玉屏风颗粒联合阿奇霉素治疗肺炎支原体肺炎患儿的疗效及对CXCL8、P2X7受体的影响

Effect of Yupingfeng Granules Combined with Azithromycin in Treatment of Children with Mycoplasma Pneumoniae Pneumonia and Its Effect on CXCL8 and P2X7 Receptors

目的探析玉屏风颗粒联合阿奇霉素治疗肺炎支原体肺炎(MPP)患儿的疗效及对外周血CXC趋化因子8(CXCL8)、血清腺嘌呤核苷酸离子通道型7(P2X7)受体的影响。方法纳入2019年1月至2022年6月南方医科大学附属珠海医院收治的100例MPP患儿,依据随机数字表法分为观察组和对照组,各50例。对照组给予阿奇霉素0.1 g/(kg·d),0.9%氯化钠注射液250 ml配制静脉滴注用药,每日1次;观察组在对照组的基础上联合玉屏风颗粒治疗,每次5 g,每日3次,两组均连续治疗2个疗程。比较两组的临床疗效,治疗前、治疗2个疗程时的免疫因子[免疫球蛋白(Ig)A、IgG、IgM、补体C3、C4]和炎症因子[降钙素原(PCT)、C反应蛋白(CRP)、CXCL8、P2X7受体]水平,以及不良反应发生情况。结果观察组治疗总有效率高于对照组[98.00%(49/50)比80.00%(40/50)](χ^(2)=8.274,P=0.004)。治疗2个疗程时,两组外周血IgA、IgG较治疗前升高(P<0.05),且观察组高于对照组[(1.41±0.20)g/L比(1.22±0.18)g/L、(9.41±2.23)g/L比(7.72±2.45)g/L](P<0.01);IgM、C3和C4较治疗前降低(P<0.05),且观察组低于对照组[(1.12±0.21)g/L比(1.39±0.27)g/L、(1.41±0.31)g/L比(1.89±0.45)g/L、(0.61±0.14)g/L比(0.85±0.18)g/L](P<0.01)。治疗2个疗程时,两组外周血PCT、CRP、CXCL8和P2X7受体均较治疗前降低(P<0.05),且观察组低于对照组[(3.15±0.63)μg/L比(4.72±0.89)μg/L、(3.11±0.52)mg/L比(5.16±0.73)mg/L、(192±18)ng/L比(229±20)ng/L、(80.4±14.3)μg/L比(99.8±15.3)μg/L](P<0.01)。两组患儿恶心呕吐、腹痛腹泻、头晕头痛、皮疹瘙痒的发生率比较差异无统计学意义(P>0.05)。结论玉屏风颗粒联合阿奇霉素治疗MPP患儿的疗效较好,患儿外周血CXCL8水平和P2X7受体表达明显降低,且联合用药的安全性良好。

Objective To explore therapeutic effect of Yupingfeng granule combined with azithromycin in the treatment of children with Mycoplasma pneumoniae pneumonia(MPP),and its effect on peripheral blood chemokine(C-X-C motif)ligand 8(CXCL8)and serum adenine nucleotide ion channel type 7(P2X7)receptors.Methods A total of 100 patients with MPP admitted to Zhuhai Hospital Affiliated to the Southern Medical University from Jan.2019 to Jun.2022 were included,and were divided into an observation group and a control group according to the random number table,50 patients each.The control group was given azithromycin 0.1 g/(kg·d),0.9%sodium chloride injection 250 ml intravenous infusion,once a day;the observation group was combined with Yupingfeng granules on the basis of control group,5 g each time,3 times a day,and both groups were treated for 2 consecutive courses of treatment.The curative effects of both groups were compared,including the immune factors[immunoglobulin(Ig)A,IgG,IgM,complement C3,C4]and inflammatory factors[procalcitonin(PCT),C-reactive protein(CRP),CXCL8,P2X7 receptors]before and after two courses of treatment,as well as the occurrence of adverse reactions.Results The total effective rate of treatment in the observation group was higher than that in the control group[98.00%(49/50)vs 80.00%(40/50)](χ^(2)=8.274,P=0.004).After 2 courses of treatment,peripheral blood IgA and IgG of the two groups were higher than those before treatment(P<0.05),and the observation group was higher than the control group[(1.41±0.20)g/L vs(1.22±0.18)g/L,(9.41±2.23)g/L vs(7.72±2.45)g/L](P<0.01).IgM,C3 and C4 were lower than those before treatment(P<0.05),and the observation group was lower than the control group[(1.12±0.21)g/L vs(1.39±0.27)g/L,(1.41±0.31)g/L vs(1.89±0.45)g/L,(0.61±0.14)vs(0.85±0.18)g/L](P<0.01).After 2 courses of treatment,peripheral blood PCT,CRP,CXCL8 and P2X7 receptors of the two groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group[(3.15±0.63)μg/L vs(4.72±0.89)μg/L,(3.11±0.52)mg/L vs(5.16±0.73)mg/L,(192±18)ng/L vs(229±20)ng/L,(80.4±14.3)μg/L vs(99.8±15.3)μg/L](P<0.01).There was no statistically significant difference in the incidence of nausea and vomiting,abdominal pain and diarrhea,dizziness and headache,rash and pruritus between the two groups(P>0.05).Conclusion Yupingfeng granule combined with azithromycin has a better effect in treatment of children with MPP.The peripheral blood CXCL8 level and P2X7 receptor expression in the children with MPP are significantly reduced,and the combined medication is safe.