中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2015年
1期
18-22
,共5页
芩柴抗毒合剂%EB病毒感染%传染性单核细胞增多症%气营两燔型
芩柴抗毒閤劑%EB病毒感染%傳染性單覈細胞增多癥%氣營兩燔型
금시항독합제%EB병독감염%전염성단핵세포증다증%기영량번형
Qinchai Kangdu mixture%EB virus infection%Infectious mononucleosis%Traditional Chinese medicine syndrome of flaring heat in Qifen and Yingfen
目的：观察自拟芩柴抗毒合剂治疗小儿EB病毒（EBV）感染传染性单核细胞增多症（IM）的临床疗效及作用机制。方法采用前瞻性研究方法，选择武汉市儿童医院收治的西医诊断为EBV感染IM，且中医辨证为气营两燔型的患儿120例，按随机数字表法分为观察组和对照组，每组60例。对照组患儿给予常规治疗，疗程7～10 d；观察组患儿在常规治疗基础上给予芩柴抗毒合剂（组成：黄芩10 g，柴胡10 g，青蒿10 g，连翘20 g，牛蒡子10 g，赤芍10 g，桂枝6 g，牡丹皮10 g，鳖甲10 g，板蓝根20 g，陈皮10 g，甘草10 g）口服，每日1剂，疗程7～10 d。观察两组患儿临床疗效、临床症状和体征恢复情况及白细胞计数（WBC）、外周血异型淋巴细胞比例、丙氨酸转氨酶（ALT）等指标恢复至正常的时间，并观察中医症状积分的变化和不良反应。结果观察组总有效率明显高于对照组〔93.33%（56/60）比76.67%（46/60），P＜0.05〕，观察组发热持续时间（d：6.9±2.3比7.7±3.4）、体温恢复正常时间（d：2.9±1.4比4.8±1.7）、咽峡炎痊愈时间（d：7.2±3.3比8.0±3.2）、淋巴结缩小时间（d：6.6±2.1比10.2±2.0）、肝脏回缩至正常时间（d：7.8±1.7比9.6±2.0）、WBC恢复正常时间（d：7.22±1.78比10.67±1.97）、异型淋巴细胞比例恢复正常时间（d：7.24±1.86比11.15±1.65）、ALT恢复正常时间（d：8.44±1.83比11.43±2.65）均较对照组明显缩短（均P＜0.05）。两组患儿治疗过程中均无不良反应发生。结论芩柴抗毒合剂治疗小儿EBV感染传染性IM气营两燔型，能有效改善IM患儿的临床症状，有助于肝脾肿大早期回缩，能促进外周血异型淋巴细胞比例等检验指标及时恢复至正常。
目的：觀察自擬芩柴抗毒閤劑治療小兒EB病毒（EBV）感染傳染性單覈細胞增多癥（IM）的臨床療效及作用機製。方法採用前瞻性研究方法，選擇武漢市兒童醫院收治的西醫診斷為EBV感染IM，且中醫辨證為氣營兩燔型的患兒120例，按隨機數字錶法分為觀察組和對照組，每組60例。對照組患兒給予常規治療，療程7～10 d；觀察組患兒在常規治療基礎上給予芩柴抗毒閤劑（組成：黃芩10 g，柴鬍10 g，青蒿10 g，連翹20 g，牛蒡子10 g，赤芍10 g，桂枝6 g，牡丹皮10 g，鱉甲10 g，闆藍根20 g，陳皮10 g，甘草10 g）口服，每日1劑，療程7～10 d。觀察兩組患兒臨床療效、臨床癥狀和體徵恢複情況及白細胞計數（WBC）、外週血異型淋巴細胞比例、丙氨痠轉氨酶（ALT）等指標恢複至正常的時間，併觀察中醫癥狀積分的變化和不良反應。結果觀察組總有效率明顯高于對照組〔93.33%（56/60）比76.67%（46/60），P＜0.05〕，觀察組髮熱持續時間（d：6.9±2.3比7.7±3.4）、體溫恢複正常時間（d：2.9±1.4比4.8±1.7）、嚥峽炎痊愈時間（d：7.2±3.3比8.0±3.2）、淋巴結縮小時間（d：6.6±2.1比10.2±2.0）、肝髒迴縮至正常時間（d：7.8±1.7比9.6±2.0）、WBC恢複正常時間（d：7.22±1.78比10.67±1.97）、異型淋巴細胞比例恢複正常時間（d：7.24±1.86比11.15±1.65）、ALT恢複正常時間（d：8.44±1.83比11.43±2.65）均較對照組明顯縮短（均P＜0.05）。兩組患兒治療過程中均無不良反應髮生。結論芩柴抗毒閤劑治療小兒EBV感染傳染性IM氣營兩燔型，能有效改善IM患兒的臨床癥狀，有助于肝脾腫大早期迴縮，能促進外週血異型淋巴細胞比例等檢驗指標及時恢複至正常。
목적：관찰자의금시항독합제치료소인EB병독（EBV）감염전염성단핵세포증다증（IM）적림상료효급작용궤제。방법채용전첨성연구방법，선택무한시인동의원수치적서의진단위EBV감염IM，차중의변증위기영량번형적환인120례，안수궤수자표법분위관찰조화대조조，매조60례。대조조환인급여상규치료，료정7～10 d；관찰조환인재상규치료기출상급여금시항독합제（조성：황금10 g，시호10 g，청호10 g，련교20 g，우방자10 g，적작10 g，계지6 g，모단피10 g，별갑10 g，판람근20 g，진피10 g，감초10 g）구복，매일1제，료정7～10 d。관찰량조환인림상료효、림상증상화체정회복정황급백세포계수（WBC）、외주혈이형림파세포비례、병안산전안매（ALT）등지표회복지정상적시간，병관찰중의증상적분적변화화불량반응。결과관찰조총유효솔명현고우대조조〔93.33%（56/60）비76.67%（46/60），P＜0.05〕，관찰조발열지속시간（d：6.9±2.3비7.7±3.4）、체온회복정상시간（d：2.9±1.4비4.8±1.7）、인협염전유시간（d：7.2±3.3비8.0±3.2）、림파결축소시간（d：6.6±2.1비10.2±2.0）、간장회축지정상시간（d：7.8±1.7비9.6±2.0）、WBC회복정상시간（d：7.22±1.78비10.67±1.97）、이형림파세포비례회복정상시간（d：7.24±1.86비11.15±1.65）、ALT회복정상시간（d：8.44±1.83비11.43±2.65）균교대조조명현축단（균P＜0.05）。량조환인치료과정중균무불량반응발생。결론금시항독합제치료소인EBV감염전염성IM기영량번형，능유효개선IM환인적림상증상，유조우간비종대조기회축，능촉진외주혈이형림파세포비례등검험지표급시회복지정상。
