柴桂增免方治疗儿童反复呼吸道感染肺脾气虚证的临床疗效  

Clinical Efficacy of Chaigui Zengmian Prescription for Recurrent Respiratory Tract Infections in Children with Syndrome of Qi Deficiency in Lung and Spleen

作　　者：陈雪明 吴珂 许帅 林燕 贾琳 CHEN Xueming;WU Ke;XU Shuai;LIN Yan;JIA Lin(Graduate School of Hebei University of Traditional Chinese Medicine(TCM),Shijiazhuang 050091,China;The First Affiliated Hospital of Hebei University of TCM,Shijiazhuang 050011,China)

机构地区：[1]河北中医药大学研究生学院,石家庄050091 [2]河北中医药大学第一附属医院,石家庄050011

出　　处：《中国实验方剂学杂志》2024年第19期139-143,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：第五批全国中医临床优秀人才研修项目(国中医药人教函〔2022〕1号)。

摘　　要：目的:观察柴桂增免方(由北柴胡、党参、黄芩、桂枝、白芍、黄芪、白术、全蝎等中药组成)治疗儿童反复呼吸道感染肺脾气虚证的效果及对免疫因子水平的影响。方法:将66例肺脾气虚证复感儿随机分为两组。对照组(n=33)服用脾氨肽口服冻干粉治疗;观察组(n=33)服用自拟柴桂增免方免煎颗粒治疗。两组皆1月为1疗程,连续治疗2疗程。比较两组患儿治疗前后的临床中医证候评分、血清总免疫球蛋白[免疫球蛋白(Ig)A、IgM、IgG]和血清辅助性T细胞(Th1、Th2、Th1/Th2)水平的变化情况。结果:①临床中医证候评分方面,与本组治疗前比较,治疗后两组患儿的中医证候评分均明显降低(P<0.05);与对照组治疗后比较,观察组改善效果明显优于对照组(P<0.05)。②临床疗效方面,治疗后,对照组的总有效率为87.50%(28/32),观察组的总有效率为96.88%(31/32),观察组总有效率高于对照组(Z=7.921,P<0.05),且其中观察组治愈患儿例数[28.13%(9/32)]明显高于对照组[6.25%(2/32)](χ^(2)=5.379,P<0.05)。③免疫因子水平方面,与本组治疗前比较,治疗后两组患儿的血清总免疫球蛋白IgA、IgM、IgG水平明显升高,血清辅助性T细胞Th1、Th1/Th2水平明显升高,Th2水平明显降低(P<0.05);与对照组治疗后比较,观察组改善程度较对照组更明显(P<0.05)。结论:柴桂增免方治疗反复呼吸道感染患儿的疗效显著,可有效改善患儿的相关临床症状,纠正免疫失衡状态,具有临床应用价值。Objective:To evaluate the clinical efficacy of Chaigui Zengmian prescription(composed of Bupleuri Radix,Codonopsis Radix,Scutellariae Radix,Cinnamomi Ramulus,Paeoniae Radix Alba,Astragali Radix,Atractylodis Macrocephalae Rhizoma,and Scorpio)in treating recurrent respiratory tract infections in children with syndrome of Qi deficiency in lung and spleen and the influences of this prescription on immune factors.Method:Sixty-six children suffering from recurrent respiratory tract infections due to Qi deficiency in lung and spleen were selected and randomized into a control group(33 cases)and an observation group(33 cases).The control group received spleen aminopeptide oral lyophilized powder and the observation group was treated with self-made Chaigui Zengmian prescription granules.Both groups were treated for two months(as two consecutive courses of treatment).The traditional Chinese medicine(TCM)symptom scores and the serum levels of total immunoglobulins(IgA,IgM,and IgG)and T-helper cells(Th1,Th2,and Th1/Th2)were measured in both groups before and after treatment and then compared.Result:①After treatment,the TCM symptom scores of both groups declined and the observation group had lower scores than the control group(P<0.05).②The observation group[87.50%(28/32)]had higher total response rate than the control group[96.88%(31/32)](Z=7.921,P<0.05).Also the observation group[28.13%(9/32)]had more cured children than the control group[6.25(2/32)](χ^(2)=5.379,P<0.05)③After treatment,the serum levels of IgA,IgM,IgG,Th1,and Th1/Th2 elevated while that of Th2 declined(P<0.05),and the changes were more obvious in the observation group than in the control group(P<0.05).Conclusion:Chaigui Zengmian prescription is effective in treating recurrent respiratory tract infections in children with the syndrome of Qi deficiency in lung and spleen.It can alleviate the symptoms and rectify immune disequilibrium,demonstrating a clinical application value.

关 键 词：柴桂增免方 复感儿 肺脾气虚证 临床疗效 免疫因子 

分 类 号：R242[医药卫生—中医临床基础] R969.4[医药卫生—中医学] R2-031R272