喜炎平治疗儿童疱疹性咽峡炎的疗效观察_临床医学论文.docVIP

喜炎平治疗儿童疱疹性咽峡炎的疗效观察_临床医学论文 喜炎平治疗儿童疱疹性咽峡炎的疗效观察_临床医学论文 【摘要】 　　目的：探讨喜炎平注射液治疗小儿疱疹性咽峡炎的免疫功能变化与临床疗效评价。方法：对符合小儿疱疹性咽峡炎临床诊断标准的389例患儿，随机分为两组，分别采用喜炎平与利巴韦林治疗。观察患儿治疗后退热时间、疱疹消失时间，并在治疗前、后行免疫功能（CD4+、CD8+、CD4+/ CD8+、IFN、IL）。结果：疱疹性咽峡炎患儿CD4+、CD4+/ CD8+、IL明显降低，CD8+、IFN明显升高，有极显著差异 (P均lt;0．0 1)。 应用喜炎平治疗后CD4+、CD4+/ CD8+明显升高,CD8+明显降低,治疗前、后差异有统计学意义(P均＜0.01)；而利巴韦林组治疗前、后CD4+、CD4+/ CD8+无明显变化(Pgt;0.05)；喜炎平组的平均退热时间、疱疹消失时间均明显短于利巴韦林组(P均lt;0.0 1)。喜炎平组的总有效率为87.18%、利巴韦林组为77.32%,喜炎组疗效优于利巴韦林组（0.01)。结论：喜炎平注射液能提高小儿疱疹性咽峡炎的免疫水平,临床疗效优于利巴韦林，值得推广应用。 【关键词】 疱疹性咽峡炎；免疫功能；喜炎平；儿童 　　［ABSTRACT］ Objective: To observe the effects of Xiyanping injection on the immune function in children with herpangina. Methods: Randomly divided 389 eligible children with herpangina into two groups treated with Xiyanping and ribavirin, respectively. Observed the disappearance time of ever and herpes of the two groups. Besides, evaluated immune function indicators including CD4+,CD8+,CD4+/ CD8+,IFNγ,IL10 before and after the treatment. Results: For those patients, CD4+,CD4+/ CD8+ and IL10 significantly decreased, while CD8+ and IFNγ increased noticeably (0.01). After treatment of Xiyanping, CD4+,CD4+/ CD8+ were significantly raised, while CD8+ was decreased (both P lt;0.01). However, patients treated with ribavirin didnt show significant improvement of CD4+ or CD4+/ CD8+ (Pgt;0.05). The disappearance time of fever and herpes in patients treated with Xiyanping were significant shorter, and total effective rate (87.18% vs 77.32%) was higher than that of patients treated with ribavirin (all P gt;0.01). Coclusions: Xiyanping injection can improve immune function for children with herpangina. It shows better therapeutic effect than that of ribavirin and is worth for application in large scale. 　　［KEY WORDS］ Herpangina; Immune function; Xiyanping; Children 　　疱疹性咽峡炎是小儿急性上呼吸道感染中的特殊类型之一，是小儿时期的常见病和多发病，由柯萨奇A组病毒感染引起，多发于夏秋季节，发病年龄多在1～7岁儿童［1］。该病目前仍缺乏特异性治疗措施。喜炎平注射液是中药制剂，具有广谱的抗菌、抗病毒及抗炎清热作用，尤其是对腺病毒、流感病毒、呼吸道合胞病毒有明显的灭活作用。我们在2008年1月～2009年1月收治小儿疱疹性咽峡炎3