目的 探討小兒解表口服液聯(lián)合帕拉米韋治療小兒流行性感冒的臨床療效。方法 選取2022年1月—2022年6月首都醫(yī)科大學(xué)附屬北京婦產(chǎn)醫(yī)院懷柔婦幼保健院兒科門(mén)診收治的流行性感冒患兒188例,按照隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組,每組各94例。對(duì)照組患兒靜脈滴注帕拉米韋氯化鈉注射液,每次10 mg/kg,1次/d。治療組在對(duì)照組的基礎(chǔ)上口服小兒解表口服液,5 mL/次,3次/d。兩組連續(xù)治療5 d。觀察兩組的臨床療效,比較兩組癥狀消失時(shí)間、白細(xì)胞、T淋巴細(xì)胞亞群指標(biāo)和血清細(xì)胞因子的變化情況。結(jié)果 治療后,治療組患兒總有效率是98.94%,顯著高于對(duì)照組的88.29%(P<0.05)。治療后,治療組患兒發(fā)熱、咳嗽、鼻塞、咽痛消失時(shí)間均顯著短于對(duì)照組(P<0.05)。治療后,兩組患兒白細(xì)胞(WBC)水平較治療前顯著降低,CD3⁺、CD4⁺、CD8⁺均顯著升高(P<0.05),治療后,治療組WBC顯著低于對(duì)照組,而CD3⁺、CD4⁺、CD8⁺高于對(duì)照組(P<0.05)。治療后,兩組患兒白細(xì)胞介素-1β(IL-1β)、腫瘤壞死因子-α(TNF-α)、高遷移率族蛋白B-1(HMGB-1)水平均低于同組治療前,而γ-干擾素(IFN-γ)水平顯著升高(P<0.05);治療后,治療組IL-1β、TNF-α、HMGB-1水平低于對(duì)照組,IFN-γ水平高于對(duì)照組(P<0.05)。治療后,治療組不良反應(yīng)發(fā)生率5.32%,顯著低于對(duì)照組的13.82%(P<0.05)。結(jié)論 小兒解表口服液聯(lián)合帕拉米韋治療小兒流行性感冒效果確切,能縮短癥狀消失時(shí)間,并可降低機(jī)體炎性因子水平,有一定的臨床應(yīng)用價(jià)值。

Objective To investigate the therapeutic effect of Xiaoer Jiebiao Oral Liquid combined with paramivir in treatment of infantile influenza.Methods A total of 188 children with influenza admitted to the pediatric clinic of Huairou Maternal and Child Health Care Hospital, Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from January 2022 to June 2022 were selected and divided into control group and treatment group according to random number table method, with 94 cases in each group. Patients in the control group were iv administered with Peramivir and Sodium Chloride Injection, 10 mg/kg each time, once daily. Patients in the treatment group were po administered with Xiaoer Jiebiao Oral Liquid on the basis of the control group, 5m L/time, three times daily. The two groups were treated continuously for 5 d. The clinical efficacy of the two groups was observed,the time of symptom disappearance between the two groups was compared, and the changes of leukocyte, T lymphocyte subsets, and serum cytokines were compared between two groups.Results After treatment, the total effective rate of the treatment group was 98.94%, which was significantly higher than that of the control group(88.29%, P<0.05). After treatment, the disappearance time of fever, cough, nasal congestion and pharyngeal pain in the treatment group was significantly shorter than that in the control group(P<0.05). After treatment, the level of leukocyte(WBC) in two groups was significantly decreased, but CD3⁺, CD4⁺ and CD8⁺ were significantly increased(P<0.05). After treatment, WBC in treatment group was significantly lower than that in control group, while CD3⁺, CD4⁺ and CD8⁺ were higher than that in control group(P<0.05). After treatment, the levels of interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), and high mobility group protein B-1(HMGB-1) in two groups were lower than before, but the levels of interferon-γ(IFN-γ) were significantly increased(P<0.05). After treatment, the levels of IL-1β, TNF-α, and HMGB-1 in treatment group were lower than those in control group, but the levels of IFN-γ in treatment group were higher than those in control group(P<0.05). After treatment, the total incidence of adverse reactions in the treatment group was 5.32%, which was significantly lower than that in the control group(13.82%, P<0.05).Conclusion Xiaoer Jiebiao Oral Liquid combined with paramivir has accurate effect in treatment of infantile influenza, and can shorten the time of symptom disappearance, also can reduce the level of inflammatory factors,which has certain clinical application value.

R974; R985

北京市懷柔區(qū)衛(wèi)生和計(jì)劃生育委員會(huì)科研項(xiàng)目(2018-A-003)