麻杏石甘汤加味联合风热咳喘贴治疗小儿支原体肺炎的疗效及对C反应蛋白、白细胞介素8、血小板计数的影响

The clinical efficacy of modified Maxing Shigan Decoction combined with Fengre Kechuan Paste for children with mycoplasma pneumonia and the regulatory effect on the expression levels of CRP,IL-8,PLT

目的观察麻杏石甘汤加味联合风热咳喘贴治疗小儿支原体肺炎的临床疗效及对C反应蛋白(CRP)、白细胞介素8(IL-8)、血小板计数(PLT)的影响。方法将88例支原体肺炎患儿按照随机数字表法分为2组,对照组44例予注射用阿奇霉素治疗,治疗组44例在对照组治疗基础上予麻杏石甘汤加味联合风热咳喘贴治疗。2组均治疗9 d。比较2组临床疗效;比较2组临床症状改善情况;比较2组治疗前后中医证候评分变化;比较2组治疗前后血清CRP、IL-8、PLT水平变化。结果治疗组总有效率93.18%(41/44),对照组总有效率72.73%(32/44),治疗组疗效优于对照组(P<0.05)。治疗组肺部X线改善时间、肺部湿啰音改善时间均较对照组缩短(P<0.05)。治疗组治疗后中医证候主症咳嗽、痰多、痰黄、痰白干黏、胸痛评分,次症发热、口渴、面红、腹胀、尿黄、大便秘结评分,以及总评分均较本组治疗前降低(P<0.05),对照组治疗后中医证候主症咳嗽、痰多、痰黄、痰白干黏、胸痛评分,次症腹胀、尿黄、大便秘结评分,以及总评分均较本组治疗前降低(P<0.05),且治疗组治疗后中医证候主症痰多、痰黄、痰白干黏、胸痛评分,次症发热、口渴、面红、腹胀、尿黄评分,以及总评分均低于对照组治疗后(P<0.05)。2组治疗后血清CRP、IL-8、PLT水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。结论麻杏石甘汤加味联合风热咳喘贴治疗小儿支原体肺炎,可有效降低血清CRP、PLT、IL-8水平,提高肺功能,促进机体恢复。

Objective To explore the clinical efficacy of modified Maxing Shigan Decoction combined with Fengre Kechuan Paste for children with mycoplasma pneumonia(MP)and the regulatory effect on the expression levels of C-reactive protein(CRP),interleukin-8(IL-8),platelet count(PLT).Methods Totally 88 children with MP were randomly assigned into treatment group(n=44)and control group(n=44).All patients were managed by injection of azithromycin,and those in treatment group were additionally treated with modified Maxing Shigan Decoction combined with Fengre Kechuan Paste.Treated for 9 days,the aim was to compare improvement of clinical symptoms,traditional Chinese medicine(TCM)syndrome score,the expression levels of serum CRP,IL-8,PLT;in addition,the curative effect was assessed.Results The overall effective rate was 93.18%(41/44)in treatment group,higher than that of 72.73%(32/44)in control group(P<0.05).The improvement time of clinical symptoms(X-ray scan result and lung wet rales)in treatment group was shorter than that in control group(P<0.05).After treatment,the main score of TCM syndromes(cough,excessive phlegm,yellow sputum,white and sticky sputum,chest pain),the secondary scores(fever,thirst,flushed face,abdominal distension,yellow urine,constipation),as well as the total score in the treatment group were all decreased(P<0.05);the main score of TCM syndromes,the secondary scores(abdominal distension,yellow urine,constipation),as well as total score were decreased in the control group(P<0.05);the main score of TCM syndromes(except for cough),the secondary scores(except for constipation),and the total score were decreased in the treatment group than those in the control group(P<0.05).The serum level of CRP,IL-8,PLT in groups were decreased(P<0.05),improvement of which in treatment group were significantly better(P<0.05).Conclusion Maxing Shigan Decoction Combined with Fengre Kechuan Paste for MP children can effectively reduce the serum levels of CRP,PLT and IL-8,with lung function improvement,body recovery,and significant therapeutic effect.