喜炎平注射液佐治儿童肺炎支原体肺炎的临床疗效评价及对血清炎症因子水平的影响

Clinical effect of Xiyanping injection in the treatment of Mycoplasma pneumoniae pneumonia in children and its influence on serum inflammatory factors

目的观察喜炎平注射液佐治儿童肺炎支原体肺炎(MPP)的临床疗效及对患儿血清中相关炎症因子水平的影响。方法随机选取2017年9月至2018年10月辽宁中医药大学附属医院儿科收治的53例MPP患儿为疾病组,将疾病组再随机分为对照组27例和观察组26例,随机选取同期15例健康体检儿童为正常组。对照组给予笔者医院常规中西医结合治疗方案,观察组在对照组基础上加用喜炎平注射液静点。对比观察组与对照组的病证总分变化、中医证候疗效及各组患儿治疗前后血清中γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-4、IL-17、IL-18炎症因子水平变化。结果治疗后,两组患儿的临床症状及中医证候疗效均明显好转,但两组比较差异无统计学意义(P>0.05)。两组患儿病证总积分均明显减少(P<0.05),观察组优于对照组,但差异无统计学意义(P>0.05)。治疗前,与正常组比较,疾病组患儿血清中各炎症因子均升高,且差异均有统计学意义(P<0.05);与治疗前比较,观察组和对照组患儿治疗后各炎症因子均降低,其中IFN-γ、TNF-α、IL-4、IL-17差异均有统计学意义(P<0.05)。与对照组治疗后比较,观察组治疗后TNF-α、IL-4、IL-17、IL-18炎症因子降幅更低,其中TNF-α、IL-4、IL-17差异有统计学意义(P<0.05)。而IFN-γ水平相对升高,但差异无统计学意义(P>0.05)。结论喜炎平注射液佐治儿童MPP安全有效,可通过调节MPP患儿血清中IFN-γ、TNF-α、IL-4、IL-17、IL-18炎症因子水平,抑制MPP炎症反应,从而提高临床治疗效果。

Objective To observe the clinical efficacy of Xiyanping injection in the treatment of Mycoplasma pneumoniae pneumonia(MPP)in children and its effect on the serum inflammatory factors.Methods A total of 53 children with MPP admitted between September 2017 and October 2018 to Department of Pediatrics,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine(TCM),were randomly selected as the disease group,and the disease group was randomly divided into the control group(27 cases)and the observation group(26 cases).Meanwhile,15 healthy children were randomly selected as the normal group.The control group was given the conventional integrated Chinese and western medicine treatment,and the observation group was added Xiyanping injection intravenous drip on the basis of the treatment for the control group.The change in the total score of disease and syndrome,the effect of TCM syndrome and the changes in IFN-γ,TNF-α,IL-4,IL-17 and IL-18 inflammatory factors in serum of each group before and after treatment were compared.Results After the treatment,the clinical symptoms and therapeutic effect of TCM in the two groups were significantly improved,but there was no significant difference between the two groups(P>0.05).The total scores of disease and syndrome in the two groups were decreased significantly(P<0.05),and the scores in the observation group were better than those in the control group,but there was no significant difference(P>0.05).Before treatment,compared with the normal group,the serum inflammatory factors in the disease group were all increased,and the difference was statistically significant(P<0.05).Compared with before treatment,all inflammatory factors in the ob⁃servation group and the control group were reduced after treatment,among which the differences in IFN-γ,TNF-α,IL-4 and IL-17 were statistically significant(P<0.05).Compared with the control group after treatment,the reduction in TNF-α,IL-4,IL-17 and IL-18 inflammatory factors was lower in the observation group after treatment,among which the difference in TNF-α,IL-4 and IL-17 was statistically significant(P<0.05).INF-γlevel was relatively increased,but the difference was not statistically significant(P>0.05).Conclusion Xiyanping injection is safe and effective in the treatment of children with MPP.It can regulate the levels of INF-γ,TNF-α,IL-4,IL-17 and IL-18 inflammatory factors in the serum of MPP children,and improve the clinical therapeutic effect by inhibiting the inflammatory response of MPP.