清热解毒方加减联合红霉素治疗儿童难治性支原体肺炎疗效观察

Observation on the therapeutic effect of Qingre Jiedu Fang combined with erythromycin on children refractory mycoplasma pneumonia

目的观察清热解毒方加减联合红霉素治疗儿童难治性支原体肺炎的疗效及对血沉(ESR)、血清C反应蛋白(CRP)和铁蛋白(SF)的影响。方法将2018年6月—2019年6月在沧州市中心医院治疗的116例难治性支原体肺炎患儿随机分为2组,对照组57例使用红霉素治疗,研究组59例在对照组治疗基础上加用清热解毒方加减治疗,2组疗程均为14 d。观察2组治疗前及治疗14 d后主要症状积分变化及治疗7 d、14 d、28 d后症状消失情况,检测2组治疗前及治疗7 d、14 d、28 d后ESR、CRP和SF水平,统计2组治疗14 d后临床疗效及治疗期间不良反应发生情况。结果治疗14 d后,2组咳嗽、发热、气喘、鼻塞、肺部啰音、食欲不振、恶心积分均明显低于治疗前(P均<0.05),且研究组均明显低于对照组(P均<0.05);随着治疗时间的延长,2组ESR、CRP、SF水平均呈降低趋势(P均<0.05),且研究组各时间点ESR、CRP、SF水平均明显低于对照组(P均<0.05)。研究组治疗7 d、14 d后高热消失率、咳嗽消失率、肺部炎症吸收率均明显高于对照组(P均<0.05)。2组治疗28 d后高热消失率、咳嗽消失率比较差异均无统计学意义(P均>0.05),研究组肺部炎症完全吸收率明显高于对照组(P<0.05)。研究组治疗14 d后治疗总有效率为93.2%(55/59),明显高于对照组的80.7%(46/57)(P<0.05),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论清热解毒方加减联合红霉素治疗儿童难治性支原体肺炎疗效优于单纯西医治疗,可加快患儿康复,且安全性高。

Objective It is to observe the curative effect of Qingre Jiedu Fang combined with erythromycin in the treatment of refractory mycoplasma pneumonia(RMPP)in children and its effect on erythrocyte sedimentation rate(ESR),serum C-reactive protein(CRP)and ferritin(SF).Methods A total of 116 children with refractory mycoplasma pneumonia treated in Cangzhou Central Hospital from June 2018 to June 2019 were randomly divided into 2 groups,57 cases in the control group were treated with erythromycin,and 59 cases in the study group were treated with Qingre Jiedu Fang on the basis of treatment in the control group,the treatment courses of both groups were14 days.The changes of main syndrome scores before and after 14 days of treatment and the symptoms disappeared after 7 days,14 days and 28 days of treatment were observed in the two groups,and the levels of ESR,CRP and SF of the two groups before and after 7 days,14 days and 28 days of treatment were detected,the clinical efficacy after 14 days of treatment was assessed and adverse reactions occurred during the treatment were counted in the two groups.Results After 14 days of treatment,the scores of cough,fever,wheezing,nasal congestion,lung rales,loss of appetite,and nausea of the two groups were significantly lower than those before treatment(P<0.05),and the study group was significantly lower than the control group(P<0.05);with the extension of treatment time,the levels of ESR,CRP,and SF in the two groups showed a decreasing trend(P<0.05),and the levels of ESR,CRP,and SF in the study group at each time point were significantly lower than those in the control group(P<0.05).After 7 days and 14 days of treatment in the study group,the disappearance rate of high fever,the disappearance rate of cough,and the absorption rate of lung inflammation were significantly higher than those of the control group(all P<0.05).There was no significant difference in the disappearance rate of high fever and cough after 28 days of treatment between the two groups(all P>0.05).The complete absorption rate of pulmonary inflammation in the study group was significantly higher than that in the control group(P<0.05).After 14 days of treatment,the total effective rate of the study group was 93.2%(55/59),which was significantly higher than that 80.7%(46/57)of the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The curative effect of combination of Qingre Jiedu Fang plus erythromycin which can speed up the recovery of children and has high safety is better than western medicine alone in the treatment of refractory mycoplasma pneumonia in children.