目的 探讨连花清瘟颗粒联合帕拉米韦氯化钠注射液治疗流行性感冒的临床疗效。方法 选取2019年8月—2021年5月沧州市中心医院收治的134例流感患者,按随机数字表法将所有患者分为对照组和治疗组,每组各67例。对照组静脉滴注帕拉米韦氯化钠注射液,300 mg/次,1次/d。治疗组在对照组基础上口服连花清瘟颗粒,1袋/次,3次/d。两组疗程均为3 d。观察两组的临床疗效,比较两组症状消失时间、体温起效时间、即刻退热率及治疗前后白细胞计数(WBC)异常率和血清C反应蛋白(CRP)、白细胞介素-6(IL-6)水平及外周血CD4⁺/CD8⁺。统计两组不良反应情况。结果 治疗后,治疗组总有效率是98.51%,显著高于对照组的88.06%(P<0.05)。治疗后,治疗组发热、咽喉肿痛、咳嗽、周身酸痛消失时间均显著短于对照组(P<0.05)。治疗后,治疗组体温起效时间显著短于对照组,即刻退热率(58.21%)较对照组(40.30%)显著增高(P<0.05);治疗后,两组WBC异常率均显著降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后,两组血清CRP、IL-6、外周血CD4⁺/CD8⁺水平均较治疗前显著降低(P<0.05),且治疗后,治疗组血清CRP、IL-6、外周血CD4⁺/CD8⁺水平低于对照组(P<0.05)。治疗后,治疗组和对照组患者不良反应发生率分别是4.48%、2.99%,差异无统计学意义。结论 连花清瘟颗粒联合帕拉米韦氯化钠注射液治疗流行性感冒整体疗效较为满意,能有效控制病毒感染,迅速缓解发热等临床症状,减轻体内炎症反应,调节机体免疫功能,值得临床推广应用。

Objective To explore the clinical efficacy of Lianhua Qingwen Granules combined with Peramivir and Sodium Chloride Injection in treatment of influenza.Methods A total of 134 influenza patients admitted to Cangzhou Central Hospital from August 2019 to May 2021 were selected and divided into control group and treatment group according to random number table method, with 67 cases in each group. Patients in the control group were iv administered with Peramivir and Sodium Chloride Injection, 300 mg/time,once daily. Patients in the treatment group were po administered with Lianhua Qingwen Granules on the basis of the control group, 1bag/time, three times daily. The treatment course of both groups was 3 d. The clinical efficacy of the two groups was observed, and the symptom disappearance time, temperature onset time, immediate fever reduction rate, abnormal rate of white blood cell count(WBC),serum C-reactive protein(CRP), interleukin-6(IL-6) levels and peripheral blood CD4⁺/CD8⁺ were compared between the two groups.The adverse reactions of the two groups were analyzed.Results After treatment, the total effective rate of the treatment group was 98.51%, which was significantly higher than that of the control group(88.06%, P<0.05). After treatment, the disappearance time of fever, sore throat, cough and body soreness in treatment group was significantly shorter than that in control group(P<0.05). After treatment, the onset time of body temperature in the treatment group was significantly shorter than that in the control group, and the rate of immediate fever reduction(58.21%) was significantly higher than that in the control group(40.30%)(P<0.05). After treatment,the abnormal rate of WBC in both groups was significantly decreased(P<0.05), and the treatment group was lower than the control group(P<0.05). After treatment, serum CRP, IL-6, and peripheral blood CD4⁺/CD8⁺ levels in both groups were significantly decreased compared with before treatment(P<0.05), and after treatment, serum CRP, IL-6 and peripheral blood CD4⁺/CD8⁺ levels in the treatment group were lower than those in the control group(P<0.05). After treatment, the incidence of adverse reactions in the treatment group and the control group was 4.48% and 2.99%, respectively, with no statistical significance.Conclusion Lianhua Qingwen Granules combined with Peramivir and Sodium Chloride Injection has satisfactory overall curative effect in treatment of influenza, and can effectively control viral infection, rapidly relieve fever and other clinical symptoms, and can reduce inflammation in the body, regulate the body's immune function, which is worthy of clinical application.

R974

河北省中医药管理局科研计划项目(2021287)