解毒活瘀化痰汤联合清宣汤治疗肺炎支原体肺炎(痰热闭肺证)患儿的临床价值研究

Clinical Value of Jiedu Huoyu Huatan Decoction Combined with Qingxuan Decoction in Treating Children with Mycoplasma Pneumoniae Pneumonia(Phlegm-heat Obstructing Lung Syndrome)

目的探讨解毒活瘀化痰汤联合清宣汤对肺炎支原体肺炎(Mycoplasma Pneumonia,MPP)(痰热闭肺证)患儿肺部体征、炎性因子和凝血功能的影响。方法选取我院儿科2021年5月至2022年7月收治的痰热闭肺型MPP患儿114例,采用数字表法随机分为单用组(n=57)和联用组(n=57)。单用组采用清宣汤治疗,联用组在单用组基础上加用解毒活瘀化痰汤治疗。两组疗程为2周,比较两组中医症候积分、肺部症状和体征、炎性因子水平、凝血功能指标及不良反应发生情况。结果治疗后,两组各项中医症候积分及总积分均降低(P<0.01)、且联用组的各项中医症候积分及总积分均低于单用组,两组差异明显(P<0.01);联用组患儿的发热、咳嗽症状消失时间以及啰音、肺部阴影等肺部体征消失时间均短于单用组,两组差异明显(P<0.01);治疗前两组各炎性因子水平无统计学差异(P>0.05),治疗后均降低、且联用组的白细胞介素6(interleukin-6,IL-6)、白细胞介素8(interleukin-8,IL-8)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、C反应蛋白(C-reactive protein,CRP)水平均低于单用组(P<0.05);治疗前两组凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、纤维蛋白原(fibrinogen,Fib)无明显差异(P>0.05),治疗后两组APTT、PT值增加、且联用组大于单用组(P<0.05),治疗后两组Fib水平降低、且联用组低于单用组(P<0.05)。结论自拟解毒活瘀化痰汤联合清宣汤口服治疗痰热闭肺型MPP患儿可降低中医症候积分,促进肺部体征消失,降低患儿炎症因子水平和凝血指标水平,且安全性值得肯定。

Objective To explore the effects of Jiedu Huoyu Huatan decoction combined with Qingxuan decoction on pulmonary signs,inflammatory factors and coagulation function in children with Mycoplasma pneumoniae pneumonia(MPP)(phlegm-heat obstructing lung syndrome).Methods A total of 114 children with MPP of phlegm-heat obstructing lung syndrome who were admitted to department of pediatrics of the hospital from May 2021 to July 2022 were selected and randomly divided into single-use group(n=57)and combined-use group(n=57)according to the number table method.The single-use group was treated with Qingxuan decoction while the combined-use group was additionally given Jiedu Huoyu Huatan decoction on the basis of the single-use group.The course of treatment in both groups was 2 weeks.The TCM symptoms scores,pulmonary symptoms signs,levels of inflammatory factors,coagulation function indicators and occurrence of adverse reactions were compared between the two groups.Results After treatment,the scores of various TCM symptoms and total score in the two groups were decreased(P<0.01),and the scores of TCM symptoms and total score in combined-use group were lower than those in single-use group(P<0.01).The disappearance times of symptoms of fever and cough and pulmonary signs of rales and pulmonary shadows were shorter in combined-use group(P<0.01).There were no statistical differences in the levels of inflammatory factors between the two groups before treatment(P>0.05),and the levels were all reduced after treatment,and the levels of interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factorα(TNF-α)and C-reactive protein(CRP)in combined-use group were lower than those in single-use group(P<0.05).There were no significant differences in prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(Fib)between the two groups before treatment(P>0.05).After treatment,the APTT and PT of the two groups were prolonged,and the two indicators were longer in combined-use group(P<0.05),and the Fib level of the two groups was declined after treatment,and the level of combined-use group was lower than that of single-use group(P<0.05).Conclusion Oral administration of self-made Jiedu Huoyu Huatan decoction combined with Qingxuan decoction can reduce the scores of TCM syndromes,promote the disappearance of pulmonary signs,lower the levels of inflammatory factors and coagulation indicators of children with MPP of phlegm-heat obstructing lung syndrome,and its safety is worthy of affirmation.