for 2 weeks,the aim was to compare regression time of fever,hand and foot swelling,mucosal hyperemia,rash,lymph node enlargement,immune function indexes(t-lymphocyte subsets CD4^(+),CD8^(+),CD4^(+)/CD8^(+),regulatory T cells[Treg],T helper 17 cells[Th17],Th17/Treg),inflammatory factors(tumor necrosis factor alpha[TNF-ɑ],C-reactive protein[CRP],interleukin 6[IL-6]).The curative effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(91.43%[64/70]vs 77.92%[60/77],P<0.05).After treatment,t-lymphocyte subsets CD4^(+),CD4^(+)/CD8^(+),Th17,Th17/Treg were significantly decreased in the two groups than those before treatment,but CD8^(+),Treg were significantly increased(all P<0.05),and the treatment group was superior to the control group for CD4^(+),CD4^(+)/CD8^(+),Th17,Th17/Treg,CD8^(+),Treg(all P<0.05).The levels of TNF-ɑ and IL-6 in the two groups after treatment were significantly decreased than those before treatment,but the levels of CRP were significantly increased(all P<0.05),and the treatment group was superior to the control group for the levels of TNF-ɑ,IL-6,CRP(all P<0.05).The overall incidence of adverse reactions during treatment in the treatment group was comparable to that in the control group(20.00%[14/70]vs 18.18%[14/77],P>0.05).Conclusion For children with KD,Qingre Huayu Yangyin Formula combined with routine Western medicine has significant clinical efficacy,which can ac

关 键 词：川崎病 中西医结合 免疫功能 炎症反应 

分 类 号：R725.5[医药卫生—儿科]