痰热清、氨溴索联合阿奇霉素治疗小儿支原体肺炎的机制研究

Mechanism of Tanreqing and ambroxol combined with Azithromycin for the treatment of mycoplasma pneumonia in children

目的:探究痰热清、氨溴索联合阿奇霉素治疗小儿支原体肺炎的机制,为支原体肺炎患儿的临床治疗提供帮助。方法:选取我院收治的86例支原体肺炎患儿,按随机数字表法分为观察组(43例)和对照组(43例),对照组给予基本治疗,观察组在此基础上给予痰热清、氨溴索和阿奇霉素的联合治疗,检测并探讨治疗前后两组支原体肺炎患儿肺功能指标潮气量(V-T)/kg、达峰时间比(t-PTEF/t-E)、呼出75%潮气量时的瞬间流速与潮气呼气峰流速比(TEF25/PTEF)以及吸气中期流速与呼气中期流速比(MTIF/MTEF),细胞因子白介素(IL)-2、IL-10、IL-6以及肿瘤坏死因子-α(TNF-α)及心肌酶谱指标乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、谷草转氨酶(AST)变化及机制。结果:治疗前两组支原体肺炎患儿肺功能、细胞因子及心肌酶谱比较差异无统计学差异(P>0.05)。与治疗前相比,两组支原体肺炎患儿经过相关治疗后MTIF/MTEF、心肌酶谱(LDH、CK-MB、CK及AST)和细胞因子(IL-10、IL-6以及TNF-α)显著降低,肺功能相关指标(V-T/kg、t-PTEF/t-E和TEF25/PTEF)和IL-2显著升高,差异存在统计学意义(P<0.05)。观察组经过联合治疗后患儿肺功能相关指标(VT/kg、t-PTEF/t-E和TEF25/PTEF)和IL-2显著高于治疗后对照组,MTIF/MTEF、心肌酶谱(LDH、CK-MB、CK及AST)和细胞因子(IL-10、IL-6以及TNF-α)显著低于治疗后对照组;组间差异存在统计学意义(P<0.05)。结论:痰热清、氨溴索和阿奇霉素联合治疗显著改善了支原体肺炎患儿的肺功能、细胞因子及心肌酶谱水平,对支原体肺炎患儿的治疗具有十分重要的临床意义。

Objective：To observe the mechanism of Tanreqing and ambroxol combined with Azithromy for the treatment of mycoplasma pneumonia in children and offer help to mycoplasma pneumonia treatment.Methods：A total of 86 cases of mycoplasma pneumonia patients in our hospital were selected and randomly divided into observation group and control group,each group were 43 cases,control group was treated with conventional therapy,observation group was treated with Tanreqing and ambroxol combined with Azithromy based on conventional therapy,the changes of lung function（V-T/Kg,t-PTEF/t-E,TEF25/PTEF and MTIF/MTEF）,cytokines（IL-2,IL-10,IL-6 and TNF-α）and the myocardial enzymes（LDH,CK-MB,CK and AST）were detected before and after treatment.Results：The comparison of lung function,cytokines and themyocardial enzymes in the two groups before treatment was not statistically significant（P〉0.05）.MTIF/MTEF,themyocardial enzymes（LDH,CK-MB,CK and AST）and cytokines（IL-10,IL-6 and TNF-α）in both groups after treatment significantly decreased compared with that before treatment;lung function（V-T/Kg,t-PTEF/t-E,TEF25/PTEF）,and IL-2 in both groups after treatment significantly increased compared with that before treatment.The changes were statistically significant（P〈0.05）.lung function（V-T/Kg,t-PTEF/t-E,TEF25/PTEF）,and IL-2 in observation group after treatment increased more significantly than that in control group,and MTIF/MTEF,themyocardial enzymes（LDH,CK-MB,CK and AST）and cytokines（IL-10,IL-6 and TNF-α）decreased more significantly than that in control group（P〈0.05）.Conclusion：Tanreqing and ambroxol combined with Azithromy could improve lung function,cytokines and the myocardial enzymes in children with mycoplasma pneumonia,which has a very important clinical significance of the treatment to mycoplasma pneumonia.