金银花颗粒联合人免疫球蛋白治疗手足口病患儿的疗效及对血清细胞因子和免疫功能的影响

Effects of honeysuckle pellet combined with human immunoglobulin on children's hand-foot-and-mouth disease and serum cytokine and immune function in children

    摘要
  • 摘要: 目的 探讨金银花颗粒联合人免疫球蛋白治疗手足口病患儿的疗效及对血清细胞因子和免疫功能的影响。方法 选取2015年6月-2017年1月于医院就诊的136例手足口病患儿为研究对象,采用随机数字表法分为对照组及观察组,各68例;两组患儿均于入院后密切观察病情,维持水电解质平衡,给予退热、抗感染、抗病毒等治疗;对照组患儿给予静脉注射人免疫球蛋白,观察组在对照组基础上口服金银花颗粒,两组疗程均为5d,比较两组疗效,主要症状、体征改善情况,治疗前后血清细胞因子和免疫功能指标变化。结果 观察组总有效率91.18%显著高于对照组75.00%(P<0.05);两组治疗前血清CRP、IL-17、TNF-α比较无统计学差异;观察组治疗后口腔疱疹消退时间、体温恢复时间及皮疹消退时间分别为(2.65±0.78)d、(1.59±0.47)d及(2.67±0.51)d均优于对照组(3.94±1.04)d、(2.79±0.68)d及(3.75±0.72)d(P<0.05);观察组治疗后血清C-反应蛋白(CRP)、白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平显著低于对照组(P<0.05);两组治疗前免疫球蛋白A(IgA)、IgG、IgM、CD3+、CD4+、CD4+/CD8+比较无统计学差异;治疗后观察组IgA、IgG、CD3+、CD4+、CD4+/CD8+显著高于对照组(P<0.05);两组治疗后IgM比较无统计学差异。结论 金银花颗粒联合人免疫球蛋白治疗小儿手足口病疗效显著,可降低血清CRP、IL-17、TNF-α细胞因子水平,改善患者免疫功能。

     

    Abstract: OBJECTIVE To investigate the effects of honeysuckle pellet combined with human immunoglobulin in treating hand-foot-and-mouth disease (HFMD) and serum cytokine and immune function in children. METHODS A total of 136 cases of HFMD were selected from Jun. 2015 to Jan. 2017 in the hospital. The patients were divided into control group and observation group by random number table, with 68 cases in each group. Two groups of children were closely observed after admission, maintaining water and electrolyte balance, and given fever, anti infection, anti-virus and other treatment. Patients in control group were received intravenous injection of human immunoglobulin, and in observation group were received oral administration of honeysuckle granules on the basis of intravenous injection of human immunoglobulin. The two groups were treated for 5d. The curative effect, main symptoms and signs, and changes of serum cytokines and immune function indexes were compared before and after treatment. RESULTS The total efficiency of observation group was 91.18%, which was higher than 75.00% of control group (P<0.05). There were no statistical differences in serum CRP, IL-17 and TNF-α between the two groups before treatment. The oral herpes subsided time, temperature recovery time and rash subsided time of observation group were (2.65±0.78) d, (1.59±0.47) d and (2.67±0.51) d, which were better than (3.94±1.04) d, (2.79±0.68) d and (3.75±0.72) d of control group (P<0.05). The serum CRP, IL-17 and TNF-a levels after treatment in observation group were significantly lower than those in control group (P<0.05). There were no significant differences in immunoglobulin A(IgA), IgG, IgM, CD3+, CD4+ and CD4+/CD8+ between the two groups before treatment. The IgG, CD3+, CD4+ and CD4+/CD8+ of observation group were significantly higher than those of control group (P<0.05), and the IgM between the two groups after treatment had no significant difference. CONCLUSION Honeysuckle pellet combined with human immunoglobulin is effective in treating HFMD, and can decrease the levels of serum CRP, IL-17 and TNF-a cytokines, and improve the immune function of children.

     

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