肺宁排毒汤治疗儿童难治性肺炎支原体肺炎的临床疗效

Clinical Effect of Feining Paidu Decoction on Refractory Mycoplasma Pneumoniae Pneumonia in Child Patients

目的:观察肺宁排毒汤治疗儿童难治性肺炎支原体肺炎的临床疗效及机制。方法:采用随机、对照的研究方法,将96例患儿随机分为对照组和观察组,每组48例。对照组给予阿奇霉素(10mg·kg^(-1)·d^(-1))静滴,疗程7d,甲泼尼龙(1 mg·kg^(-1)·d^(-1))静滴,疗程3 d,并予补液、退热等对症治疗,观察组口服肺宁排毒汤,每日1剂,疗程7 d。观察两组患儿中医证候积分、临床疗效、血清可溶性B7-H3(sB7-H3)、血清炎性因子、凝血功能及肺部影像学[计算机断层扫描(CT)]评分变化,记录不良反应事件的发生情况。结果:观察组临床疗效总有效率为95.74%(45/47),对照组为80.43%(37/46),观察组总有效率显著高于对照组(Z=-3.702,P<0.01)。与本组治疗前比较,两组患儿中医证候积分、肺部影像学评分、sB7-H3、肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、D-二聚体(D-D)、纤维蛋白原(FIB)均明显下降(P<0.05,P<0.01)。与对照组治疗后比较,观察组上述指标均明显优于对照组(P<0.05,P<0.01)。与本组治疗前比较,对照组凝血酶时间(TT)差异无统计学意义,而观察组较前明显延长(P<0.05);与本组治疗前比较,两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)指标差异均无统计学意义;两组均未发生严重不良反应。结论:肺宁排毒汤可通过减轻炎症反应,改善高凝状态,促进肺部炎症吸收,提高儿童难治性肺炎支原体肺炎的临床疗效。

Objective:To observe the clinical efficacy of Feining Paidu decoction on refractory Mycoplasma pneumoniae pneumonia in child patients.Method:A randomized controlled trial(RCT)was conducted,with 96 child patients randomly divided into a control group and an observation group,each containing 48 cases.The control group received intravenous azithromycin(10 mg·kg^(-1)·d^(-1))for 7 days,intravenous methylprednisolone(1 mg·kg^(-1)·d^(-1))for 3 days,along with supportive treatments such as fluid infusion and antipyretics.The observation group received oral administration of Feining Paidu decoction once a day for 7 days.Changes in traditional Chinese medicine(TCM)syndrome scores,clinical efficacy,serum soluble B7-H3(sB7-H3),serum inflammatory factors,coagulation function,and lung imaging[computer tomography(CT)]scores were observed in both groups.Adverse reaction events were also recorded.Result:The total effective rate in the observation group was 95.74%(45/47),significantly higher than 80.43%(37/46)in the control group(Z=-3.702,P<0.01).Compared with the results before treatment,TCM syndrome scores,lung imaging scores,sB7-H3,tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),D-dimer(D-D),and fibrinogen(FIB)levels in both groups all significantly decreased after treatment(P<0.05,P<0.01).After treatment,the observation group showed significantly better results in these indicators than the control group(P<0.05,P<0.01).There was no statistically significant difference in thrombin time(TT)in the control group before and after treatment,while the observation group showed a significant prolongation after treatment(P<0.05).There were no statistically significant differences in activated partial thromboplastin time(APTT)and prothrombin time(PT)between the two groups before treatment,and no serious adverse reactions occurred in either group.Conclusion:Feining Paidu decoction combined with conventional treatment can alleviate inflammatory responses,improve hypercoagulable states,promote the absorption of pulmonary inflammation,and enhance the clinical efficacy of refractory Mycoplasma pneumoniae pneumonia in children.