辛开苦降方联合阿奇霉素治疗儿童肺炎支原体肺炎(痰热闭肺证)临床研究

Clinical Observation of Xinkai Kujiang Decoction Combined with Azithromycin on Mycoplasma Pneumoniae Pneumonia of Phlegm-heat Obstructing Lung Type

目的观察辛开苦降方联合阿奇霉素治疗儿童肺炎支原体肺炎(MPP)(痰热闭肺证)的临床疗效及其对肺功能的影响。方法60例患儿按照随机数字表法分为观察组和对照组各30例。两组均予常规治疗,对照组在常规治疗基础上予阿奇霉素干混悬剂口服,观察组在对照组基础上加服辛开苦降方,两组均治疗14 d。比较两组疾病疗效愈显率、中医证候疗效愈显率、中医证候单项证候消失率、完全退热时间和治疗前后肺功能的变化。结果观察组疾病疗效愈显率为86.67%,高于对照组的73.33%(P<0.05);观察组中医证候疗效愈显率为80.00%,亦高于对照组的53.33%(P<0.05);观察组中医证候咳嗽、咯痰和纳呆消失率高于对照组(P<0.05),其他证候消失率差别均不大(均P>0.05)。两组完全退热时间差别不大(P>0.05)。两组治疗后,肺功能各项指标与治疗前比较均升高(均P<0.05)。观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最大呼气流量(PEF)与预计值比值百分比均高于对照组(均P<0.05),而用力呼出50%肺活量最大呼气流量(FEF50)、用力呼出75%肺活量最大呼气流量(FEF75)和最大呼气中期流量(MMEF)与预计值均差别不大(均P>0.05)。结论辛开苦降方联合阿奇霉素治疗儿童肺炎支原体肺炎(痰热闭肺证)能改善症状和肺功能指标,可提高临床疗效。

Objective:To observe the clinical effect of Xinkai Kujiang Decoction combined with Azithromycin on Mycoplasma pneumoniae(MPP)in children with phlegm-heat obstructing the lung type and its effect on pulmonary function and explore its mechanism.Methods:60 children were randomly divided into the observation group and the control group,30 cases in each.Both groups were given general treatment.The control group was given Azithromycin dry suspension on that basis,and the observation group was given Xinkai Kujiang Decoction on the basis of the control group.Both groups were treated for 14 days.The curative effect rate,TCM syndrome response rate,TCM syndrome single syndrome disappearance rate,the complete antipyretic time and the changes of lung function before and after treatment were compared between the two groups.Results:The effective rate of the observation group was 86.67%,higher than that of control group(73.33%)(P<0.05).The effective rate of TCM syndrome in the observation group was 80.00%,also higher than 53.33%in the control group(P<0.05).The disappearance rate of cough,expectoration and natto in the observation group was higher than that in the control group(P<0.05),and there was no significant difference in the disappearance rate of other syndromes(P>0.05).After treatment,the indices of pulmonary function in the two groups were higher than those before treatment(P<0.05).The percentage of FVC,FEV1 and PEF to estimated value in the observation group was higher than that in the control group(P<0.05).That of FEF50,FEF75 and MMEF showed no significant difference(P>0.05).Conclusion:Xinkai Kujiang Decoction combined with Azithromycin can improve symptoms and lung function of MPP children with phlegm-heat obstructing the lung type,which can improve clinical efficacy.