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目的:观察扶正固表汤联合敷贴疗法治疗小儿反复上呼吸道感染(RRTI)的疗效及对免疫功能和微量元素的影响。方法:将150例患儿按就诊先后以随机数字表法分为对照组和观察组各75例。两组患儿在急性感染期给予抗生素、抗病毒、退热、止咳、补液等对症治疗;并采用匹多莫德口服溶液治疗。对照组给予玉屏风口服液,5~10 m L/次,3次/d,口服。观察组给予扶正固表汤联合敷贴疗法。两组疗程均为16周,再进行32周的随访。记录48周内的发病次数;记录每次发病的天数;记录发病病种;进行肺脾两虚证评分;检测血清免疫球蛋白(Ig)A,IgG,IgM,T淋巴细胞亚群和补体C3及补体C4,检测钙(Ca),铁(Fe),锌(Zn),镁(Mg),铜(Cu)水平。结果:观察组临床疗效总有效率为94.29%,高于对照组的82.09%(P<0.05);在48周的观察随访期间,观察组平均发作次数少于对照组,平均病程短于对照组,病情程度轻于对照组(P<0.01);治疗后观察组CD3~+,CD4~+和CD4~+/CD8~+均高于对照组,而CD8~+低于对照组(P<0.01);治疗后观察组血清IgG,IgA,IgM水平均高于对照组(P<0.01);两组患儿C3和C4水平治疗前后变化无统计学意义;治疗后观察组Ca,Fe,Zn,Mg水平均高于对照组(P<0.05,P<0.01),两组患儿Cu水平的组间比较,差异无统计学意义。结论:扶正固表汤联合敷贴疗法治疗肺脾两虚型RRTI,能提高机体免疫力,调节微量元素水平,能预防RRTI的发作次数和发作程度,近期和远期均有明显疗效。
Objective: To observe the therapeutic effect of Fuzheng Gu Tui Decoction combined with therapies on the treatment of children with recurrent upper respiratory tract infections (RRTI) and its effects on immune function and trace elements. Methods: 150 cases of children were treated according to the random number table divided into control group and observation group of 75 cases. Two groups of children given antibiotics, anti-virus, antipyretic, cough, rehydration and other symptomatic treatment during acute infection; and treated with pidotimod oral solution. The control group was given Yupingfeng oral liquid, 5 ~ 10 m L / time, 3 times / d, orally. Observation group given Fuzheng Guwei soup combined with dressing therapy. Two courses of treatment were 16 weeks, followed by 32 weeks of follow-up. Record the incidence of disease within 48 weeks; record the number of days of each incidence; record the incidence of disease; score of lung and spleen deficiency syndrome; detect serum immunoglobulin (Ig) A, IgG, IgM, T lymphocyte subsets and complement C3 And complement C4 to detect the levels of Ca, Fe, Zn, Mg and Cu. Results: The total effective rate in the observation group was 94.29%, higher than that in the control group (82.09%, P <0.05). During the 48-week follow-up period, the average number of attacks in the observation group was less than that in the control group, (P <0.01). After treatment, the levels of CD3 +, CD4 + and CD4 + / CD8 + in the observation group were higher than those in the control group, while the levels of CD8 + in the observation group were lower than those in the control group ); After treatment, serum IgG, IgA and IgM levels in the observation group were higher than those in the control group (P <0.01). There was no significant difference in the levels of C3 and C4 between the two groups before and after treatment. After treatment, the levels of Ca, Fe, Zn, Mg levels were higher than the control group (P <0.05, P <0.01), two groups of children with Cu levels between the groups, the difference was not statistically significant. Conclusion: Combination of Fuzheng Gu Tui decoction with Radix Astragali and Radix Astragali combined with Radiotherapy can improve the body immunity, regulate the level of trace elements, prevent the number and severity of RRTI episodes, and have significant curative effect both in the short and long term.