加味生脉汤辅助治疗儿童肺炎支原体性心肌损伤30例临床观察

Clinical observation on the effect of Modified Shengmai Decoction(加味生脉汤) in adjunctive treating of 30 cases of children with myocardial injury caused by mycoplasma pneumoniae

目的观察加味生脉汤辅助治疗儿童肺炎支原体性心肌损伤的临床疗效。方法将60例肺炎支原体感染致心肌损伤患儿随机分为对照组和治疗组,各30例。对照组给予阿奇霉素、磷酸肌酸钠等对症治疗,治疗组在对照组治疗方法的基础上予加味生脉汤辅助治疗,2组均治疗7 d后统计疗效。结果对照组总有效率为96.7%,治疗组为100.0%,2组总有效率经统计学分析,差异有统计学意义(P<0.05)。2组治疗前主、次症积分比较,差异均无统计学意义(P>0.05),具有可比性。治疗后2组主症(胸闷憋气、心悸、胸痛、乏力、头晕)及次症(精神、食欲食量、恶心呕吐)积分均较同组治疗前显著下降(P<0.05或P<0.01),治疗组在改善主症胸闷憋气、乏力及次症食欲食量方面优于对照组(P<0.05或P<0.01)。2组治疗前肌酸磷酸激酶(CK)、肌酸激酶同工酶(CK-MB)、谷草转氨酶(AST)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH)水平比较,差异均无统计学意义(P>0.05),具有可比性;治疗后2组上述指标均较同组治疗前显著下降(P<0.05或P<0.01),且治疗组下降幅度大于对照组(P<0.05或P<0.01)。结论加味生脉汤辅助治疗儿童肺炎支原体性心肌损伤,可明显改善患儿症状、体征,降低血清心肌酶谱水平,临床疗效显著,值得临床推广应用。

Objective To observe the effect of Modified Shengmai Decoction in adjunctive treating of 30 cases of children with myocardial injury caused by mycoplasma pneumoniae.Methods 60 cases of myocardial injury caused by mycoplasma pneumoniae infection were randomly divided into control group and therapy group,30 cases in each group.The control group was given symptomatic treatment such as azithromycin and creatine phosphate sodium,the therapy group was supplemented with Modified Shengmai Decoction on the basis of the treatment method in the control group.After 7 days of treatment in both groups,statistical results were obtained.Results The total effective rate was 96.7%in the control group and 100.0%in the therapy group,the total effective rate in the 2 groups was statistically analyzed,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of main and secondary diseases symptom before treatment in the 2 groups(P>0.05),which has comparability.After treatment,the scores of the main symptoms(chest tight and suffocated,palpitation,chest pain,fatigue,dizziness)and secondary symptoms(spirit,appetite and food intake,nausea and vomiting)were significantly lower than those before treatment in the 2 groups(P<0.05 or P<0.01).The therapy group was superior to the control group in improving the main symptoms of chest tight and suffocated,fatigue and secondary symptoms of appetite,food intake(P<0.05 or P<0.01).The levels of creatine phosphokinase(CK),creatine kinase isoenzyme(CK-MB),glutamic pyruvate aminotransferase(AST),lactate dehydrogenase(LDH)andα-hydroxybutyrate dehydrogenase(α-HBDH)before treatment in the 2 groups were not statistically significant(P>0.05),which has comparability.After treatment,the above indexes in the 2 groups were significantly lower than those in the same group before treatment(P<0.05 or P<0.01),and the decrease in the therapy group was better than that in the control group before treatment(P<0.05 or P<0.01).Conclusion Modified Shengmai Decoction in adjunctive treating of children with myocardial injury caused by mycoplasma pneumoniae obviously improve the symptoms and signs of children,reduce the level of serum myocardial enzymes,and have significant clinical efficacy,which is worthy of clinical promotion and application.