阿奇霉素联合小儿豉翘清热颗粒治疗支原体肺炎效果及降低炎症细胞因子水平作用机制研究

Effect of azithromycin combined with Xiaoer Chiqiao Qingre Granule on mycoplasma pneumonia and the mechanism of reducing the levels of inflammatory cytokines

目的研究阿奇霉素联合小儿豉翘清热颗粒治疗支原体肺炎效果及降低炎症细胞因子水平作用机制。方法收集2017年8月至2018年12月上海市宝山区罗店医院支原体肺炎患儿92例,将规定排秩号码为单号的患儿作为观察组、双号为对照组,各46例。对照组第1周使用阿奇霉素注射液,第2周、第3周口服阿奇霉素分散片,3周为1个疗程;观察组第1周使用阿奇霉素注射液,同时第1~3周予以小儿豉翘清热颗粒,3周为1个疗程。观察2组患儿治疗前后血清炎症细胞因子[如白细胞介素(IL)-6、IL-10、γ-干扰素(IFN-γ)]水平变化和临床表现消失时间、药物不良反应事件。结果观察组临床痊愈率63%高于对照组的41%,差异有统计学意义(P<0.05)。观察组体温消退、咳嗽憋喘、肺部音消失及胸部X线片示炎症吸收时间均少于对照组,差异有统计学意义(P<0.05)。治疗前后IL-6、IL-10水平在各组内比较均呈逐渐下降,IFN-γ呈逐渐升高,且差异有统计学意义(P<0.05);但治疗第2周,第3周结束时,观察组IL-6、IL-10水平均低于对照组,IFN-γ高于对照组,差异有统计学意义(P<0.05)。观察组用药1级安全性构成比89%高于对照组的72%,差异有统计学意义(P<0.05)。结论阿奇霉素联合小儿豉翘清热颗粒治疗支原体肺炎效果显著,能有效减轻炎症反应强度,避免机体过度损伤,且安全可靠。

Objective To study the effect of azithromycin combined with Xiaoer Chiqiao Qingre Granule on mycoplasma pneumonia and the mechanism of reducing inflammatory cytokine level. Methods Ninty-two children with mycoplasma pneumonia in Luodian Hospital of Shanghai Baoshan District from August 2017 to December 2018 were sellected. The children with rank number as single number were treated as observation group and double number as control group, 46 cases in each group. The control group was treated with azithromycin injection in the first week, and azithromycin dispersible tablets in the second and third weeks. The observation group was treated with azithromycin injection in the first week, and Xiaoer Chiqiao Qingre Granule was given in the first, second and third weeks. The changes of serum inflammatory cytokines (such as interleukin-6 (IL-6), interleukin-10 (IL-10),γ-interferon (IFN-γ) levels, the disappearance time of clinical manifestations and adverse drug reactions were observed before and after treatment. Results The clinical recovery rate of the observation group was 63%, higher than that of the control group (41%, P<0.05). The time of temperature subsidence, cough and asthma, lung rale disappearance and chest X-ray showing inflammation absorption in the observation group were less than those in the control group, and the dif-ference was statistically significant (P<0.05). The levels of T0, T1, T2, T3, IL-6, IL-10 in each group showed a gradual down-ward trend, and IFN-γ showed a gradual upward trend, and the difference was statistically significant (P<0.05);but at the time of T2 and T3, the levels of IL-6 and IL-10 in the observation group were lower than those in the con-trol group, and IFN-γ was higher than that in the control group, the difference was statistically significant (P<0.05).The constituent ratio of grade 1 medication in the observation group was 89% higher than 72% in the control group, and the difference was statistically significant (P<0.05). Conclusion Azithromycin combined with Xiaoer Chiqiao Qingre Granule is effective in treating mycoplasma pneumonia, which can effectively reduce the intensity of inflamma-tion, avoid excessive body damage, and it is safe and reliable.