Objective To observe the clinical efficacy of self made Qinchai Kangdu mixture for treatment of infantile EB virus (EBV) infectious mononucleosis and explore its potential mechanism. Methods A prospective study was conducted. One hundred and twenty children with pediatric EBV infectious mononucleosis and traditional Chinese medicine (TCM) syndrome of flaring heat in Qifen and Yingfen in Wuhan Children Hospital were randomly divided into observation group and control group (each, 60 cases). Conventional western medical treatment was given to the two groups for 7-10 days;the observation group was additionally given Qinchai Kangdu mixture which included the following ingredients:Scutellariae Radix 10 g, Bupleuri Radix 10 g, Artemisiae Annuae Herba 10 g, Forsythiae Fructus 20 g, Arctii Fructus 10 g, Paeoniae Radix Rubra 10 g, Cinnamomi Ramulus 6 g, Moutan Cortex 10 g, Trionycis Carapax 10 g, Isatidis Radix 20 g, Citri Reticulatae Pericarpium 10 g, Glycyrrhizae Radix 10 g, orally, once daily for 7-10 days. The times of returning to normal for clinical symptoms and signs, white blood cell count (WBC), peripheral blood abnormal lymphocyte ratio and the level of alanine aminotransferase (ALT) were observed in the two groups. And the clinical efficacy, changes in score of TCM syndrome and adverse reactions were also investigated in the two groups. Results The total effective rate in the observation group was significantly higher than that in the control group [93.33%(56/60) vs. 76.67%(46/60), P<0.05]. In observation group, the duration of fever (days:6.9±2.3 vs. 7.7±3.4), and the recovery times to normal for body temperature (days:2.9±1.4 vs. 4.8±1.7), angina (days:7.2±3.3 vs. 8.0±3.2), lymph node reduction in size (days: 6.6±2.1 vs. 10.2±2.0), enlarged liver bounce back in size (days: 7.8±1.7 vs. 9.6±2.0), WBC (days:7.22±1.78 vs. 10.67±1.97), peripheral blood abnormal lymphocyte ratio (days:7.24±1.86 vs. 11.15±1.65), and ALT (days:8.44±1.83 vs. 11.43±2.65) were all significantly shorter than those in the control group (all P < 0.05). No adverse reactions occurred in the therapeutic course in the two groups. Conclusions Qinchai Kangdu mixture can effectively improve the clinical symptoms of infantile EBV infectious mononucleosis with TCM syndrome of flaring heat in Qifen and Yingfen. The mixture may also promote the enlarged liver and spleen to contract in size at early stage and peripheral blood abnormal lymphocyte ratio and other laboratory indexes return to normal in time.
