Methods From January 2017 to October 2019, a total of 286 children with the second stage of HFMD in the Second Nanning People′s Hospital were selected as research subjects, and they were included into observation group. According to random digits table method, cases in observation group were randomly divided into 4 subgroups which were reduning subgroup (n=73, treated with reduning), glycyrrhizin subgroup (n=72, treated with glycyrrhizin), combined treatment subgroup (n=75, treated with reduning and glycyrrhizin) and routine treatment subgroup (n=66, with routine treatment). Healthy children who had physical examination in the same hospital at the same time were selected as control group (n=63). Flow cytometry was used to detect the percentage of T cells, helper T cell (Th), cytotoxic T lymphocyte (Tc), natural killer (NK) cell and B cells in peripheral blood lymphocytes of all subjects; the levels of serum immunoglobulin (Ig)G, IgM and IgA were detected by immunoturbidimetry method. Independent-samples t test was used to compare the above indexes between observation group and control group; one-way ANOVA and least significant difference (LSD)-t test were used to compare the above indexes among 4 subgroups and further comparison between any 2 subgroups. Pearson correlation analysis was used to analyze the correlation between serum IgM level and the percentage of B cells in peripheral blood lymphocytes of HFMD children. The procedure followed in this study was consistent with World Medical Association Declaration of Helsinki revised in 2013.
Results ① The percentages of T cells, Th and NK cell in peripheral blood lymphocytes, ratio of Th percentage to Tc percentage (Th/Tc), and levels of serum IgG and IgA in observation group of children with the second stage of HFMD were significantly lower than those in control group; while the percentage of B cells in peripheral blood lymphocytes and serum IgM level in observation group were significantly higher than those in control group, and the differences were statistically significant (P<0.05). ② The percentages of T cells and Th in peripheral blood lymphocytes, and serum IgG levels in reduning subgroup, glycyrrhizin subgroup and combined treatment subgroup of children were (55.9±9.4)%, (33.7±7.7)%, (10.9±2.4) g/L; (57.2±8.9)%, (35.3±7.3)%, (11.2±2.9) g/L; (58.8±9.9)%, (36.5±7.3)%, (11.8± 2.9) g/L, respectively, which were significantly higher than those of (51.3±11.9)%, (29.8±6.8)%, (9.3±2.8) g/L respectively in routine treatment subgroup; while the percentages of B cells in peripheral blood lymphocytes, and serum IgM and IgA levels in those three subgroups were (22.8±5.2)%, (1.7±0.5) g/L, (0.79±0.26) g/L; (21.9±4.9)%, (1.7±0.4) g/L, (0.81±0.17) g/L; (20.9±5.6)%, (1.6±0.5) g/L, (0.84±0.23) g/L, respectively, which were significantly lower than those of (24.5±5.3)%, (1.8±0.4) g/L, (0.89±0.20) g/L, respectively in routine treatment subgroup; and all differences above were statistically significant (P=0.012, P=0.002, P<0.001; P=0.001, P<0.001, P<0.001; P<0.001, P<0.001, P<0.001; P=0.022, P=0.047, P=0.013; P=0.014, P=0.043, P=0.013; P=0.003, P=0.014, P=0.046). ③ The percentages of Th in peripheral blood lymphocytes, Th/Tc (2.0±0.4), and serum IgG and IgA levels in combined treatment subgroup of children were higher than those in reduning subgroup[Th/Tc was (1.8±0.4)], while the percentage of B cells in peripheral blood lymphocytes was lower than that in reduning subgroup, and all differences above were statistically significant (P=0.026, 0.003, 0.042, 0.047; P=0.025). ④ There were no significant differences between combined treatment subgroup and glycyrrhizin subgroup of children in above mentioned 9 indexes (P>0.05). ⑤ Correlation analysis showed that there was a positive correlation between serum IgM level and percentage of B cells in peripheral blood lymphocytes in children with the second stage of HFMD (r=0.841, P=0.018).