目的 探討山蠟梅葉顆粒聯(lián)合利巴韋林注射液治療兒童急性上呼吸道感染的療效及安全性。方法 選取2014年1月-2015年1月上海交通大學(xué)附屬上海市第六人民醫(yī)院收治的急性上呼吸道感染患兒128例,隨機(jī)分為對照組和治療組,每組各64例。對照組靜脈滴注利巴韋林注射液,10 mg/kg,1次/d,7 d為1療程。治療組在對照組基礎(chǔ)上,口服山蠟梅葉顆粒,1袋/次,3次/d,7 d為1療程。觀察兩組的臨床療效,同時比較兩組治療前后患者臨床癥狀改善時間、住院時間、血常規(guī)、免疫功能指標(biāo)、不良反應(yīng)的情況。結(jié)果 治療后,對照組和治療組的總有效率分別為89.06%、98.44%,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,治療組患者體溫正常、咳嗽消失、咽痛充血、扁桃體發(fā)炎、流涕鼻塞的改善時間及住院時間顯著低于對照組,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組白細(xì)胞(WBC)計數(shù)顯著升高,淋巴細(xì)胞比例顯著下降,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);治療3 d后,治療組這些觀察指標(biāo)改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者免疫球蛋白A(IgA)、免疫球蛋白E(IgE)、免疫球蛋白M(IgM)、血清腺普脫氨酶(ADA)均顯著降低,免疫球蛋白G(IgG)顯著升高,同組治療前后比較差異有統(tǒng)計學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。對照組和治療組的不良反應(yīng)發(fā)生率分別為18.75%、6.25%,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 山蠟梅葉顆粒聯(lián)合利巴韋林注射液治療兒童急性上呼吸道感染療效較好,能快速改善臨床癥狀,縮短住院時間,不良反應(yīng)少,具有一定的臨床推廣應(yīng)用價值。

ObjectiveTo investigate the clinical effect and safety of Shanlameiye Granules with Ribavirin Injection in treatment of pediatric acute upper respiratory infection.Methods Children (128 cases) with acute upper respiratory infection in Shanghai the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from January 2014 to January 2015 were randomly divided into control and treatment groups, and each group had 64 cases. Patients in the control group were iv administered with Ribavirin Injection, 10 mg/kg, once daily, 7 d as one course. Patients in the treatment group were po administered with Shanlameiye Granules on the basis of control group, 1 bag/time, three time daily, 7 d as one course. After treatment, the clinical efficacies were evaluated, and the improvement time of clinical symptoms, hospital stay time, blood routine, immune function indexes, and adverse reaction in two groups before and after treatment were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 89.06% and 98.44%, respectively, and there was difference between two groups (P < 0.05). After treatment, the time of hospitalization and the clinical symptom improvement including normal temperature, cough disappeared, pharyngalgia and hyperemia, infection of tonsil, and runny nose and nasal congestion in the treatment group were significantly lower than those in the control group, and there were differences between two groups (P < 0.05). After treatment, WBC in two groups were significantly increased, but lymphocyte ratio in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment for 3 d, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, IgA, IgE, IgM, and ADA in two groups were significantly decreased, but IgG in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The incidence of adverse reactions in control and treatment groups were 18.75% and 6.25%, respectively, and there was difference between two groups (P < 0.05).Conclusion Shanlameiye Granules with Ribavirin Injection has clinical curative effect in treatment of pediatric acute upper respiratory infection, and can rapidly improve the clinical symptoms of patients, can shorten the time of hospitalization, less adverse reactions, which has a certain clinical application value.