小兒解表口服液聯(lián)合小兒氨酚黃那敏顆粒治療小兒外感發(fā)熱的臨床研究

劉福珍 李中英

[摘要] 目的 探討小兒解表口服液聯(lián)合小兒氨酚黃那敏顆粒治療小兒外感發(fā)熱的臨床效果及安全性。 方法 選擇2018年7月—2019年4月山東省濱州市人民醫(yī)院收治的外感發(fā)熱患兒230例為研究對象。依照隨機數(shù)字表法分為對照組（115例）和觀察組（115例）。對照組給予小兒氨酚黃那敏顆粒治療，觀察組給予小兒解表口服液聯(lián)合小兒氨酚黃那敏顆粒治療，兩組連續(xù)治療3 d。治療后評價臨床療效。比較兩組退熱起效時間、解熱時間及完全退熱時間。比較兩組治療前后中醫(yī)證候積分和血清腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素-1β（IL-1β）、γ干擾素（IFN-γ）、C反應(yīng)蛋白（CRP）水平。記錄并比較兩組治療過程中不良反應(yīng)的發(fā)生情況。 結(jié)果 觀察組總有效率高于對照組（P < 0.01）。觀察組退熱起效時間、解熱時間及完全退熱時間短于對照組（均P < 0.01）。兩組治療前中醫(yī)證候積分比較，差異無統(tǒng)計學(xué)意義（P > 0.05）;治療后，兩組中醫(yī)證候積分低于治療前，且觀察組低于對照組（均P < 0.01）。治療前，兩組血清TNF-α、IL-1β、IFN-γ及CRP水平比較，差異無統(tǒng)計學(xué)意義（P > 0.05）;治療后，兩組血清TNF-α、IL-1β、IFN-γ及CRP水平低于治療前，且觀察組低于對照組（均P < 0.05）。治療期間，兩組均未發(fā)生嚴(yán)重的不良反應(yīng)。 結(jié)論 小兒解表口服液聯(lián)合小兒氨酚黃那敏顆粒治療小兒外感發(fā)熱臨床療效明確，能縮短退熱時間，改善臨床癥狀，降低血清炎癥因子水平，且具有較好的安全性。

[關(guān)鍵詞] 小兒;外感發(fā)熱;小兒解表口服液;小兒氨酚黃那敏顆粒;療效

[中圖分類號] R725? ? ? ? ? [文獻標(biāo)識碼] A? ? ? ? ? [文章編號] 1673-7210（2020）07（c）-0117-04

Clinical study of Xiaoer Jiebiao Oral Liquid combined with Xiaoer Paracetamol Huangnamin Granules in the treatment of exogenous fever in children

LIU Fuzhen? ?LI Zhongying

The First Department of Pediatrics， Binzhou People′s Hospital， Shandong Province， Binzhou? ?256600， China

[Abstract] Objective To investigate the clinical efficacy and safety of Xiaoer Jiebiao Oral Liquid combined with Xiaoer Paracetamol Huangnamin Granules in the treatment of exogenous fever in children. Methods From July 2018 to April 2019， 230 children with exogenous fever who admitted to Binzhou People′s Hospital of Shandong Province were selected as objects. According to the random number table method， they were divided into control group （115 cases） and observation group （115 cases）. Control group was treated with Xiaoer Paracetamol Huangnamin Granules， while observation group was treated with Xiaoer Jiebiao Oral Liquid combined with Xiaoer Paracetamol Huangnamin Granules. Both groups were given continuous treatment for three days. The clinical efficacy was evaluated after treatment. The antipyretic onset time， antipyretic time and complete antipyretic time of two groups were compared. The TCM syndrome scores and serum tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， γ interferon （IFN-γ） and C-reactive protein （CRP） levels were compared between two groups before and after treatment. The incidence of adverse reactions during the treatment was recorded and compared between two groups. Results The total clinical effective rate of observation group was higher than that of control group （P < 0.01）. The antipyretic onset time， antipyretic time and complete antipyretic time of observation group were shorter than those of control group （all P < 0.01）. There was no statistically significant difference in TCM syndrome scores between two groups before treatment （P > 0.05）; TCM syndrome scores in two groups after treatment were lower than those before treatment， and observation group was lower than control group （all P < 0.01）. Before treatment， there was no significant difference in serum TNF-α， IL-1β， IFN-γ and CRP levels between two groups （P > 0.05）; after treatment， the levels of serum TNF-α， IL-1β， IFN-γ and CRP in two groups were lower than those before treatment， and observation group was lower than control group （all P < 0.05）. During the treatment period， no serious adverse reactions occurred in both groups. Conclusion Xiaoer Jiebiao Oral Liquid combined with Xiaoer Paracetamol Huangnamin Granules has definite clinical efficacy in treating exogenous fever in children. It can shorten the antipyretic time， improve clinical symptoms and reduce the level of serum inflammatory factors， and has good safety.

[Key words] Children; Exogenous fever; Xiaoer Jiebiao Oral Liquid; Xiaoer Paracetamol Huangnamin Granules; Efficacy

外感發(fā)熱是兒科一種常見的疾病，屬于急性上呼吸道感染范疇，由多種病毒和細(xì)菌感染所致，90%以上為流感病毒、呼吸道合胞病毒、鼻病毒等病毒感染，臨床常表現(xiàn)為發(fā)熱、流涕、鼻塞、咽部刺激感、噴嚏等癥狀，具有發(fā)病急、發(fā)熱迅速、病情轉(zhuǎn)變快等特點[1]。小兒外感發(fā)熱在我國有較高的發(fā)病率，平均每年發(fā)病6～7次，有15%左右的幼兒每年發(fā)病甚至超過12次，若得不到及時有效的治療會引發(fā)肺炎、中耳炎、喉炎、心肌炎等多種并發(fā)癥，甚至導(dǎo)致患兒抽搐、高熱昏迷，嚴(yán)重者危及生命[2]?！?br>