健脾固肾颗粒联合现代医学常规疗法治疗小儿反复呼吸道感染脾肾两虚证临床研究
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河南省中医药科学研究专项课题(2021ZY2289)


Clinical Study on Jianpi Gushen Granules Combined with Routine Therapy of Modern Medicine for Children with Recurrent Respiratory Tract Infection with Spleen-Kidney Deficiency Syndrome
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    摘要:

    目的:观察健脾固肾颗粒联合现代医学常规疗法治疗脾肾两虚型小儿反复呼吸道感染的临床疗效。方法:选取90 例脾肾两虚型反复呼吸道感染患儿作为研究对象,按随机数字表法分为对照组及观察组各45 例。对照组给予现代医学常规治疗,观察组在常规治疗基础上给予健脾固肾颗粒口服。观察2 组临床疗效及不良反应发生情况,比较2 组治疗前后中医证候评分、肺功能[肺活量(FVC)、最大呼气流量(PEF)、第1 秒用力呼气容积(FEV1)]、炎症因子[血清肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、血清C-反应蛋白(CRP)]水平及免疫功能指标[疫球蛋白A(IgA)、免疫球蛋白G(IgG) 及免疫球蛋白M(IgM)、T细胞亚群(CD3+、CD4+、CD8+、CD4+/CD8+)]的变化。结果:治疗后,观察组临床疗效为93.33%,对照组为77.78%,2 组比较,差异有统计学意义(P<0.05)。治疗后,2 组咳嗽痰多、气喘、神疲乏力、食少纳呆、气短懒言中医证候评分均较治疗前下降,观察组上述5 项中医证候评分均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组FVC、PEF、FEV1 指标值均较治疗前升高,观察组上述3 项指标值均高于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组TNF-α、CRP、IL-4 水平均较治疗前下降,观察组上述3 项水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2 组IgA、IgG、IgM、CD3+、CD4+、CD4+/CD8+指标值均较治疗前上升,CD8+指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,观察组IgA、IgG、IgM、CD3+、CD4+、CD4+/CD8+指标值均高于对照组,CD8+指标值低于对照组,差异均有统计学意义(P<0.05)。2 组治疗期间未见明显不良反应发生。结论:健脾固肾颗粒联合现代医学常规疗法治疗脾肾两虚型小儿反复呼吸道感染具有较好的临床疗效,可缓解临床症状,减轻炎症反应,提高机体免疫功能,提高肺功能。

    Abstract:

    Abstract:Objective:To observe the clinical effect of the therapy of Jianpi Gushen granules combined with routine therapy of modern medicine on children with recurrent respiratory tract infection with spleenkidney deficiency syndrome. Methods: A total of 90 children with recurrent respiratory tract infection of spleen-kidney deficiency type were selected and divided into the control group and the observation group according to the random number table method,with 45 cases in each group. The control group was given routine therapy of modern medicine, and the observation group was additionally given Jianpi Gushen granules orally based on the treatment of the control group. The clinical effects and adverse reactions in the two groups were observed. Before and after treatment, the changes of Chinese medicine syndrome scores,lung function,including forced vital capacity(FVC),peak expiratory flow(PEF) and forced expiratory volume in one second(FEV1),levels of inflammatory factors,including serum tumor necrosis factor-α(TNF- α), interleukin- 4(IL- 4) and serum C- reactive protein(CRP), and indexes of immune function, including immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM) and T cell subsets(CD3+,CD4+, CD8 + and CD4 +/CD8 + ) were compared between the two groups. Results: After treatment, the clinical effect was 93.33% in the observation group and 77.78% in the control group, the difference being significant(P<0.05). After treatment, the Chinese medicine syndrome scores of cough and excessive phlegm, dyspnea, lassitude of spirit and lack of strength, torpid intake and shortage of qi and disinclination to talk in the two groups were decreased when compared with those before treatment,and the above five Chinese medicine syndrome scores in the observation group were lower than those in the control group,differences being significant(P<0.05). After treatment,the values of FVC,FEF and FEV1 in the two groups were increased when compared with those before treatment,and the above three values in the observation group were higher than those in the control group,differences being significant(P<0.05). After treatment,the levels of TNF- α,CRP and IL-4 in the two groups were decreased when compared with those before treatment,and the above three levels in the observation group were lower than those in the control group,differences being significant(P<0.05). After treatment,the values of IgA,IgG,IgM, CD3 + , CD4 + and CD4 +/CD8 + in the two groups were increased when compared with those before treatment,and the CD8+ values were decreased,differences being significant(P<0.05);after treatment, the values of IgA,IgG,IgM,CD3+,CD4+ and CD4+/CD8+ in the observation group were higher than those in the control group,and the CD8+ value in the observation group was lower,differences being significant (P<0.05). During treatment, no obvious adverse reactions were found in both groups. Conclusion: The therapy of Jianpi Gushen granules combined with routine therapy of modern medicine has a good clinical effect on children with recurrent respiratory tract infection of spleen- kidney deficiency type, which can improve the clinical symptoms,reduce the inflammatory responses,enhance the immune function of the body,and improve the lung function.

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李宁,李君,李兴永,任大鹏.健脾固肾颗粒联合现代医学常规疗法治疗小儿反复呼吸道感染脾肾两虚证临床研究[J].新中医,2022,54(19):165-170

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  • 在线发布日期: 2022-10-08
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