银翘白虎汤联合利巴韦林治疗小儿急性上呼吸道腺病毒感染的疗效及对血清TNF-α、CRP及IL-6的影响

摘要

目的 观察银翘白虎汤联合利巴韦林治疗小儿急性上呼吸道腺病毒感染的疗效及对血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及白细胞介素-6(IL-6)的影响并探讨其机制.方法 将患儿108例按随机数字表法分为观察组和对照组各54例,两组均予退热、纠正水/电解质紊乱等基础干预,对照组给予利巴韦林治疗,观察组在对照组基础上联合银翘白虎汤治疗.结果 治疗后两组中医证候积分显著低于治疗前(P＜0.05),且观察组显著低于对照组(P＜0.05);观察组总有效率94.44％,显著高于对照组的81.48％(P＜0.05);观察组咳嗽消失时间、咽痛消失时间、鼻塞流涕消失时间、腹泻消失时间、体温恢复正常时间显著短于对照组(P＜0.05);治疗后两组血清CRP、TNF-α、IL-6水平显著低于治疗前(P＜0.05),且观察组显著低于对照组(P＜0.05).结论 银翘白虎汤联合利巴韦林可有效改善急性上呼吸道腺病毒感染患儿临床症状和血清TNF-α、CRP及IL-6水平,提高治疗效果.%Objective:To observe curative effect of Yinqiao Baihu Decoction combined with ribavirin in treatment of children with acute upper respiratory tract adenovirus infection and influence on serum tumor necrosis factor α(TNF-α),C reactive protein(CRP) and interleukin-6(IL-6).Methods:108 cases of children with adenovirus infection in acute upper respiratory tract were divided into the observation group and the control group according to random number table method,54 cases in each group.All the patients were given the basic intervention,such as reducing fever,correcting water and electrolyte disturbance,on the basis of which,the control group were given ribavirin treatment,and the observation group were combined with Yinqiao Baihu Decoction on the basis of the control group.TCM symptom score,clinical efficacy,disappearance time of clinical symptoms were observed,serum TNF-α,CRP and IL-6 levels were detected,and the incidence of adverse reactions was figured.Results:After treatment,TCM symptoms scores were significantly lower than those before treatment in the two groups (P＜ 0.05),and those in the observation group were significantly lower than those in the control group (P＜0.05).The total effective rate of the observation group was 94.44％,significantly higher than that of 81.48％ of the control group (P ＜ 0.05).The disappearance times of cough,throat,congestion,diarrhea,temperature recovery time in the observation group were significantly lower than those in the control group(P＜ 0.05).After treatment,serum CRP,TNF-α and IL-6 levels were significantly lower than those before treatment in the two groups (P＜ 0.05),and those in the observation group were significantly lower than those in the control group (P＜ 0.05).The incidence of adverse reactions in the observation group was 1.85％,slightly lower than that of 7.41％ in the control group (P＞ 0.05).Conclusion:Yinqiao Baihu Decoction combined with ribavirin can effectively improve clinical symptoms and serum TNF-α,CRP and IL-6 levels of children with acute upper respiratory tract adenovirus infection,and improve treatment effect.