热毒净治疗儿童传染性单核细胞增多症临床疗效的回顾性研究

目的 探讨热毒净治疗儿童传染性单核细胞增多症的临床疗效及其安全性.方法 将2013年1月1日至2015年12月31日首都医科大学附属北京友谊医院儿科病房收治的传染性单核细胞增多症患儿共113例纳入本研究,热毒净组86例,非热毒净组27例.观察两组的临床症状(发热),体征(皮疹、淋巴结肿大、咽峡炎、肝脾肿大)及实验室检查指标(外周血异型淋巴细胞比例、外周血白细胞计数、外周血淋巴细胞比例、肝功能、外周血T细胞亚群CD4+、CD8+及CD4-/CD8+值、外周血EBV-DNA),不良反应情况.比较两组临床疗效及其安全性,并对结果进行统计学分析.结果 热毒净组86例,显效41例,有效40例,无效5例;非热毒净组27例,显效8例,有效14例,无效5例;热毒净组总有效率显著高于非热毒净组(94.2％ vs.81.5％,P＜ 0.05).热毒净组热退时间、咽峡炎消失时间、颈部淋巴结肿大消退时间、肝脾肿大消退时间明显短于非热毒净组(P＜0.05).热毒净组治疗后的外周血异型淋巴细胞比例、外周血白细胞计数、外周血淋巴细胞比例与非热毒净组治疗后的指标比较,差异无统计学意义(P＞0.05);治疗后两组患儿的证候总积分比治疗前均明显降低(P=0.000),且热毒净组临床症状总积分的改善明显优于非热毒净组(P=0.046).热毒净组治疗后肝功能、外周血T细胞亚群CD4+、CD8+及CD4+/CD8+值与非热毒净组治疗后的指标比较,差异均有统计学意义(P＜0.05);热毒净组治疗后外周血EBV-DNA阴性率明显高于非热毒净组(81.4％ vs.63.0％,P＜0.05).两组患儿实验室检查结果(血、尿、便、肾功能)、胃肠道反应均未出现明显异常改变.结论 热毒净口服液能够提高儿童传染性单核细胞增多症的治疗效果,安全性较高,可进一步推广.

Retrospective study of the clinical efficacy of redujing to treat children's infectious mononucleosis

Objective To estimate the safety and efficacy of redujing oral liquid to treat children's infectious mononucleosis (IM).Methods Children diagnosed IM in the pediatric ward of Beijing Friendship Hospital from January 1,2013 to December 31,2015 were registered in this study.Patients were divided into two groups:redujing group and the control group (without redujing).The clinical symptoms,signs (skin rash,lymphadenectasis,isthmitis,hepatomegaly,splenomegaly) and laboratory index (peripheral blood abnormal lymphocyte percentage,peripheral blood leukocyte count,the proportion of peripheral blood lymphocytes,liver function,peripheral blood T cell subgroup CD4+,CD8+ and CD4+/CD8+,the copies of EBV-DNA) were analyzed.The adverse reactions,which included abnormal blood routine examination,stool and urinary routine examination,renal function and gastrointestinal reaction were recorded.Results In redujing group,41 cases had excellent effect,40 cases had effect,5 cases were invalid.In control group,8 cases had excellent effect,14 cases had effect,5 cases were invalid.For the total efficacy,there was significant difference between redujing group and the control group(94.2％ vs.81.5％,P ＜ 0.05).For the time of antipyretic,disappearing time of anginaandenlarged cervical lymph nodes,hepatosplenomegaly regression time,which were much shorter in redujing group than in control group (P ＜ 0.05).For peripheral blood abnormal lymphocyte percentage,peripheral blood leukocyte count and the proportion of peripheral blood lymphocytes,there was no significant difference (P ＞ 0.05) between redujing group and the control group.For the liver function,peripheral blood T cell subgroup CD4+,CD8+ and CD4+/CD8+ value,there was significantly different between redujing group and the control group(P ＜ 0.05).Compared with the control group,the proportion of negative conversion of EBV-DNA in redujing group significantly increased(P ＜ 0.05).Adverse reactions monitoring:physical examination,laboratory examination results (blood,urine,stool,renal function) and gastrointestinal reaction of the two groups had no obvious abnormal changes.Conclusion Redujing oral liquid can enhance clinical efficacy in treating IM and it is safe.