清金化痰饮联合中药外用治疗小儿支原体肺炎临床观察

Clinical Observation of Qingjin Huatan Decoction(清金化痰饮)Combined with Traditional Chinese Medicine in Treatment of Mycoplasma Pneumonia in Children

目的观察口服中药汤剂清金化痰饮联合中药外用治疗小儿支原体肺炎的临床疗效。方法选取近5年内在附属医院儿科住院的70例支原体肺炎患儿,将其随机分为观察组和对照组,每组35例。对照组采用静脉滴注红霉素和盐酸氨溴索,以及常规对症治疗。观察组在对照组治疗基础上,口服自拟中药汤剂清金化痰饮并配合中药敷胸散外敷,两组均治疗10 d,疗程结束后观察临床疗效。结果两组临床总有效率比较,观察组总有效率为97.1%(34/35),对照组总有效率为74.3%(26/35),两组相比,观察组总有效率显著高于对照组,差异有统计学意义(P<0.05)。两组治疗后发热、咳嗽、喘息、肺部罗音消失时间比较,观察组显著短于对照组(P<0.05)。两组治疗前后中医证候及体征积分变化比较,治疗前相比差异无统计学意义(P>0.05),治疗后观察组显著低于对照组(P<0.05)。两组治疗前后肺功能最大呼气流量(peak expiratory flow,PEF)、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV1)比较,治疗前相比差异无统计学意义(P>0.05),治疗后观察组改善情况显著优于对照组(P<0.05)。两组治疗前后血清炎性因子白细胞介素-6(interleukin-6,IL-6)、反应蛋白(C-reactive protein,CRP)、血清淀粉样蛋白A(serumamyloid A,SAA)水平比较,治疗前相比差异无统计学意义(P>0.05),治疗后观察组显著低于对照组(P<0.05)。两组均未发生严重不良反应。结论口服中药清金化痰饮联合中药敷胸散外用治疗小儿支原体肺炎可以明显提高临床疗效,能有效改善临床症状和肺功能,降低血清炎性因子水平,并且安全性好,不良反应小,能促进患儿较快康复,值得临床推广应用。

Objective To observe the clinical effect of oral traditional Chinese medicine decoction Qingjin Huatan Decoction(清金化痰饮)combined with external use of traditional Chinese medicine in the treatment of mycoplasma pneumonia in chil⁃dren.Methods Seventy children with mycoplasma pneumonia hospitalized in pediatrics of Affiliated Hospital in recent 5 years were randomly divided into observation group and control group,with 35 cases in each group.The control group was treated with intravenous drip of erythromycin and ambroxol hydrochloride,as well as routine symptomatic treatment.On the basis of the treat⁃ment of the control group,the observation group took Qingjin Huatan Decoction orally and combined with external application of Fuxiong Powder(敷胸散).Both groups were treated for 10 days.The clinical effect was observed after the course of treatment.Results The total effective rate was 97.1%(34/35)in the observation group and 74.3%(26/35)in the control group.The total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The disappearance time of fever,cough,wheezing and pulmonary rales in the observation group was significantly shorter than that in the control group(P<0.05).There was no significant difference between the two groups before and after treatment(P>0.05),and that of the observa⁃tion group was significantly lower than that of the control group after treatment(P<0.05).Before and after treatment,there was no significant difference in the maximum expiratory flow(PEF),forced vital capacity(FVC)or forced expiratory volume in the first second(FEV1)between the two groups before and after treatment(P>0.05).After treatment,the improvement of the obser⁃vation group was significantly better than that of the control group(P<0.05).There was no significant difference in the levels of serum inflammatory factors interleukin-6(IL-6),C-reactive protein(CRP)and serum amyloid A(SAA)between the two groups before and after treatment(P>0.05).After treatment,the levels of serum inflammatory factors in the observation group were significantly lower than those in the control group(P<0.05).No serious adverse reactions occurred in both groups.Con⁃clusion Oral Qingjin Huatan Decoction combined with Fuxiong Powder can significantly improve the clinical efficacy,effectively improve the clinical symptoms and lung function,reduce the levels of serum inflammatory factors,have good safety and few side effects,and can promote the rapid recovery of children,which is worthy of clinical application.