玉屏风颗粒联合阿奇霉素治疗小儿难治性支原体肺炎的效果及机制研究

Effect and mechanism of Yupingfeng granules combined with azithromycin in the treatment of refractory mycoplasma pneumonia in children

目的探讨玉屏风颗粒联合阿奇霉素治疗小儿难治性支原体肺炎的临床效果及机制。方法选取我院2015年5月~2017年5月收治的小儿难治性支原体肺炎患儿100例,随机数字表法分为观察组和对照组,每组50例。对照组在常规治疗的基础上口服阿奇霉素,观察组在常规治疗的基础上联用玉屏风颗粒与阿奇霉素。观察两组患儿的临床治疗效果,并采用酶联免疫吸附(ELISA)法检测治疗前后两组患儿血清中肿瘤坏死因子-α(TNF-α)、白细胞介素4(IL-4)、白细胞介素6(IL-6)、白细胞介素10(IL-10)水平;采用微量免疫比浊法检测治疗前后两组患儿血清中的IgA、IgG、IgM的水平。结果两组均未发生严重的不良反应;两组临床症状比较,观察组患儿在咳嗽、喘息、高热、肺部啰音、肺部阴影的消失时间上明显少于对照组(P<0.05)。治疗前两组患儿炎症因子TNF-α、IL-4、IL-6和IL-10水平比较无显著差异(P>0.05),治疗后观察组TNF-α、IL-4、IL-6和IL-10明显下降且低于对照组,差异有统计学意义(P<0.05)。治疗前两组患儿体液免疫指标IgA、IgG、IgM水平比较无显著差异(P>0.05),治疗后观察组IgA、IgG、IgM明显下降且低于对照组,差异有统计学意义(P<0.05)。结论玉屏风颗粒联合阿奇霉素治疗小儿难治性支原体肺炎效果显著,其机制可能与降低炎性反应以及改善患儿免疫功能有关。

Objective To investigate the clinical efficacy and mechanism of Yupingfeng granules combined with azithromycin in the treatment of children with refractory mycoplasma pneumonia.Methods A total of 100 children with refractory mycoplasma pneumonia treated in our hospital from May 2015 to May 2017 were selected.Participants were divided into observation group and control group using random table with 50 cases in each group.The control group was given oral azithromycin on the basis of conventional treatment,and observation group was treated with Yupingfeng particles combined with azithromycin on the basis of conventional treatment.The clinical efficacy of the two groups was observed.Serum levels of tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),IL-6,IL-10 were measured by enzyme-linked immunosorbent assay(ELISA)before and after treatment.Serum levels of IgA,IgG and IgM in the two groups were measured by micronephelometric method before and after treatment.Results There was no serious adverse reaction in both groups.The duration for coughing,wheezing,high fever,lung rales,and pulmonary shadow in the observation group was shorter than the control group(P<0.05).The levels of inflammatory cytokines such as TNF-α,IL-4,IL-6 and IL-10 in the two groups before treatment were not significantly different(P>0.05).The levels of TNF-α,IL-4,IL-6 and IL-10 decreased significantly after treatment and was significant lower than the control group(P<0.05).There was no significant difference in IgA,IgG and IgM between the two groups before treatment(P>0.05).IgA,IgG,and IgM in the observation group decreased significantly after treatment and were significant lower than those in the control group(P<0.05).Conclusion Yupingfeng granules combined with azithromycin are effective in the treatment of refractory pneumonia in children.The mechanism may be related to the reduction of inflammatory reaction and improvement of immune function in children.