小儿豉翘清热颗粒联合小剂量激素治疗难治性肺炎支原体肺炎临床研究

Clinical Study on Treating Refractory Mycoplasma Pneumoniae Pneumonia with Xiaoerchiqiaokeli and Small Dose Hormone in Children

目的:探讨小儿豉翘清热颗粒联合小剂量激素治疗难治性肺炎支原体肺炎的临床疗效。方法:将120例患儿随机分为对照组和观察组各60例。分别给予正常剂量激素,小儿豉翘清热颗粒联合小剂量激素,疗程均为15d。观察治疗前后患儿的肺功能指标、血清促炎因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)]和抗炎因子[白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)]的含量。比较两组不良反应。结果 :研究期间脱落7例。观察组总有效率94.8%,高于对照组的81.8%(P<0.05)。观察组TPTEF、VPTEF、PFV、TNF-α、IL-6、IL-17较对照组明显升高(P<0.05),TIL-2、IL-4、IL-10较对照组明显降低(P<0.05)。观察组患儿不良反应发生率为10.3%,低于对照组的41.4%(P<0.05)。结论:小儿豉翘清热颗粒联合小剂量激素可有效改善难治性肺炎支原体肺炎患儿的肺功能指标、血清炎性因子含量,且可能具有降低正常剂量激素的不良反应。

Objective:To investigate the clinical efficacy of Xiaoerchiqiaokeli and small dose hormone in the treatment of refractory mycoplasma pneumoniae pneumonia.Methods:120 cases were randomly divided into control group and observation group,60 cases each.Normal doses of hormones were given respectively,and xiaoerchiqiaokeli combined with small doses of hormones.The course of treatment was 15 d.Lung function indexes,serum proinflammatory factors[(TNF-a),interleukin-6(IL-6),interleukin-17(IL-17))]and anti-inflammatory factors[(interleukin-2(IL-2),interleukin-4(IL-4)and interleukin-10(IL-10)]were observed before and after treatment.Adverse reactions were compared between the two groups.Results:7 cases were shed during the study.The total effective rate was 94.8%in the observation group was higher than that 81.8%in the control group(P<0.05).TPTEF,VPTEF and PFV in the observation group were significantly higher than those in the control group(P<0.05).TNF-a,IL-6 and IL-17 in the observation group were significantly higher than those in the control group(P<0.05),while IL-2,IL-4 and IL-10 were significantly lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 10.3%,lower than that in the control group 41.4%(P<0.05).Conclusion:Xiaoerchiqiaokeli and small dose hormone can effectively improve the pulmonary function index,serum inflammatory factor with refractory mycoplasma pneumoniae pneumonia in children,and may have adverse effects of reducing normal dose hormone.