Effects Of Huaiqihuang Granule On Lymphocyte Subsets In Children With Infectious Mononucleosis

Objective: To observe the clinical feature and immune function of children with infectious mononucleosis(IM),and to explore the possible role of Chinese medicine Huaiqihuang granules.Methods: A total of 77 children diagnosed with IM who were admitted to the Department of Pediatric Hematology and Oncology of Qingdao University Affiliated Hospital from January 2016 to February 2018 were selected as the IM group.The healthy children with normal physical examination in our hospital during the same period were selected as the normal control group.The IM patient were treated.Clinical and laboratory data were collected and analyzed,including gender,age,symptoms,signs,peripheral blood,lymphocytes subsetes,liver function,lymphocyte subsets,EBV-DNA quantitative and outcome.EBV-DNA of the blood was reviewed after treatment of the IM group patient.The patient with EBV-DNA positive were involved in the research group,and were divided into huai qi huang granules treatment group and control group,according to the wishes of parents and adherence of oral or not oral huai qi huang particles.The two groups of lymphocyte subsets,EBV-DNA and side effects were observed after 3 weeks of treatment following by data analysis.Results:(1)A total of 85 cases of children diagnosed with IM were identified,of which 77 cases were valid,41 were male,36 were female,male: female = 1.14,age ranged from 1 to 12,with an average age of 4.31±2.56 years.The number of digits is 4.2 years old.(2)The first clinical manifestations were fever(96.20%),cough(48.31%),rash(12%);signs were: angina splenicitis(95.76%),lymphadenopathy(83.90 %),bilateral eyelid edema(20%),hepatomegaly(39.83%),splenomegaly(36.44%);(3)The cell count and lymphocyte count of children with IM were significantly higher than normal..The increased number of atypical lymphocytes was 87.Twenty-seven percent of the patients with atypical lymphocyte were 68.19%;The 75 cases of ebv-dna positive were 97.40%.The number of patients who were diagnosed with CRP during admission was 39 cases,accounting for 50.45%;There were 51 cases of serum ferritin and 5 patients with high concentration,accounting for 10.13% The increase of serum alanine aminotransferase(ALT)was 29.87%,which was mostly mild and moderate..(4)The T lymphocytes of 77 patients with IM were significantly different than those of normal controls.,The expression of CD3+ T,CD8+ T,CD3+ hla-dr activation T,CD3-CD19+ hla-dr + activation B was significantly increased.,CD4+ T,CD4+/CD8+ T ratio,CD19+B,CD3-CD56+/CD16+NK cells were significantly reduced.,Statistically significant difference(P<0.05).(5)The symptoms of children with IM disappeared but EBV-DNA was not transferred.The lymphocyte cells in the treatment group and the control group were gradually restored.,Treatment or observation after 3 weeks(4 to 6 weeks after onset).,CD3+ T,CD8+ T,CD3+ hla-dr activation T,CD3-CD19+ hla-dr + activation B were lower than before.,CD4+ T,CD4+/CD8+ T ratio,CD19+B,CD3-CD56+/CD16+NK were higher than before.,The P values of CD3,CD8,CD4,CD4/CD8 and activated T cells in lymphocyte subgroups were all <0.01 after 3 weeks of treatment,and the difference was statistically significant..The P value of CD4+CD25+(regulating T cells)was <0.05,and the difference in the apparatus was statistically significant..(6)After 3 weeks of treatment with the treatment group,the ebv-dna transfer was 17/32(53.12%)and 9/22(40.91%)in the control group,but there was no statistically significant difference in the treatment group(P>0).05).(7)Thirty-two children with IM were treated with HuaiQihuang granules for 3 weeks except occasional mild diarrhea and no other adverse reactions.Conclusion:(1)There are obvious abnormalities in lymphocyte subsets in children with infectious mononucleosis,which are lymphocyte activation,mainly for the CD8 + T significantly increased and activated,and CD4 + T lymphocyte percentage decrease.Although CD19 + B cells decreased,the CD19 + HLA-DR + activated B cell ratio increased significantly: Both T cell and B cells are involved in the immune response of EBV infection while T cell immunity is the main part.(2)Huaiqihuang granules can promote the recovery of immune function in children with IM,so that CD4+T increases,CD8+T cells decrease,and the increase of CD4+/CD8+ T ratio may be beneficial to the elimination of EBV(3)The safety of Huaiqihuang granules treament is high.