麻杏石甘汤合清金化痰汤加减辅助西药治疗小儿肺炎支原体肺炎(痰热闭肺证)疗效观察

Efficacy of Modified Maxing Shigan Decoction and Qingjin Huatan Decoction Supplemented with Western Medicine in the Treatment of Children with Mycoplasma Pneumoniae Pneumonia(phlegm-heat obstructing the lung syndrome)

目的:探究麻杏石甘汤合清金化痰汤加减辅助西药治疗小儿肺炎支原体肺炎(MPP)(痰热闭肺证)的疗效。方法:选择辨证为痰热闭肺证的MPP患儿120例,随机分组为对照组(n=60,西药治疗)和观察组(n=60,麻杏石甘汤合清金化痰汤加减辅助西药治疗),比较疗效、中医证候积分、潮气呼吸肺功能(呼吸频率、潮气量及呼吸比)、炎症状态[单核细胞趋化蛋白-4(MCP-4)、白细胞介素-17(IL-17)及白细胞介素-25(IL-25)]、免疫状态[T淋巴细胞亚群(CD3^(+)、CD4^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)比值)、红细胞免疫复合物(RBC-ICR)]及不良反应情况。结果:观察组治疗愈显率为90.00%,高于对照组的75.00%(P<0.05);治疗后,两组咳嗽、痰黄粘稠、痰涎壅盛、喘促鼻煽评分均降低(P<0.05),且观察组降低幅度更大(P<0.05);两组呼吸频率降低(P<0.05),潮气量、呼吸比升高(P<0.05),且观察组变化幅度更大(P<0.05);两组MCP-4、IL-17及IL-25水平降低(P<0.05),且观察组降低幅度更大(P<0.05);两组CD3^(+)、CD4^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)比值升高(P<0.05),RBC-ICR水平降低,且观察组变化幅度更大(P<0.05);两组患儿治疗期间均无严重不良反应。结论:麻杏石甘汤合清金化痰汤加减辅助西药治疗小儿痰热闭肺证MPP疗效确切,可缓解症状、改善潮气呼吸肺功能,还有助于减轻炎症反应并提高机体免疫。

Objective To explore the efficacy of modified Maxing Shigan decoction and Qingjin Huatan decoction supplemented with western medicine in the treatment of children with Mycoplasma pneumoniae pneumonia(phlegm-heat obstructing the lung syndrome).Methods 120 children with MPP of phlegm-heat obstructing the lung syndrome were selected and randomly divided into control group(n=60,western medicine treatment)and the observation group(n=60,modified Maxing Shigan decoction with Qingjin Huatan decoction supplemented with western medicine).The efficacy,TCM symptoms scores,tidal breathing lung function(respiratory rate,tidal volume,respiratory ratio),inflammatory status[monocyte chemotactic protein-4(MCP4),interleukin-17(IL-17),interleukin-25(IL-25)],immune status[T lymphocyte subsets(CD3^(+)T lymphocyte percentage,CD4^(+)T lymphocyte percentage and CD4^(+)/CD8^(+)ratio),red blood cell-immune complex(RBC-ICR)]and adverse reactions were compared.Results The healing rate of the observation group was 90.00%,which was higher than 75.00%in the control group(P<0.05).After treatment,the scores of cough,yellow and sticky phlegm,abundant sputum,dyspnea and tachypnea,flapping of nasal wings were decreased in both groups(P<0.05),and the magnitude of the decrease was greater in the observation group(P<0.05).The respiratory rate in the two groups was reduced(P<0.05)while the tidal volume and respiratory ratio were enhanced(P<0.05),and the changes in observation group were larger(P<0.05).The levels of MCP-4,IL-17 and IL-25 were reduced in the two groups(P<0.05),and the decrease were greater in observation group(P<0.05).The CD3^(+)T lymphocyte percentage,CD4^(+)T lymphocyte percentage and CD4^(+)/CD8^(+)ratio were increased in both groups(P<0.05)while the level of RBC-ICR was decreased,and the changes in observation group were greater(P<0.05).There were no serious adverse reactions in both groups during the treatment.Conclusion Modified Maxing Shigan decoction with Qingjin Huatan decoction supplemented with western medicine has an exact efficacy in the treatment of children with MPP of phlegm-heat obstructing the lung syndrome.It can relieve the symptoms,improve the tidal breathing lung function,help relieve the inflammatory response and enhance the body's immunity.