目的 探讨小儿解表口服液联合帕拉米韦治疗小儿流行性感冒的临床疗效。方法 选取2022年1月—2022年6月首都医科大学附属北京妇产医院怀柔妇幼保健院儿科门诊收治的流行性感冒患儿188例,按照随机数字表法将所有患者分为对照组和治疗组,每组各94例。对照组患儿静脉滴注帕拉米韦氯化钠注射液,每次10 mg/kg,1次/d。治疗组在对照组的基础上口服小儿解表口服液,5 mL/次,3次/d。两组连续治疗5 d。观察两组的临床疗效,比较两组症状消失时间、白细胞、T淋巴细胞亚群指标和血清细胞因子的变化情况。结果 治疗后,治疗组患儿总有效率是98.94%,显著高于对照组的88.29%(P<0.05)。治疗后,治疗组患儿发热、咳嗽、鼻塞、咽痛消失时间均显著短于对照组(P<0.05)。治疗后,两组患儿白细胞(WBC)水平较治疗前显著降低,CD3⁺、CD4⁺、CD8⁺均显著升高(P<0.05),治疗后,治疗组WBC显著低于对照组,而CD3⁺、CD4⁺、CD8⁺高于对照组(P<0.05)。治疗后,两组患儿白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、高迁移率族蛋白B-1(HMGB-1)水平均低于同组治疗前,而γ-干扰素(IFN-γ)水平显著升高(P<0.05);治疗后,治疗组IL-1β、TNF-α、HMGB-1水平低于对照组,IFN-γ水平高于对照组(P<0.05)。治疗后,治疗组不良反应发生率5.32%,显著低于对照组的13.82%(P<0.05)。结论 小儿解表口服液联合帕拉米韦治疗小儿流行性感冒效果确切,能缩短症状消失时间,并可降低机体炎性因子水平,有一定的临床应用价值。

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

北京市怀柔区卫生和计划生育委员会科研项目(2018-A-003)