甲基泼尼松龙联合易坦静治疗小儿难治性肺炎的疗效

Clinical efficacy of methylprednisolone combined with Yi Tan Jing in the treatment of refractory pneumonia in children

目的研究甲基泼尼松龙联合易坦静治疗小儿难治性支原体肺炎的疗效。方法收集我院2017年2月至2018年1月收治的90例难治性支原体肺炎患儿,将其随机分为对照组和观察组,每组45例。对照组接受常规对症治疗及阿奇霉素治疗,在此基础上,观察组患儿给予静滴甲基泼尼松龙联合口服易坦静治疗。比较两组患儿的退热时间、镇咳时间、肺部啰音消失时间、住院时间、不良反应发生率,以及治疗前后的血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、D-二聚体、外周血白细胞计数和淋巴细胞计数水平。结果观察组的治疗总有效率高于对照组(P <0. 05),退热时间、镇咳时间、肺部啰音消失时间及住院时间较对照组缩短(P <0. 01);观察组的血清CRP、TNF-α、D-二聚体水平,以及外周血白细胞计数和淋巴细胞计数水平均低于对照组(P<0. 01);两组患儿的不良反应发生率比较差异无统计学意义(P> 0. 05)。结论甲基泼尼松龙联合易坦静治疗小儿难治性支原体肺炎的效果良好且能减轻患儿典型的细菌感染征象,改善顽固性剧烈咳嗽。

Objective To investigate the efficacy of methylprednisolone combined with Yi Tan Jing in the treatment of children with refractory mycoplasma pneumonia.Methods Totally90children with mycoplasma pneumonia in our hospital from February2017to January2018were randomly divided into control group and observation group,45cases in each group.Control group received routine symptomatic treatment and azithromycin,and observation group was given intravenous infusion of methylprednisolone combined with Yi Tan Jing oral solution in addition to the treatment for control group.The antipyretic and antitussive time,the disappearance time of lung rales,the time of hospitalization,the incidence of adverse reactions,the serum levels of C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)and the levels of D-dimer and peripheral white blood cell counts and lymphocyte counts were compared before and after treatment.Results The total effective rate of observation group was higher than that of control group(P<0.05).The antipyretic and antitussive time,disappearance time of lung rales and hospital stay in observation group were less than those in control group(P<0.01).After treatment,the serum levels of CRP,TNF-αand D-dimer,and the levels of peripheral white blood cell counts and lymphocyte counts in observation group were lower than those in control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion Methylprednisolone combined with Yi Tan Jing is effective in treating children with refractory mycoplasma pneumonia.It can effectively reduce the inflammatory reaction in children and improve the intractable severe cough.