中西医结合治疗小儿支原体肺炎(风热闭肺证)的临床研究

Clinical Observation on the Combination of Traditional Chinese and Western Medicine on Mycoplasma Pneumonia in Children with Wind-heat and Closed Lung Syndrome

目的基于中西医结合的方法治疗小儿支原体肺炎(风热闭肺证),对中西医结合治疗组与西药组(对照组)在改善支原体肺炎患儿症状、体征方面进行评价。方法将肺炎支原体风热闭肺证患儿68例,采用随机数字表法分为治疗组和对照组各34例。对照组予阿奇霉素,同时给予退热止咳等对症处理;治疗组在对照组基础上加用麻杏清肺平喘口服液,7 d为1个疗程。观察临床疗效,检测理化指标。结果治疗组治疗总有效率为90.32%,高于对照组的84.85%(P <0.05);治疗组治疗后发热、口渴、呕吐、腹痛和便干症状改善优于对照组(P <0.05)。两组支原体抗体转阴率、胸片(炎症吸收)转阴率相近(P> 0.05)。与治疗前比较,治疗组治疗后谷草转氨酶(GOT)升高,差异有统计学意义(P <0.01);中性粒细胞计数(NE)和淋巴细胞计数(LY)升高,差异有统计学意义(P <0.05);对照组治疗后LY升高,差异有统计学意义(P <0.05)。结论中西医结合治疗小儿支原体肺炎(风热闭肺证)疗效优于西药治疗,尤其在改善发热、口渴、呕吐、腹痛症状和大便性质方面优于西药治疗,中西医结合治疗可以加强退热效果并降低大环内酯类药物的胃肠道不良反应。

Objective:To objectively evaluate the improvement of symptoms and signs of children with mycoplasma pneumonia,and to explore the curative effect,based on the combination of traditional Chinese and Western medicine on wind-heat and closed lung syndrome in children. Methods:68 children were randomly divided into the treatment group and the control group,34 cases in each. The control group was treated with azithromycin,antipyretic and cough treatment. The treatment group was given extra oral liquid of Maxing Qingfei Pingchuan Decoction. 7 days was a course of treatment. The clinical effect and the physical and chemical indexes were observed and detected. Results:The total effective rate of the treatment group(90.32%)was higher than that of the control group(84.85%)and the improvement of fever,thirst,vomiting,abdominal pain and dry stool was better than that of the control group;the difference was statistically significant(P < 0.05). There was no significant difference in the negative rate of mycoplasma antibody and chest film(inflammatory absorption)(P > 0.05). Compared with before treatment,GOT(P < 0.01),NE and LY(P < 0.05)in the treatment group increased,and LY in the control group increased(P < 0.05);the difference was statistically significant. Conclusion:The combination of traditional Chinese medicine and Western medicine is better than Western medicine on mycoplasma pneumoniae with wind-heat and closed lung syndrome,especially in improving fever,thirst,vomiting,abdominal pain symptoms and stool properties. The combination of traditional Chinese and Western medicine can enhance the antipyretic effect and reduce the adverse reactions of macrolides in gastrointestinal tract,worthy of clinical promotion.