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目的探讨化痰清热方联合盐酸氨溴索对小儿肺炎C反应蛋白(CRP)、白介素-18(IL-18)水平及免疫功能的影响。方法选择2014年1月至2016年1月期间收治的肺炎患儿180例,依据随机数字表法随机分为观察组90例与对照组90例。两组均给予常规抗感染、退热、平喘、止咳治疗,同时对照组给予盐酸氨溴索治疗,观察组在对照组基础上结合化痰清热方治疗。两组疗程均为10 d。比较两组患儿治疗疗效,治疗前后CRP、IL-18、免疫功能指标水平变化及主要症状、体征积分变化,不良反应发生情况。结果观察组总有效率(96.67%)高于对照组(77.78%,P<0.01);两组治疗后CRP、IL-18及免疫功能指标均显著改善(P均<0.01)。观察组血清CRP、IL-18水平治疗后低于对照组(P均<0.01);观察组治疗后CD3+、CD4+、CD4+/CD8+水平高于对照组(P均<0.01);观察组发热、咳嗽、肺内痰鸣音积分治疗后低于对照组(P均<0.01);两组心电图、血常规、尿常规、肝肾功能均未见异常,且未见严重药物不良反应。结论化痰清热方联合盐酸氨溴索治疗小儿肺炎疗效明显,其作用机制可能与降低CRP、IL-18水平及提高免疫功能相关。
Objective To investigate the effect of Huatan Qingre Fang combined with ambroxol hydrochloride on the levels of C-reactive protein (CRP), interleukin-18 (IL-18) and immune function in children. Methods 180 children with pneumonia admitted from January 2014 to January 2016 were randomly divided into observation group (n = 90) and control group (n = 90) according to the random number table method. Both groups were given routine anti-infective, antipyretic, antiasthmatic, cough treatment, while the control group was treated with ambroxol hydrochloride, the observation group on the basis of the control group with the treatment of phlegm Qingre Fang. The two courses of treatment were 10 d. The curative effect of two groups of children were compared. CRP, IL-18 levels before and after treatment, the changes of immune function indexes and the main symptoms and signs score changes, the occurrence of adverse reactions. Results The total effective rate (96.67%) in the observation group was significantly higher than that in the control group (77.78%, P <0.01). The CRP, IL-18 and immune function indexes of the two groups were significantly improved after treatment (all P <0.01). The serum levels of CRP and IL-18 in the observation group were lower than those in the control group after treatment (all P <0.01); the levels of CD3 +, CD4 + and CD4 + / CD8 + in the observation group were higher than those in the control group (P <0.01) (P <0.01). The electrocardiogram, blood routine, urine routine, liver and kidney function were not abnormal in both groups, and no serious adverse drug reactions were observed. Conclusions Huatan Qingrefang combined with ambroxol hydrochloride has obvious curative effect on infantile pneumonia. The mechanism may be related to decreasing the levels of CRP and IL-18 and improving the immune function.