硝黄散外敷联合加味五虎汤口服治疗痰热闭肺型肺炎支原体肺炎患儿对肺功能和血清TNF-α、IFN-γ、IL-4水平的影响

Effect of External Application of Xiaohuang Powder Combined with Oral Administration of Jiawei Wuhu Decoction on Lung Function and Serum TNF-α, IFN-γ, IL-4 in Children with Mycoplasma Pneumoniae Pneumonia of Phlegm Heat Blocking Lung Type

目的:观察硝黄散外敷联合加味五虎汤口服治疗痰热闭肺型肺炎支原体肺炎(MPP)患儿对肺功能和血清肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、白介素-4(IL-4)水平的影响。方法:研究对象为我院2019年6月~2021年1月期间收治的MPP患儿80例,采用随机数字表法将患儿分为对照组(n=40,阿奇霉素抗感染治疗)和研究组(n=40,对照组基础上加用硝黄散外敷联合加味五虎汤口服治疗),均治疗7 d。比较两组患儿临床疗效,比较两组治疗前、治疗7 d后的中医证候积分、临床症状改善情况、肺功能和血清TNF-α、IFN-γ、IL-4水平。结果:研究组治疗7 d后的临床总有效率为92.50%(37/40),高于对照组的72.50%(29/40),差异有统计学意义(P<0.05)。与对照组相比,研究组的症状(咳嗽憋喘、发热、肺部干湿啰音)消失时间均更短(P<0.05)。与对照组相比,研究组治疗7 d后用力肺活量(FVC)、最高呼气峰流速(PEF)、第1秒最大呼气容积(FEV1)、FEV1/FVC均更高(P<0.05),研究组治疗7 d后的中医证候积分及血清TNF-α、IFN-γ和IL-4水平均更低(P<0.05)。结论:痰热闭肺型MPP患儿采用硝黄散外敷联合加味五虎汤口服治疗,可有效缩短患儿症状消失时间,显著改善其肺功能、血清炎症因子水平,疗效显著。

Objective: To observe the effect of external application of Xiaohuang powder combined with oral administration of Jiawei Wuhu decoction on lung function and serum tumor necrosis factor-α(TNF-α), γ-Interferon(IFN-γ), interleukin-4(IL-4) in children with Mycoplasma pneumoniae pneumonia(MPP) of phlegm heat blocking lung type. Methods: The research objects were 80 children with MPP who were admitted to our hospital from June 2019 to January 2021, the children were randomly divided into control group(n=40, azithromycin anti infection treatment) and study group(n=40, on the basis of control group, combined with external application of Xiaohuang powder and oral administration of Jiawei Wuhu decoction) by using computer program to generate random number, all patients were treated for 7 days. The clinical effects of the two groups were compared. The traditional Chinese medical symptom score, clinical symptom relief, lung function and the levels of serum TNF-α, IFN-γ and IL-4 between the two groups were compared before treatment and 7 d after treatment. Results: The clinical total effective rate of the study group at 7 d after treatment was92.50%(37/40), which was higher than 72.50%(29/40) of the control group(P<0.05). Compared with the control group, the disappearance time of symptoms(cough wheezing, fever, lung dry and wet rales) of the study group were shorter(P<0.05). Compared with the control group, the forced vital capacity(FVC), peak expiratory flow(PEF), maximal expiratory volume in the first second(FEV1) and FEV1/FVC of the study group at 7 d after treatment were higher(P<0.05), the traditional Chinese medical syndrome score and the level of TNF-α,IFN-γ, IL-4 of the study group at 7 d after treatment were lower(P<0.05). Conclusion: The treatment of MPP children with external application of Xiaohuang powder combined with oral administration of Jiawei Wuhu decoction can effectively shorten the time of symptom improvement, and the improvement of lung function and serum cytokines level is more significant, and the effect is reliable.