三拗汤合二陈汤加味辅助治疗小儿肺炎支原体感染伴咳嗽43例临床观察

Clinical observation on 43 cases of children with mycoplasma pneumoniae infection concomitant cough treated by modified San’ao Tang(三拗汤)combined Erchen Tang(二陈汤)as adjuvant therapy

目的观察三拗汤合二陈汤加味辅助治疗小儿肺炎支原体感染伴咳嗽的临床疗效。方法选取2019年5月至2020年5月江门市新会区中医院儿科门诊就诊的肺炎支原体感染伴咳嗽患儿86例,采用随机数字表法分为对照组和治疗组,各43例。对照组给予阿奇霉素+酮替芬+孟鲁司特钠西医常规治疗,治疗组在对照组治疗方法的基础上加用三拗汤合二陈汤加味,2组均连续治疗3周并随访2个月后,统计2组的临床疗效,治疗前、后中医症状积分和不良反应。结果治疗组总有效率为93.02%(40/43),明显高于对照组的76.44%(33/43),2组比较,差异有统计学意义(P<0.05)。治疗组咳嗽症状缓解和消失时间分别为(5.02±2.39)d、(9.16±4.12)d,均短于对照组的(9.26±4.06)d、(13.28±4.17)d,2组比较,差异有统计学意义(P<0.05)。治疗前,2组咳嗽、咳痰、痰质、大便干结、小便黄等症状积分比较,差异均无统计学意义(P>0.05),具有可比性。治疗后,2组上述中医症状积分均降低(P<0.05),且治疗组降低更显著,差异有统计学意义(P<0.05)。治疗组的不良反应发生率为6.98%(3/43),显著低于对照组的37.21%(16/43),2组比较,差异有统计学意义(P<0.01)。结论三拗汤合二陈汤加味辅助治疗小儿肺炎支原体感染伴咳嗽疗效满意,可显著改善中医症状积分,缩短咳嗽缓解和消失时间,且不良反应少,值得临床推广应用。

Objective To observe the clinical efficacy of children with mycoplasma pneumoniae infection concomitant cough treated by modified San’ao Tang(三拗汤)combined Erchen Tang(二陈汤)as adjuvant therapy.Methods From May 2019 to May 2020,86 cases of children with mycoplasma pneumoniae infection concomitant cough consulted in outpatient service of pediatrics department in Jiangmen Municipal Xinhui District Hospital of TCM were chosen and divided into control group and treatment group according to random number table method,with 43 cases in each group.The control group was given routine Western medicine treatment with azithromycin,ketotifen and montelukast,on this basis,the treatment group was given modified San’ao Tang(三拗汤)combined Erchen Tang(二陈汤).Both groups were continuously treated for 3 weeks and followed up for 2 months.We kept statistics about the clinical efficacy,TCM symptom scores before and after treatment and adverse reactions between the 2 groups.Results The total effective rate of the treatment group was 93.02%(40/43),which was significantly higher than 76.44%(33/43)of the control group,and the difference was statistically significant between the 2 groups(P<0.05).The relieving and disappearance time of cough symptoms in the treatment group were(5.02±2.39)days and(9.16±4.12)days respectively,which were shorter than(9.26±4.06)days and(13.28±4.17)days in the control group,and the difference was statistically significant between the 2 groups(P<0.05).Before treatment,there was no statistical significant difference in the symptom scores of cough,expectoration,sputum quality,dry stool and yellow urine between the 2 groups(P>0.05),and they were comparable.After treatment,the above-mentioned TCM symptom scores in the 2 groups all reduced(P<0.05),and the treatment group reduced more significantly,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the treatment group was 6.98%(3/43),which was significantly lower than 37.21%(16/43)in the control group,and the difference was statistically significant(P<0.01)between the 2 groups.Conclusion It has satisfactory curative effects,can markedly improve TCM symptom scores,shorten the relieving and disappearance time of cough with lower incidence of adverse reactions to use modified San’ao Tang combined Erchen Tang in adjuvant treatment of children with mycoplasma pneumoniae infection concomitant cough,which deserves clinical promotion and application.