世界中医药

目的：比较柴葛解肌汤辅助西药和单纯西药治疗小儿上呼吸道感染高热的疗效。方法：选取2016年1月至2018年1月武汉市红十字会医院收治的上呼吸道感染高热患儿192例作为研究对象，随机分为对照组和观察组，每组96例。2组患者均采用物理降温，并给予布洛芬混悬液、利巴韦林颗粒口服治疗，观察组加用柴葛解肌汤治疗，均治疗5 d。观察2组患者治疗前、完成治疗后炎性反应指标白细胞介素-1β（IL-1β）、白细胞介素-10（IL-10）、降钙素原（PCT）、超敏C反应蛋白（CRP）、细胞间黏附因子（ICAM-1）、血管细胞黏附因子（VCAM-1）含量并进行比较；观察治疗前、完成治疗后2组患者的免疫应答标志物IgA、IgM、IgG、C3、C4的含量并进行比较；比较2组患者热退起效时间、热退消失时间、住院时间；对治疗过程中进行不良反应监测；完成治疗后进行疗效评定。结果：1)2组患者治疗前IL-1β、IL-10、PCT、CRP、ICAM-1、VCAM-1比较，差异无统计学意义（P>0.05），2组患者完成治疗后以上指标均较治疗前均显著下降（P<0.05），完成治疗后观察组患者以上指标显著低于对照组（P<0.05）。2）2组患者治疗前IgA、IgM、IgG、C3、C4比较，差异无统计学意义（P>0.05），2组患者完成治疗后以上指标均较治疗前均显著升高（P<0.05），完成治疗后观察组患者以上指标显著高于对照组（P<0.05）。3)观察组在热退起效时间、热退消失时间、住院时间上明显短于对照组，2组比较差异有统计学意义（P<0.05）4)观察组总有效率上显著高于对照组，2组比较差异有统计学意义（P<0.05）。5)2组患者恶心呕吐、腹泻、便秘、过敏等不良反应发生率比较，差异无统计学意义（P>0.05）。结论：柴葛解肌汤能抑制上呼吸道感染高热患儿炎性反应，提高免疫力，疗效显著。

English Summary:

To compare the effects of Chaige Jieji Decoction assisted with western medicine and western medicine alone on children with upper respiratory tract infection with high fever.Methods:A total of 192 children with high fever due to upper respiratory tract infection admitted to WuHan Red Cross Hospital from January 2016 to January 2018 were randomly divided into a control group(96 cases)and an observation group(96 cases)according to the order of visiting.The control group was treated with physical hypothermia，ibuprofen suspension and ribavirin granules，and the observation group was added Chaige Jieji Decoction for 5 days.Interleukin-1β(IL-1β)，interleukin-10(IL-10)，procalcitonin(PCT)，hypersensitive C-reactive protein(CRP)，intercellular adhesion factor-1(ICAM-1)and vascular cell adhesion factor-1(VCAM-1)were observed and compared before and after treatment.The immune response index IgA，IgM，IgG，C3，C4 content before and after the treatment were observed and compared; The fever onset time，fever disappearance time，hospitalization time changes of the 2 groups were compared; adverse reaction detection was conducted in the course of treatment; After completion of the treatment，the clinical effect was evaluated.Results:There was no significant difference in IL-1β，IL-10，PCT，CRP，ICAM-1 and VCAM-1 between the 2 groups before treatment(P > 0.05).After treatment，the above indexes in both groups were significantly decreased than those before treatment(P<0.05)，and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).2)There was no significant difference in IgA，IgM，IgG，C3，C4 between the 2 groups before treatment(P>0.05).After treatment，the above indexes in both groups were significantly increased than those before treatment(P<0.05).After treatment，the above indexes in the observation group were significantly higher than those in the control group(P<0.05).3)The onset time，disappearance time and hospitalization time of fever regression in the observation group were significantly shorter than those in the control group(P<0.05).4)The cure rate and total effective rate of the observation group were significantly higher than those of the control group，with significant differences(P<0.05).5)There was no significant difference in the incidence of nausea，vomiting，diarrhea，constipation and allergic reaction between the 2 groups(P > 0.05).Conclusion:Chaige Jieji Decoction can inhibit inflammation and improve immunity in children with high fever caused by upper respiratory tract infection，with significant efficacy.

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