肺力咳合剂联合阿奇霉素治疗小儿肺炎支原体气管炎的疗效

Curative effect of Feilike Mixture combined with azithromycin in children with mycoplasma pneumoniae tracheitis

目的探讨肺力咳合剂联合阿奇霉素治疗小儿肺炎支原体气管炎(mycoplasma pneumoniae bronchitis,MPB)的效果及对肺功能和辅助T细胞1型/辅助T细胞2型(T helper cell type 1/T helper cell type 2,Th1/Th2)平衡的影响。方法选取确诊的75例MPB患儿,采用随机数字表法分为观察组(38例)和对照组(37例)。对照组口服阿奇霉素治疗,观察组在对照组治疗的基础上口服肺力咳合剂,2组患儿的疗程均为7 d。治疗结束后比较2组患儿的治疗有效率、症状消失时间、总症状积分、肺功能、Th1/Th2平衡、血清C反应蛋白(C-reactive protein,CRP)、血沉(erythrocyte sedimentation rate,ESR)和不良反应发生率。结果观察组的治疗有效率高于对照组(P<0.05);观察组治疗后的症状消失时间即平均退热时间及平均咳嗽消失时间短于对照组(P<0.05);观察组治疗后的咳嗽、喘息和发热积分低于对照组(P<0.05);观察组治疗后的潮气量(tidal volume,V-T)、达峰时间比(ratio of time to peak tidal expiratory flow to time of expiratory,t-PTEF/t-E)、用力呼气25%流速(maximal expiratory flow at 25%,MEF25)和最大呼气中段流速(maximum mid-expiratory flow rate,MEF25-75)高于对照组(P<0.05);观察组治疗后的干扰素-γ(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)和白细胞介素-6(interleukin-6,IL-6)低于对照组,白细胞介素-2(interleukin-2,IL-2)高于对照组(P<0.05);观察组治疗后的CRP和ESR低于对照组(P<0.05);观察组治疗后的不良反应发生率低于对照组,2组比较差异无统计学意义。结论肺力咳合剂联合阿奇霉素治疗MPB可有效改善患者的肺功能和Th1/Th2平衡情况。

Objective To explore the curative effect of Feilike Mixture combined with azithromycin in children with mycoplasma pneumoniae tracheitis(MPB)and the influences on lung function and T helper cell type 1/T helper cell type 2(Th1/Th2)balance.Methods A total of 75 children confirmed with MPB were enrolled and divided into observation group(38 cases)and control group(37 cases)by random number table method.The control group was given oral azithromycin.The observation group was given oral Feilike Mixture on the basis of control group.The both groups were treated for 7 days.After treatment,the response rate of treatment,symptoms disappearance time,changes in total scores of symptoms,lung function,Th1/Th2 balance,the levels of serum C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR),and the incidence of adverse reactions were compared between the 2 groups.Results After treatment,the response rate of treatment in observation group was higher than that in control group(P<0.05).After treatment,the disappearance time of symptoms(average fever clearance time,average disappearance time of cough)in observation group was shorter than that in control group(P<0.05),the scores of cough,wheezing and fever were lower than those in control group(P<0.05),the tidal volume(V-T),ratio of time to peak tidal expiratory flow to time of expiratory(t-PTEF/t-E),forced expiratory flow after 25%of the FVC has been exhaled(MEF25)and the maximum mid-expiratory flow rate(MEF25-75)were higher than those in control group(P<0.05),the levels of interferon-γ(IFN-γ),interleukin-4(IL-4)and interleukin-6(IL-6)were lower than those in control group,the interleukin-2(IL-2)was higher than that in control group(P<0.05),the CRP and ESR were lower than those in control group(P<0.05),and the incidence of adverse reactions was lower than that in control group(P>0.05).Conclusion Feilike Mixture combined with azithromycin can effectively improve lung function and Th1/Th2 balance in MPB children.