益气涤痰通腑汤联合乌司他丁治疗儿童重症支原体肺炎伴心肌损伤

Effect of Yiqi Ditan Tongfu Decoction Combined with Ulinastatin in the Treatment of Children with Severe Mycoplasma Pneumonia Complicated with Myocardial Injury

目的:研究益气涤痰通腑汤联合乌司他丁对重症支原体肺炎伴心肌损伤患儿的治疗效果。方法:选取2019年8月至2020年12月邢台市第三医院收治的重症支原体肺炎伴心肌损伤患儿82例作为研究对象,采用随机数字表法分为对照组和观察组,每组41例。对照组在常规治疗的基础上给予乌司他丁注射液治疗,观察组在对照组治疗基础上加用益气涤痰通腑汤治疗。比较2组总有效率、治疗前后免疫功能、炎症介质水平变化,对心功能、心肌损害程度治疗效果进行评估,并进行不良反应评价。结果:观察组治疗总有效率为92.68%,高于对照组的78.05%,差异有统计学意义(P<0.05)。2组患儿外周静脉血血清CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前明显升高,且观察组高于对照组,差异有统计学意义(P<0.05);CD8^(+)水平较治疗前降低,且观察组结果低于对照组,差异有统计学意义(P<0.05);2组患儿的血清炎症介质较治疗前均降低,观察组的降低程度优于对照组,差异均有统计学意义(均P<0.05);2组患儿心电图QT离散程度、心肌损伤标志物较治疗前均降低,降低程度观察组优于对照组,差异均有统计学意义(均P<0.05)。结论:益气涤痰通腑汤联合乌司他丁治疗方案可有效改善重症支原体肺炎患儿的临床症状,调整细胞免疫功能,改善炎症反应,并能够有效保护心肌细胞,改善心肌损伤,安全性较好。

Objective:To study the therapeutic effect of Yiqi Ditan Tongfu Decoction(YQDTTF)combined with ulinastatin on children with severe mycoplasma pneumonia(MP)complicated with myocardial injury.Methods:Eighty-two severe MP children complicated with myocardial injury admitted to Xingtai Third Hospital from August 2019 to December 2020 were selected and divided into a control group(n=41)and an observation group(n=41)by a random number table.All patients were treated with ulinastatin injection combined with conventional treatment,and those in the observation group received additional YQDTTF.The total effective rate,the changes in immune function and inflammatory factors before and after treatment were compared between the two groups.The therapeutic effect on cardiac function and myocardial injury was evaluated,and the adverse reactions were evaluated.Results:The total effective rate of the observation group was 92.68%,higher than 78.05%of the control group(P<0.05).The serum levels of CD4^(+)and CD4^(+)/CD8^(+)in peripheral venous blood in the two groups were higher than those before treatment,and the observation group was higher than the control group(P<0.05).The post-treatment levels of CD8^(+)decreased in the two groups compared with those before treatment,and the observation group was lower than the control group(P<0.05).The serum inflammatory factors in the two groups decreased compared with those before treatment,and the observation group was superior to the control group in terms of reduction degree(P<0.05).QT dispersion in the electrocardiogram and myocardial injury markers in the two groups decreased compared with those before treatment,and the observation group was superior to the control group in terms of reduction degree(all P<0.05).Conclusion:YQDTTF combined with ulinastatin can effectively improve the clinical symptoms of children with severe MP,adjust cellular immune function,improve inflammatory response,and effectively protect myocardial cells to improve myocardial injury,with good safety.