CAJ | 학술논문

目的：对比观察早期口服加味四君子汤对严重烧伤患者免疫功能的影响。方法将50例严重烧伤患者随机分为治疗组和对照组，每组25例，在常规给予全身治疗和局部治疗的同时，治疗组于伤后1 d给予加味四君子汤口服，200 mL/d，分两次餐后服用，连续服用10 d；对照组于伤后1 d 给予生理盐水口服，200 mL/d，分两次餐后服用，连续服用10 d。分别于服药前及服药后1、4、7、10 d清晨抽取两组患者空腹静脉血，检测血清IgA、 IgG、 IgM、 CD 4＋、 CD 8＋的含量，并计算CD 4＋/CD 8＋比值。结果治疗组患者服药后1、4、7、10 d血清IgA含量均高于服药前，服药后7、10 d血清IgG、 IgM含量均较服药前升高（ P＜0.05）；对照组患者服用生理盐水后7、10 d血清IgA含量均较服药前明显下降（ P＜0.05）， IgG、 IgM含量在治疗过程中持续下降。治疗组患者服药后4、7、10 d CD4＋含量升高， CD8＋含量降低， CD4＋/CD8＋比值升高；对照组患者服药后1、4、7、10 d CD 4＋含量减少， CD 8＋含量及CD 4＋/CD 8＋比值上下波动；两组对比，差异具有统计学意义（ P＜0.05）。结论加味四君子汤能调节T淋巴细胞亚群的比例，促进机体免疫功能的恢复，有利于严重烧伤患者的康复。
목적：대비관찰조기구복가미사군자탕대엄중소상환자면역공능적영향。방법장50례엄중소상환자수궤분위치료조화대조조，매조25례，재상규급여전신치료화국부치료적동시，치료조우상후1 d급여가미사군자탕구복，200 mL/d，분량차찬후복용，련속복용10 d；대조조우상후1 d 급여생리염수구복，200 mL/d，분량차찬후복용，련속복용10 d。분별우복약전급복약후1、4、7、10 d청신추취량조환자공복정맥혈，검측혈청IgA、 IgG、 IgM、 CD 4＋、 CD 8＋적함량，병계산CD 4＋/CD 8＋비치。결과치료조환자복약후1、4、7、10 d혈청IgA함량균고우복약전，복약후7、10 d혈청IgG、 IgM함량균교복약전승고（ P＜0.05）；대조조환자복용생리염수후7、10 d혈청IgA함량균교복약전명현하강（ P＜0.05）， IgG、 IgM함량재치료과정중지속하강。치료조환자복약후4、7、10 d CD4＋함량승고， CD8＋함량강저， CD4＋/CD8＋비치승고；대조조환자복약후1、4、7、10 d CD 4＋함량감소， CD 8＋함량급CD 4＋/CD 8＋비치상하파동；량조대비，차이구유통계학의의（ P＜0.05）。결론가미사군자탕능조절T림파세포아군적비례，촉진궤체면역공능적회복，유리우엄중소상환자적강복。
Objective To observe the effect of early administrating modified decoction of four noble drugs orally on immune function in patients with severe burns .Mtehods Fifty Patients were randomly divided into control group and treatment group , 25cases each .While being given routine systemic treatment and local treatment , the treatment group and the control group were also administered orally modified decoction of four noble drugs and normal saline respectively , begin-ning one day after injury, 200ml /d and twice a day after meal, continued for 10 days.Fasting venous blood samples were drawn every morning before oral administration treatment and 1, 4, 7, 10 d after, and the concentration of serum IgA , IgG, IgM, CD4 +, CD8 +were examined , CD4 +/CD8 +ratio was calculated .Results In treatment group, the concentration of serum IgA was higher than before1, 4, 7, 10d after oral drug administration;the concentrations of serum IgG and IgM were all higher than before 7,10 d after oral drug administration (P<0.05).In control group, the concentration of serum IgA was significantly decreased 7, 10 d after taking normal saline (P<0.05), and IgG and IgM continuted to decrease in the course of treatment.In treatment group, 4, 7, 10 d after oral drug administration, CD 4 +concentration increased and CD 8 +concentrationdecreased, CD4 +/CD8 +ratio increased;In control group, 1, 4, 7, 10 d after oral saline administration, pe-ripheral blood CD4 +concentration decreased, while the CD8 +concentrationand CD4 +/CD8 +ratiofluctuated.The difference be-tween the two groups is statistically significant (P<0.05).Conclusion:Modified decoction of four noble drugs can promote im-mune function recovery by regulating the proportion of T lymphocyte subsets, helping the healing of severely burned patients.