小儿肺热咳喘颗粒联合甲泼尼龙琥珀酸钠治疗儿童重症支原体肺炎的效果研究

Efficacy of Xiaoer Feire Kechuan Granule combined with methylprednisolone sodium succinate in the treatment of severe mycoplasma pneumonia in children

目的探讨小儿肺热咳喘颗粒联合甲泼尼龙琥珀酸钠治疗儿童重症支原体肺炎(MP)的效果。方法前瞻性选取2021年6月—2023年6月广州市红十字会医院收治的112例重症MP患儿为研究对象,以随机数字表法分为对照组、研究组,每组56例。对照组给予甲泼尼龙琥珀酸钠治疗,研究组在对照组基础上给予小儿肺热咳喘颗粒,连续治疗10 d评估效果。对比两组症状改善情况、肺功能、临床疗效、气道重塑指标、炎症相关细胞因子、免疫细胞功能及药物不良反应发生情况。结果研究组发热消退时间、咳嗽消失时间、肺部啰音消失时间均短于对照组(P<0.05)。研究组治疗前后达峰时间比、达峰容积比、呼吸频率的差值均高于对照组(P<0.05)。研究组总有效率高于对照组(P<0.05)。研究组治疗前后气道壁厚度/外径比值、气道面积/总横截面积比值的差值均高于对照组(P<0.05)。研究组治疗前后表面活性蛋白D、半乳糖凝集素-3、C-C基序趋化因子配体5的差值均高于对照组(P<0.05)。研究组治疗前后的Th17/Treg、CD4^(+)/CD8^(+)差值均高于对照组(P<0.05)。两组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论小儿肺热咳喘颗粒联合甲泼尼龙琥珀酸钠治疗重症MP疗效显著,可改善患儿肺功能,抑制气道重塑,调控炎症相关细胞因子分泌及免疫细胞功能,且安全可靠。

Objective To investigate the efficacy of Xiaoer Feire Kechuan Granule combined with methylprednisolone sodium succinate in the treatment of severe mycoplasma pneumonia(MP) in children.Methods A total of 112 children with severe MP admitted to our hospital from June 2021 to June 2023 were prospectively selected,and were divided into the control group and the study group by the random number table method,with 56 cases in each group.The control group was treated with methylprednisolone sodium succinate,and the study group was additionally treated with Xiaoer Feire Kechuan Granule on the basis of methylprednisolone sodium succinate.The efficacy was evaluated after continuous treatment for 10 days.Symptom improvement,lung function,clinical efficacy,airway remodeling indices,inflammation-related cytokines,immune cell function and adverse drug reactions were compared between the two groups.Results The time to resolution of fever,cough and rales in the study group was shorter than that in the control group(P < 0.05).The differences of the time to peak tidal expiratory flow as a proportion of expiratory time,volume to peak expiratory flow as a proportion of exhaled volume and respiratory rate before and after treatment in the study group were higher than those in the control group(P <0.05).The overall effective rate of the study group was higher than that of the control group(P < 0.05).The differences of the ratio of airway wall thickness to outer diameter and the percentage wall area and after treatment were higher in the study group than in the control group(P < 0.05).The differences of the levels of surfactant protein D,galectin-3 and C-C motif chemokine ligand 5 before and after treatment in the study group were higher than those in the control group(P < 0.05).The differences of ratios of Th17/Treg and CD4^(+)/CD8^(+) before and after treatment in the study group were higher than those in the control group(P < 0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P > 0.05).Conclusions Xiaoer Feire Kechuan Granule combined with methylprednisolone sodium succinate exhibits pronounced therapeutic efficacy for severe MP,which improves the lung function,inhibits airway remodeling,and regulates the secretion of inflammationrelated cytokines and immune cell function safely and reliably.