白葡奈氏菌片联合布地奈德雾化吸入治疗小儿急性肺炎的临床疗效

Clinical effect of meglonella albus tablets combined with budesonide aerosol inhalation in treatment of acute pneumonia(AP)in children

目的 探究白葡奈氏菌片联合布地奈德雾化治疗小儿急性肺炎(AP)的临床疗效。方法 选取2021年2月至2023年2月界首市人民医院收治的92例AP患儿,采用随机数字表法将其分为观察组与对照组,每组各46例,对照组在常规治疗的基础上给予安慰剂治疗,观察组在常规治疗的基础上口服白葡奈氏菌片。治疗5 d后评估两组患儿疗效,酶联免疫法检测血清炎症因子水平,流式细胞法检测免疫功能水平,脉冲震荡肺功能仪检测患儿呼吸力学指标,并观察治疗方案的安全性。结果 与对照组相比,观察组总有效率(78.26%vs. 95.65%)升高(P<0.05);观察组治疗后肿瘤坏死因子-α(TNF-α)水平低于对照组[(16.02±2.54) ng/L vs.(18.47±2.39) ng/L],白细胞介素-10(IL-10)水平也低于对照组[(105.68±12.59) ng/L vs.(146.92±17.33) ng/L],干扰素-γ(IFN-γ)水平高于对照组[(189.76±24.59) ng/L vs.(161.40±20.76) ng/L](P<0.05);两组患儿治疗后CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均升高,观察组各免疫指标优于对照组(P<0.05);两组患儿治疗后5 Hz时气道阻力(R5)、共振频率(Fres)均降低,总顺应性(Ct)升高(P<0.05);观察组各项呼吸力学指标优于对照组(P<0.05);观察组退热时间、咳嗽消失时间、肺啰音消失时间及住院时间均短于对照组(P<0.05);两组患儿治疗期间均未见明显的不良反应。结论 白葡奈氏菌片联合雾化治疗能够提高AP患儿的疗效,减轻机体炎症反应,提高患儿呼吸功能及免疫功能,加速改善临床症状,且安全性较高。

Objective To explore the clinical effect of meglunella albus tablets combined with budesonide aerosol inhalation in the treatment of acute pneumonia(AP)in children.Methods A total of 92 children with AP admitted to the hospital from February 2021 to February 2023 were divided into observation group and control group by random number table method,with 46 cases in each group.The control group was given placebo treatment on the basis of conventional treatment,and the observation group was given oral glucomellae albus tablets on the basis of conventional treatment.The therapeutic effects of the 2 groups were evaluated after 5 days of the treatment,and the serum levels of inflammatory factors were detected by enzyme-linked immunoassay.Flow cytometry was used to detect the immune function,pulse shock pulmonary function apparatus was used to detect the respiratory mechanical index,and the safety of treat-ment was observed.Results Compared with control group(78.26%),the total effective rate of observa-tion group(95.65%)was increased(P<0.05).After the treatment,the levels of tumor necrosis factor-α[TNF-α(18.47±2.39),ng/L vs.(16.02±2.54)ng/L]and interleukin-10[IL-10,(105.68±12.59)ng/L vs.(146.92±17.33)ng/L]in observation group were lower than those in control group,and the levels of interferon-γ[IFN-γ,(161.40±20.76)ng/L vs.(189.76±24.59)ng/L]were higher than those in con-trol group(P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups were increased after the treatment,and the immune indexes in the observation group were better than those in control group(P<0.05).The levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in both groups were increased after the treat-ment,and the immune indexes in the observation group were better than those in control group(P<0.05).Airway resistance(R5)and resonance frequency(Fres)were decreased in both groups at 5 Hz after the treatment,and total compliance(Ct)was increased(P<0.05).All respiratory mechanical indexes in observation group were better than those in control group(P<0.05).The time of fever reduction,cough disappearance,lung rales disappearance and hospital stay in observation group were lower than those in control group(P<0.05).No obvious adverse reactions were observed in both groups during the treat-ment.Conclusion The combination of meglunella albus tablets and compound with budesonide aerosol in-halation can improve the therapeutic effect of AP children,improve body inflammatory response,improve respiratory function and immune function of the children,accelerate the improvement of clinical symp-toms,with high safety.