莨菪碱注射液辅助阿奇霉素序贯治疗小儿支原体肺炎的疗效研究

Clinical efficacy and mechanism of scopolamine injection assisted with azithromycin sequential therapy on children with mycoplasma pneumonia

目的探讨莨菪碱注射液辅助阿奇霉素序贯治疗小儿支原体肺炎的临床疗效及对患儿肺功能、细胞免疫功能的影响。方法选取湖南省人民医院及拉萨市人民医院接诊的支原体肺炎患儿178例,随机分为联合组和阿奇霉素组,每组89例。阿奇霉素组给予阿奇霉素序贯治疗+基础治疗,联合组在阿奇霉素组基础上加用莨菪碱注射液肺腧穴注射。比较两组临床疗效、肺功能、细胞免疫功能的变化。结果治疗后,联合组临床疗效优于阿奇霉素组(P<0.05);联合组用力肺活量(FVC)、第1秒用力呼气量(FEV1)、最高呼气峰流速(PEF)均高于阿奇霉素组(P<0.05);联合组血清CD3+、CD4+水平高于阿奇霉素组,CD8+低于阿奇霉素组(P<0.05);联合组单核细胞趋化蛋白-4(MCP-4)、半胱氨酰白三烯(CysLTs)及细胞间黏附分子-1(ICAM-1)质量浓度均低于阿奇霉素组,Clara细胞分泌蛋白(CCSP)高于阿奇霉素组(P<0.05)。结论莨菪碱注射液辅助阿奇霉素序贯治疗小儿支原体肺炎疗效好,可改善肺功能和细胞免疫功能,促进患儿康复。

Objective To explore the clinical efficacy of scopolamine injection assisted with azithromycin sequential therapy for mycoplasma pneumonia (MPP) in children and its effects on pulmonary function and cellular immune function.Methods Totally 178 cases of MPP patients admitted to Hunan Provincial People’s Hospital and Lhasa People’s Hospital were randomly divided into the combined group (n=89) and the azithromycin group (n=89).The azithromycin group was given azithromycin sequential therapy and basic therapy,and the combined group was additionally given scopolamine injection via Feishu point.The clinical efficacy,pulmonary function and cellular immune function were compared between the two groups.Results After treatment,the clinical efficacy in the combined group was better than that in the azithromycin group (P < 0.05).The forced vital capacity (FVC),forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF) in the combined group were significantly higher than those in the azithromycin group (P < 0.05).The levels of serum CD3^+,CD4^+,and Clara cell secretory protein (CCSP) in the combined group were significantly higher than those in the azithromycin group (P < 0.05).The levels of serum CD8^+,monocyte chemoattractant protein-4 (MCP-4),cysteinyl leukotriene (CysLTs),and intercellular adhesion molecule-1 (ICAM-1) in the combined group were lower than those in the azithromycin group.Conclusions Scopolamine injection assisted with azithromycin sequential therapy for MMP children has significant efficacy,which can effectively improve pulmonary function and cellular immune function,and promote the rehabilitation of MMP children.