小儿消积止咳口服液联合阿奇霉素治疗支原体肺炎患儿疗效及对T淋巴细胞亚群水平的影响

Curative Effect of Xiaoji Zhike Oral Solution Combined with Azithromycin in Treatment of Mycoplasmal Pneumonia Children and Effect on the T-lymphocyte Subset Level

目的探讨小儿消积止咳口服液联合阿奇霉素治疗支原体肺炎(mycoplasma pneumonia MP)患儿疗效及对T淋巴细胞亚群水平的影响。方法选取2015年11月—2017年5月该院儿科收治的确诊支原体肺炎症60例,随机分为对照组(n=30例),观察组(n=30例),两组患儿均给予常规住院治疗(止咳、退热、雾化治疗等),对照组给予阿奇霉素静脉滴注治疗,观察组加用小儿消积止咳口服液,观察两组临床疗效和免疫球蛋白(IgA、IgM)、血清C反应蛋白(CRP)及T淋巴细胞亚群(CD3+、CD4+、CD8+、CD4/CD8)水平,统计不良反应。结果观察组临床有效率(93.33%)高于对照组(73.33%);差异有统计学意义(χ~2=4.32,P<0.05))。与对照组比较,观察组治疗后IgM、IgA、CRP水平[(1.19±0.36)、(0.86±0.36)、(5.4±2.00)g/L]显著低于对照组[(1.86±0.57)、(1.24±0.64)、(14.3±2.40)g/L],差异有统计学意义(P<0.05);观察组治疗后CD3+、CD4+、CD4/CD8水平[(86.24±10.95)%、(41.11±8.65)%、(1.71±0.62)]高于对照组[(65.21±9.32)%、(32.55±5.26)%、(1.01±0.58)],差异有统计学意义(t=8.01,4.63,4.52,P<0.05);观察组治疗后CD8+(23.04±4.32)%低于对照组(26.52±5.68)%,差异有统计学意义(t=2.671,P<0.05)。结论小儿消积止咳口服液联合阿奇霉素治疗小儿支原体肺炎,可明显改善患儿发热、咳嗽、厌食等症,使CD4+淋巴细胞增多,CD8+淋巴细胞减少,二者趋向正常水平,CD4/CD8比值处于正常范围。

Objective To study the curative effect of xiaoji zhike oral solution combined with azithromycin in treatment of mycoplasmal pneumonia children and effect on the T-lymphocyte subset level. Methods 60 cases of patients with mycoplasma pneumonia admitted and treated in our hospital from November 2015 to May 2017 were selected and randomly divided into two groups with 30 cases in each, both groups used the routine hospitalization therapy（antitussive,antipyretic, atomization therapy）, while the control group used the intravenous therapy of azithromycin, while the observation group increased the xiaoji zhike oral solution, and the clinical curative effect and IgA, IgM, CRP and CD3 ＋,CD4＋, CD8＋, CD4/CD8 levels of the two groups were observed, and the adverse reactions were counted. Results The clinical effective rate in the observation group was higher than that in the control group,（93.33% vs 73.33%）, and the difference was statistically significant（χ2=4.32, P 〈0.05）, after treatment, the IgM, IgA, CRP levels in the observation group were obviously lower than those in the control group [（1.19 ±0.36）、（0.86 ±0.36）、（5.4 ±2.00）g/L vs（1.86 ±0.57）、（1.24 ±0.64）、（14.3 ±2.40）g/L], and the differences were statistically significant（P 〈0.05）, after treatment, the CD3 ＋,CD4＋, CD4/CD8 levels in the observation group were higher than those in the control group [（86.24±10.95）%、（41.11±8.65）%、（1.71±0.62） vs（65.21±9.32）%、（32.55±5.26）%、（1.01±0.58）], and the differences were statistically significant,（t=8.01, 4.63,4.52,P 〈0.05）, after treatment, the CD8 ＋ in the observation group was lower than that in the control group,[（23.04±4.32）% vs（26.52±5.68）%], and the difference was statistically significant（t =2.671,P 〈0.05）. Conclusion The xiaoji zhike oral solution combined with azithromycin in treatment of mycoplasmal pneumonia children can obviously improve the symptoms of fever, cough and anorexia, make the CD4＋ lymphocyte increase and CD8＋ lymphocyte decrease, and the two tend to the normal level, and the ratio of CD4/CD8 is in the normal range.