支原体感染相关儿童哮喘中西医诊疗进展

Progress in Diagnosis and Treatment of Asthma in Children with Mycoplasma Infection

MP感染是诱发或加重支气管哮喘发作的重要因素,二者密切相关,但是对于MP诱发哮喘的发病机制目前尚无明确结论。近年来研究表明,MP感染可以引起或加重炎症反应、免疫反应以及细胞因子的释放。MP感染诱发的哮喘有其独特的临床表现:剧烈咳嗽伴中重度喘息。西医治疗上,急性期选用大环内酯类抗生素合并β2受体激动剂、吸入性糖皮质激素治疗;缓解期联合应用匹多莫德、阿奇霉素治疗。中医认为其病因病机在于感受外邪,引动伏痰;痰热互结,壅阻于肺;湿热内生,病情迁延;痰瘀互结,哮喘反复。中医治疗方面,根据哮喘的不同时期,应从“风痰”“痰热”“湿热”“痰瘀”方面论治,且尤其重视清热利湿化痰方药的运用。

MP infection is an important factor in inducing or aggravating the onset of bronchial asthma.The two are closely related,but there is no clear conclusion on the pathogenesis of MP-induced asthma.Recent studies have shown that MP infection can cause or aggravate inflammatory response,immune response,and release of cytokines.Asthma induced by MP infection has its unique clinical manifestations,severe cough with moderate to severe wheezing.In the treatment of western medicine,macrolide antibiotics combined withβ2 receptor agonist and inhaled corticosteroids were used in the acute phase and pidotimod and azithromycin were combined in the remission phase.Chinese medicine believes that its etiology and pathogenesis lies in feeling the evil spirits,stimulating Fuxi,heat and mutual knot,phlegm obstruction in the lungs,damp heat endogenous,disease progression,phlegm and blood stasis,asthma repeated.In the treatment of traditional Chinese medicine,according to different periods of asthma,it should be treated from the aspects of“wind sputum”,“hot”,“damp heat”and“sputum”,and pay special attention to the application of clearing away heat and dampness and removing phlegm.