阿奇霉素序贯疗法联合加味麻杏石甘汤治疗对于小儿支原体肺炎的意义

Significance of azithromycin sequential therapy combined with modified Maxingshigan decoction in the treatment of mycoplasma pneumonia in children

目的:探讨阿奇霉素序贯疗法联合加味麻杏石甘汤治疗小儿支原体肺炎的疗效。方法:纳入2021年2月—2022年2月江西省萍乡市上栗县妇幼保健院收治的小儿支原体肺炎病例60例,采取随机数字表法进行分组,两组各30例。对照组接受阿奇霉素序贯疗法治疗,先10 mg/kg+5%葡萄糖注射液100 mL静脉滴注,1次/d,连续治疗4 d后停药3 d;之后口服阿奇霉素干混悬剂10 mg/kg,1次/d,连续治疗4 d后停药3 d。共治疗14 d。观察组在此基础上加用加味麻杏石甘汤治疗。比较两组疗效、肺炎症状消失时间、血清炎症因子和肺功能指标。结果:观察组的治疗总有效率为96.67%,高于对照组的80.00%(P<0.05)。观察组肺炎症状消失时间较对照组快(P<0.05)。治疗后,观察组血清肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)水平均低于对照组(P<0.05);肺功能指标第一秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、呼气峰流速(PEF)水平则均高于对照组(均P<0.05)。结论:阿奇霉素序贯疗法联合加味麻杏石甘汤治疗小儿支原体肺炎,可以改善患儿肺炎症状,提高肺功能,值得临床推荐。

Objective:To explore the effect of azithromycin sequential therapy combined with modified Maxingshigan decoction in the treatment of mycoplasma pneumonia in children.Methods:Sixty cases of mycoplasma pneumonia in children admitted to Maternal and Child Health Care Hospital in Shangli County,Pingxiang,Jiangxi Province from February 2021 to February 2022 were brought into studied,and with randomized number table method divided into two groups with 30 patients each.The control group was treated with azithromycin sequential therapy,first,10 mg/kg+5%glucose injection 100 mL intravenous drip,once a day,after continuous treatment for 4 days,and the drug was stopped for 3 days;after that,oral azithromycin dry suspension 10 mg/kg,once a day,after continuous treatment for 4 days,the drug was stopped for 3 days,and total treatment was 14 days.The observation group was treated with modified Maxingshigan decoction on this basis.The therapeutic effect,time of disappearance of pneumonia symptoms,the serum inflammatory factor and lung function index were compared.Results:The total effective rate in the observation group was 96.67%,which was higher than that in the control group 80.00%(P<0.05).The time of disappearance of pneumonia symptoms in the observation group were faster than that in the control group(P<0.05).After treatment,the levels of serum tumor necrosis factor(TNF-α),C-reactive protein(CRP)and procalcitonin(PCT)in the observation group were lower than those in the control group(all P<0.05);the pulmonary function index of forced expiratory volume at the first second(FEV_(1)),forced vital capacity(FVC)and peak expiratory flow rate(PEF)in the observation group after treatment were higher than those in the control group(P<0.05). Conclusion: Azithromycin sequential therapy combined with modified Maxingshigan decoction in the treatment of mycoplasma pneumonia in children can improve the pneumonia symptoms and pulmonary function, which is worth recommending clinically.