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[中医治疗儿童EB病毒感染的临床研究]

[Treatment of children with EB virus infection by Chinese medicine: a clinical study].

作者信息

Zhen Xiao-Fang, Yao Yuan, Qin Li-Na, Chen Fang

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2014 Feb;34(2):167-73.

PMID:24672940
Abstract

OBJECTIVE

To provide evidence for Chinese medical treatment of children with EB virus infection by exploring its clinical efficacy from multiple angles.

METHODS

Totally 81 children patients were randomly assigned to the treatment group (46 cases) and the control group (35 cases). Patients in the treatment group took Chinese medical decoction, while those in the control received intravenous dripping of Ganciclovir and oral administration of pidotimod. The treatment period for the two groups was 2 weeks. Patients were followed-up till the 12th week. Clinical symptoms such as fever, lymphadenopathy and hepatosplenomegaly, as well as lab indices such as abnormal lymphocyte percentage, EB virus antibody, virus DNA load, T cell subsets, immunoglobulin, and so on were observed before and after treatment, at week 4 and 12 of follow-ups.

RESULTS

(1) The total effective rate at week 2 was 95.6% in the treatment group, higher than that of the control group (94.3%), but there was no statistical difference between the two groups. (2) The time for defervescence, duration of pharyngeal hyperemia, duration of swollen tonsils was shorter in the treatment group than in the control group (P<0.05). The subsidence of lymphadenopathy, hepatomegaly, and abnormal lymphocytes was better in the treatment group than in the control group (P < 0.05). (3) The positive cases of peripheral blood hetero-lymphocyte was significantly reduced after treatment, at week 4 and 12 of follow-ups both in the treatment group and the control group (P < 0.01). The expression of IgA and IgM decreased after treatment in the two groups when compared with before treatment in the same group (P < 0.05, P < 0.01). IgG in the treatment group also obviously decreased after treatment, at week 4 and 12 of follow-ups (P < 0.05, P < 0.01), while it decreased only after treatment in the control group (P < 0.05). Activities of AST and ALT in the treatment group and the AST activity in the control group were markedly improved when compared with those before treatment (P < 0.05). Compared with the control group, the abnormal lymphocyte positive case number obviously decreased in the treatment group after treatment, at week 4 and 12 of follow-ups (P < 0.05). (4) After treatment, at week 4 and 12 of follow-ups, CD3+ and CD8+ significantly decreased; CD4+, CD4/CD8, and B cells significantly increased in the two groups, when compared with before treatment (P < 0.05). NK cells significantly increased more in the treatment group after treatment, at week 4 and 12 of follow-ups, higher than before treatment as well as the control group (P < 0.05). (5) EB viral DNA and EB viral CA-IgM negative conversion case numbers significantly increased in the two groups after treatment, at week 4 and 12 of follow-ups (P < 0.05). Compared with the control group, EB viral DNA and EB viral CA-IgM negative conversion case numbers significantly increased in the treatment group after treatment and at week 4 of follow-ups (P < 0.05).

CONCLUSIONS

Treatment of EB virus infection by Chinese medical treatment was effective. It could promote the recovery of EB viral infection, and reduce the risk of vicious disease after EB viral infection.

摘要

目的

从多个角度探讨中医治疗儿童EB病毒感染的临床疗效,为中医治疗儿童EB病毒感染提供依据。

方法

将81例儿童患者随机分为治疗组(46例)和对照组(35例)。治疗组患儿服用中药汤剂,对照组患儿采用静脉滴注更昔洛韦及口服匹多莫德治疗。两组治疗周期均为2周,随访至第12周。观察治疗前、治疗后、随访第4周及第12周时患儿的发热、淋巴结肿大、肝脾肿大等临床症状,以及淋巴细胞百分比异常、EB病毒抗体、病毒DNA载量、T细胞亚群、免疫球蛋白等实验室指标。

结果

(1)治疗组第2周总有效率为95.6%,高于对照组(94.3%),但两组差异无统计学意义。(2)治疗组退热时间、咽充血持续时间、扁桃体肿大持续时间均短于对照组(P<0.05)。治疗组淋巴结肿大、肝肿大及淋巴细胞异常恢复情况优于对照组(P<0.05)。(3)治疗后及随访第4周、第12周时,两组外周血异型淋巴细胞阳性病例数均显著减少(P<0.01)。两组治疗后IgA、IgM表达较治疗前均降低(P<0.05,P<0.01)。治疗组随访第4周、第12周时IgG也明显降低(P<0.05,P<0.01),而对照组仅治疗后降低(P<0.05)。治疗组及对照组AST、ALT活性较治疗前均明显改善(P<0.05)。与对照组比较,治疗后及随访第4周、第12周时治疗组异型淋巴细胞阳性病例数明显减少(P<0.05)。(4)治疗后及随访第4周、第12周时,两组CD3+、CD8+显著降低;CD4+、CD4/CD8及B细胞显著升高(P<0.05)。治疗组随访第4周、第12周时NK细胞升高更明显,高于治疗前及对照组(P<0.05)。(5)治疗后及随访第4周、第12周时,两组EB病毒DNA及EB病毒CA-IgM转阴病例数均显著增加(P<0.05)。与对照组比较,治疗后及随访第4周时治疗组EB病毒DNA及EB病毒CA-IgM转阴病例数显著增加(P<0.05)。

结论

中医治疗儿童EB病毒感染有效,可促进EB病毒感染的恢复,降低EB病毒感染后恶病发生风险。

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