清热化痰法联合阿奇霉素治疗小儿肺炎支原体感染的支气管炎临床疗效研究

Clinical Effect Study on Bronchitis in Infantile Pneumonia Mycoplasma Infection Treated with the Therapy for Clearing Heat and Resolving Phlegm and Azithromycin

目的探讨以清热化痰为主的中药汤剂联合西药阿奇霉素治疗小儿肺炎支原体感染的支气管炎的有效性和安全性。方法选取2013年3月-2014年6月期间收治的98例小儿肺炎支原体感染的支气管炎患儿作为研究对象,根据随机数字表法分为治疗组(49例)和对照组(49例)。对照组49例患儿给予口服西药阿奇霉素常规治疗,而治疗组49例患儿在对照组治疗基础上加服清热化痰法中药汤剂联合治疗,1剂/d,400 ml水煎服,1次/d,7 d为一疗程,两组均持续治疗两周。分别于治疗前后记录两组患儿退热时间、止咳时间、X线阴影消失时间、肺部体征消失时间及炎症因子水平影响比较,并对两组总有效率进行对比分析。结果两组患儿治疗两周后,临床症状均有显著改善,其中对照组总有效率为83.67%,治疗组治疗后的总有效率为97.96%,两组比较,差异具有统计学意义(P<0.05)。治疗组患儿退热时间、止咳时间、X线阴影消失时间、肺部体征消失时间均明显优于对照组,两组比较,差异有统计学意义(P<0.05)。两组患儿炎症因子水平均得到明显改善,且治疗组与对照组比较,炎症因子水平下降更为明显,差异有统计学意义(P<0.05)。两组患者对两种药物具有较好耐受,未曾发现严重肝肾等不良反应。结论清热化痰法联合阿奇霉素治疗小儿肺炎支原体感染所引发的支气管炎临床效果显著,治疗后效果明显优于单纯使用阿奇霉素治疗,安全性高,且中西药合用起到内外协同,标本兼治的作用。

Objective To explore the effectiveness and safety in the treatment of bronchitis in infantile pneumonia mycoplasma infection treated with Chinese herbal decoction for clearing heat and resolving phlegm and azithromycin. Methods From March 2013 to June 2014,98 cases of bronchitis in infantile pneumonia mycoplasma infection were selected as the study participants. According to the random number table,a treatment group（49 cases） and a control group（49 cases） were divided. In the control group,the convention western medication was used with azithromycin. In the treatment group,on the basis of the treatment as the control group,Chinese herbal decoction for clearing heat and resolving phlegm was applied in combination,one dose a day,400 ml decoction,once a day,for 7 days as one session. The treatment of the two groups lasted 2 weeks. The impacts on the time of pyretolysis,the time of cough relieving,the disappearing time of X-ray audio,the disappearing time of physical signs and the levels of inflammatory factors were recorded and compared before and after treatment in the two groups. The total effective rates were compared in analysis between the two groups. Results In 2 weeks of treatment,the clinical symptoms were relieved significantly in the two groups. The total effective rate was 83. 67% in the control group and was 97. 96% in the treatment group,indicating the significant difference in comparison（P〈0. 05）. The results of the time of pyretolysis,the time of cough relieving,the disappearing time of X-ray audio and the disappearing time of physical signs in the treatment group were apparently superior to the control group,indicating the significant differences（P〈0. 05）. The levels of inflammatory factors were improved apparently in the two groups and the results in the treatment group was reduced more apparently as compared with the control group,indicating the significant difference（P〈0.05）.The patients presented the good tolerance to the two drugs and the severe liver and kidney adverse reactions were not discovered.Conclusion The combined medication of Chinese herbal decoction for clearing heat and resolving phlegm and azithromycin achieves the significant therapeutic effects on bronchitis in infantile pneumonia mycoplasma infection.The therapeutic effects are apparently superior to the simple application of azithromycin.The combined medication is high in safety and acts coordinately on the interior and the exterior,and on the primary and the secondary.