青贝苇茎汤联合耳穴压豆治疗儿童难治性支原体肺炎

Clinical Study of Qingbei Weijing Decoction combined with Auricular Point Pressing Bean in Treatment of Refractory Mycoplasma Pneumonia in Children

目的:观察青贝苇茎汤口服联合耳穴压豆外用治疗儿童难治性支原体肺炎的临床疗效。方法:选择难治性支原体肺炎患儿95例,按照随机数字表法分为对照组48例,治疗组47例。对照组予西药常规治疗,治疗组在对照组治疗基础上给予青贝苇茎汤口服(每日2次,连服7 d),同时配合耳穴压豆(每日1次,连用7 d),7 d为1个疗程,共两个疗程。观察治疗前后两组患儿的中医证候积分、肺部湿啰音评分、肺功能指标、血清炎性指标、临床疗效及不良反应。结果:两组患儿治疗后主症、次症各单项症状积分及主症、次症总积分均低于治疗前,而治疗组以上评分显著低于同期对照组(P<0.05);与对照组比较,治疗组治疗后发热、咳嗽、咳痰、喘息、纳差、口渴、便秘单项症状积分及主症、次症总积分均显著低于对照组(P<0.05),但在改善精神差方面,两组差异无统计学意义(P=0.05)。两组患儿治疗后C-反应蛋白(C-reactive protein,CRP)、细胞沉降率(erythrocyte sedimentation rate,ESR)水平及肺部湿啰音评分均明显降低,且治疗组优于对照组(P<0.05)。与治疗前比较,治疗组肺功能用力肺活量(forced vital capcacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)、呼气峰值流量(peak expiratory flow,PEF)、最大呼气中期流速(maximal mid-expiratory flow,MMEF)、25%用力肺活量时的用力呼气流量(forced expiratory flow of 25%,FEF25%)、50%用力肺活量时的用力呼气流量(forced expiratory flow of 50%,FEF50%)及75%用力肺活量时的用力呼气流量(forced expiratory flow of 75%,FEF75%)显著升高,且高于同期对照组,差异均有统计学意义(P<0.05);对照组治疗后FVC、FEV1、MMEF、FEF25%、FEF50%及FEF75%显著高于治疗前,差异均有统计学意义(P<0.05)。治疗组有效率为97.9%,对照组为93.8%,两组比较,差异有统计学意义(P<0.05)。结论:青贝苇茎汤联合耳穴压豆治疗儿童难治性支原体肺炎临床疗效显著,可有效减轻患儿发热、咳嗽、咳痰、精神差、肺部湿啰音等临床症状及肺部体征,改善血清CRP、ESR水平,提高肺功能。

Objective:To evaluate the therapeutic effect of oral administration of Qingbei Weijing Decoction combined with external application of auricular bean pressing on refractory Mycoplasma pneumonia in children.Methods:A total of 95 children with refractory mycoplasma pneumonia were selected and randomly divided into the control group with 48 cases and the treatment group with 47 cases.The control group was given conventional western medicine treatment,while the treatment group was given Qingbei Weijing Decoction orally(twice a day for 7 days) on the basis of the treatment of the control group,and combined with auricular bean pressing(once a day for 7 days).7 days is one course of treatment,with a total of 2 courses of treatment.The TCM syndrome scores,lung rales scores,pulmonary function indexes,serum inflammatory indexes,clinical efficacy,and adverse reactions of the two groups of children before and after treatment were observed.Results:After treatment,the individual symptom scores of primary and secondary symptoms and the total score of primary and secondary symptoms in the two groups were lower than those before treatment,while the treatment group was significantly lower than the control group at the same period(P<0.05).Compared with the control group,the individual symptom scores of fever,cough,expectoration,wheezing,anorexia,thirst,constipation and the total score of primary and secondary symptoms in the treatment group were significantly lower than those in the control group(P<0.05),but in terms of improvement of mental health,the difference between the two groups was not statistically significant(P=0.05).After treatment,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR) indexes,and lung rales scores in the two groups were significantly decreased,and the treatment group was better than the control group(P<0.05).Compared with before treatment,the pulmonary function in the treatment group including forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow(PEF),maximal mid-expiratory flow(MMEF),forced expiratory flow of 25%(FEF25%),forced expiratory flow of 50%,(FEF50%) and forced expiratory flow of 75%(FEF75%) were significantly increased,and higher than the control group at the same period,the differences were statistically significant(P<0.05).The FVC,FEV1,MMEF,FEF25%,FEF50% and FEF75% of the control group after treatment were significantly higher than those before treatment,and the differences were statistically significant(P<0.05).The effective rate was 97.9% in the treatment group and 93.8% in the control group,and the difference was statistically significant(P<0.05).Conclusion:Qingbei Weijing Decoction combined with auricular bean pressing has a significant clinical effect in the treatment of children with refractory mycoplasma pneumonia.It can effectively relieve the clinical symptoms and pulmonary signs of children with fever,cough,expectoration,poor spirit,pulmonary rales,etc.,improve serum CRP and ESR indicators,and improve lung function.