摘要
目的从多角度探讨中药治疗EB病毒感染的疗效,为EB病毒感染的中医治疗提供依据。方法 81例患儿随机分为治疗组46例及对照组35例,中药组采用中药汤剂口服,西药组采用更昔洛韦静脉滴注及匹多莫德口服,两组疗程均为2周。治疗后随访至12周。治疗前后及随访4、12周观察发热、淋巴结和肝脾肿大等临床情况,及异常淋巴细胞百分比,EB病毒抗体,病毒DNA载量,T细胞亚类、免疫球蛋白等实验室指标。结果 (1)治疗2周治疗组总有效率为95.6%,对照组为94.3%,两组比较差异无统计学意义。(2)治疗组在退热时间、咽充血持续时间,扁桃体肿大持续时间均短于对照组,淋巴结和肝肿大消退,异常淋巴细胞消退优于对照组,差异有统计学意义(P<0.05)。(3)治疗后及随访4、12周时,两组末梢血常规异型淋巴细胞阳性例数与同组治疗前比较均明显减少(P<0.01);两组免疫球蛋白IgA和IgM表达与同组治疗前比较下降(P<0.05,P<0.01)。治疗后及随访4、12周时,治疗组中IgG亦明显下降(P<0.05,P<0.01),而对照组中IgG仅治疗后与同组治疗前比较下降(P<0.05);治疗组AST、ALT及对照组AST与同组治疗前比较明显改善(P<0.05)。与对照组比较,治疗组治疗后及随访4、12周异常淋巴细胞阳性例数减少明显,差异有统计学意义(P<0.05)。(4)治疗后及随访4、12周时,与同组治疗前比较,两组CD3+、CD8+均明显下降,CD4+、CD4/CD8及B细胞均明显上升,差异有统计学意义(P<0.05)。治疗组NK细胞治疗后及随访4、12周时明显高于同组治疗前,并高于对照组,差异有统计学意义(P<0.05)。(5)治疗后及随访4、12周与同组治疗前比较,两组EB病毒DNA及EB病毒CA-IgM转阴例数均明显增多,差异有统计学意义(P<0.05)。与对照组比较,治疗组治疗后、随访4周时EB病毒DNA转阴例数及治疗后EB病毒CA-IgM转阴例数均明显增多,差异有统计学意义(P<0.05)。结论中医药治疗EB病毒感染具有较好的疗效,有促进EB病毒感染恢复的作用,减少EB病毒感染后发生恶性疾患的风险。
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. Pa- tients were followed-up till the 12th week. Clinical symptoms such as fever, lymphadenopathy and hepato- splenomegaly, 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 twogroups. （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 treat- ment, at week 4 and 12 of follow-ups both in the treatment group and the control group （P 〈0.01 ）. The ex- pression 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 treat- ment, at week 4 and 12 of follow-ups （P 〈0.05,P 〈0.01 ）, while it decreased only after treatment in the con- trol 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 signifi- cantly 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.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2014年第2期167-173,共7页
Chinese Journal of Integrated Traditional and Western Medicine
基金
北京中医药科技项目(首发基金自主创新项目
No.SF-2007-Ⅲ-20)
关键词
EB病毒
中药
免疫干预
Epstein-Barr virus
Chinese pharmacy
immune intervention
