痰热清注射液雾化吸入联合孟鲁司特钠治疗小儿肺炎的临床研究

Clinical study on nebulized inhalation of Tanreqing Injection combined with montelukast sodium in treatment of children with pneumonia

目的探讨痰热清注射液雾化吸入联合孟鲁司特钠治疗小儿肺炎的临床疗效。方法回顾性选取2020年11月—2021年11月淮南朝阳医院收治的72例小儿肺炎患者,根据治疗方案不同,分为对照组和试验组,每组36例。对照组采用常规西医对症治疗,如平喘止咳、祛痰等,抗病毒药物采用利巴韦林含片,按照患儿体质量每次剂量为0.01 g·kg^(−1),每天3次,同时口服孟鲁司特钠,每次5 mg,每天1次。试验组在对照组基础上加用痰热清注射液,每次取痰热清注射液2 mL加入0.9%氯化钠注射液2 mL雾化吸入,每天2次。两组患儿均治疗1周。比较两组患儿临床疗效、体温恢复时间、咳嗽消失时间和肺部啰音消失时间;检测两组患儿治疗前后淋巴细胞亚群(CD4+/CD8+)水平及血清白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平。观察两组患儿治疗过程中的不良反应发生情况。结果试验组治疗总有效率为97.22%,显著高于对照组的91.67%(P<0.05);试验组显效率为69.44%,也显著高于对照组的44.44%(P<0.01);试验组患儿体温恢复时间、咳嗽消失时间和肺部啰音消失时间均显著短于对照组(P<0.05、0.01)。治疗前,两组患儿淋巴细胞亚群CD4+/CD8+及炎症因子IL-6和TNF-α水平比较,差异无统计学意义(P>0.05);治疗后两组患儿IL-6和TNF-α水平均显著低于治疗前(P<0.01);淋巴细胞亚群CD4^(+)/CD8^(+)水平显著高于治疗前(P<0.01)。治疗后,试验组IL-6和TNF-α水平显著低于对照组(P<0.05、0.01),淋巴细胞亚群CD4^(+)/CD8^(+)水平显著高于对照组(P<0.01)。两组患儿治疗过程中发生的不良反应有呕吐、恶心和皮疹,两组不良反应总发生率相同,差异不显著。结论痰热清注射液雾化吸入联合孟鲁司特钠能有效治疗小儿肺炎,效果优于常规西医治疗,且不增加不良反应,值得临床推广。

Objective To investigate the clinical efficacy of nebulized inhalation of Tanreqing Injection combined with montelukast sodium in treatment of children with pneumonia.Methods A total of 72 children with pneumonia admitted to Huainan Chaoyang Hospital from November 2020 to November 2021 were retrospectively selected.According to different treatment schemes,they were divided into control group and experimental group,with 36 cases in each group.Children in the control group were treated with conventional symptomatic western medicine,such as asthma relieving,cough relieving,expectorant,etc.The antiviral drugs were treated with Ribavirin Buccal Tablets,with a dose of 0.01 g·kg^(−1)for each time,three times a day according to the body weight of the children,and at the same time,montelukast sodium were administrated orally,5 mg each time,once a day.Children in The experimental group were added with Tanreqing Injection on the basis of the control group.Tanreqing Injection of 2 mL was added with 2 mL of 0.9%Sodium Chloride Injection for nebulized inhalation two times once day.Both groups were treated for one week.The clinical efficacy,body temperature recovery time,cough disappearance time and lung rale disappearance time were compared between the two groups.The levels of lymphocyte subsets(CD4^(+)/CD8^(+)),serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)were measured before and after treatment.The adverse reactions of the two groups were observed.Results The total effective rate of the experimental group was 97.22%,which was significantly higher than that of the control group(91.67%,P<0.05).The effective rate of the experimental group was 69.44%,which was also significantly higher than that of the control group(44.44%,P<0.01).The recovery time of body temperature,the disappearance time of cough and the disappearance time of pulmonary rales in the experimental group were significantly shorter than those in the control group(P<0.05,0.01).Before treatment,there were no significant difference between the two groups on lymphocyte subsets CD4^(+)/CD8^(+)and inflammatory factors IL-6 and TNF-α(P>0.05).After treatment,the levels of IL-6 and TNF-αin the two groups were significantly lower than those before treatment of two groups(P<0.01),and CD4^(+)/CD8^(+)level of lymphocyte subsets were significantly higher than that before treatment of two groups(P<0.01).After treatment,the levels of IL-6 and TNF-αin the experimental group were significantly lower than those in the control group,and the level of CD4^(+)/CD8^(+)level of lymphocyte subsets was significantly higher than that in the control group(P<0.01).The adverse reactions of the two groups during treatment included vomiting,nausea and rash.The total incidence of adverse reactions in the two groups was the same,and the difference was not significant.Conclusion The nebulized inhalation of Tanreqing Injection combined with montelukast sodium can effectively treat pediatric pneumonia.The effect is better than that of conventional western medicine,and does not increase adverse reactions.It is worthy of clinical promotion.