小儿肺咳颗粒联合阿奇霉素对MPP患儿潮气呼吸肺功能、Th1/Th2免疫平衡及血清APC、IL-1R1水平的影响

Effects of Xiaoer Feike Granule Combined with Azithromycin on Tidal Breathing Pulmonary Function,Th1/Th2 Immune Balance and Serum APC,IL-1R1 Levels in Children with MPP

目的:探讨小儿肺咳颗粒联合阿奇霉素对肺炎支原体肺炎(MPP)患儿潮气呼吸肺功能、Th1/Th2免疫平衡及血清活化蛋白C(APC)、白介素1受体1型(IL-1R1)水平的影响。方法:选取2018年7月至2020年6月期间我院收治的MPP患儿160例。根据入院奇偶顺序法将患儿分为对照组和实验组,各80例。在常规治疗的基础上,对照组给予阿奇霉素治疗,实验组在对照组基础上联合小儿肺咳颗粒治疗,对比两组疗效、症状缓解时间、潮气呼吸肺功能、Th1/Th2免疫平衡、血清APC、IL-1R1水平及不良反应发生情况。结果:治疗10 d后,实验组的临床总有效率较对照组升高(P<0.05)。实验组的发热、咳嗽、肺部啰音、气促等症状缓解时间短于对照组(P<0.05)。治疗10 d后,两组潮气量(TV)、呼气时间(TE)升高,且实验组高于对照组(P<0.05),呼气峰值流速(PEF)降低,且实验组低于对照组(P<0.05)。治疗10 d后,两组干扰素γ(IFN-γ)、白介素-5(IL-5)降低,实验组较对照组低(P<0.05);两组IFN-γ/IL-5升高,实验组较对照组高(P<0.05)。治疗10 d后,两组血清IL-1R1水平降低,且实验组低于对照组(P<0.05);两组血清APC水平升高,且实验组高于对照组(P<0.05)。对照组、实验组的不良反应发生率分别为6.25%(5/80)、8.75%(7/80),不良反应发生率两组对比无统计学差异(P>0.05)。结论:MPP患儿采用小儿肺咳颗粒联合阿奇霉素治疗,可改善临床症状和潮气呼吸肺功能,其作用机制可能与调节Th1/Th2免疫平衡及血清APC、IL-1R1水平有关。

Objective:To investigate the effects of Xiaoer Feike granule combined with azithromycin on tidal breathing pulmonary function,Th1/Th2 immune balance,serum activated protein C(APC)and interleukin-1 receptor type 1(IL-1 R1)levels in children with Mycoplasma pneumoniae pneumonia(MPP).Methods:160 children with MPP who were admitted to our hospital from July 2018 to June 2020 were selected.According to the admission parity order method,the children were divided into control group and experimental group,80 cases in each group.On the basis of conventional treatment,the control group was treated with azithromycin,and the experimental group was treated with Xiaoer Feike granule on the basis of the control group.The curative effect,symptom relief time,tidal breathing pulmonary function,Th1/Th2 immune balance,serum APC,IL-1 R1 levels and occurrence of adverse reactions were compared between the two groups.Results:10 days after treatment,the total effective rate in the experimental group was higher than that in the control group(P<0.05).The remission time of fever,cough,lung rales and shortness of breath in the experimental group were shorter than those in the control group(P<0.05).10 days after treatment,the tidal volume(TV)and expiratory time(TE)in the two groups increased,and the experimental group was higher than the control group(P<0.05),and the peak expiratory flow rate(PEF)decreased,and the experimental group was lower than the control group(P<0.05).10 days after treatment,the interferon-γ(IFN-γ)and interleukin-5(IL-5)were decreased in both groups,and the experimental group was lower than the control group(P<0.05).The IFN-γ/IL-5 was increased in both groups,and the experimental group was higher than the control group(P<0.05).10 days after treatment,the serum IL-1 R1 levels was decreased in both groups,and the experimental group was lower than the control group(P<0.05).The serum APC level was increased in both groups,and the experimental group was higher than the control group(P<0.05).The incidence of adverse reactions in the control group and the experimental group were 6.25%(5/80)and 8.75%(7/80),there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The children with MPP use Xiaoer Feike granule combined with azithromycin treatment can improve the clinical symptoms and pulmonary function of tidal breathing.The mechanism may be related to the regulation of Th1/Th2 immune balance and the serum APC and IL-1 R1 levels.