银翘散合麻杏石甘汤加减方对风热闭肺证小儿肺炎支原体肺炎Th1/Th2、Th17/Treg细胞因子影响

Effect of Yinqiao powder combined with Maxing Shigan decoction on modified formula Th1/Th2 and Th17/Treg cytokine levels in child mycoplasma pneumoniae pneumonia with syndrome of wind-heat invading lung

目的 探究银翘散合麻杏石甘汤加减方对风热闭肺证小儿肺炎支原体肺炎(MPP)的临床疗效及Th1/Th2、Th17/Treg细胞因子影响。方法 选择2021年10月至2023年6月在南京中医药大学常熟附属医院住院治疗的MMP风热闭肺型患儿为研究对象,按随机数字表法分为中药组(阿奇霉素干混悬剂+银翘散合麻杏石甘汤加减方)和对照组(阿奇霉素干混悬剂)。治疗前和治疗后7 d,比较中药组和对照组的临床疗效、中医证候积分(发热积分、咳嗽积分、咯痰积分和气喘积分)、肺功能[用力肺活量(FVC)、第1秒最大呼气量(FEV1)、峰值呼气流速(PEF)]、Th1/Th2细胞因子[γ-干扰素(IFN-γ)和白细胞介素-4(IL-4)]和Th17/Treg细胞因子[白细胞介素-17(IL-17)和白细胞介素-10 (IL-10)]。观察并记录治疗过程中不良反应发生情况。结果 研究共纳入106例MMP患者,每组各53例。治疗前,中药组和对照组在中医证候积分、肺功能、血清Th1/Th2细胞因子和血清Th17/Treg细胞因子方面差异无统计学意义(P> 0.05)。治疗后,中药组临床疗效显著优于对照组(P <0.05);中医组发热积分、气喘积分、咳嗽积分、咳痰积分、血清INF-γ水平和血清IL-17水平显著低于对照组(P <0.05),而FVC、FEV1、PEF、IL-4和IL-10水平显著高于对照组(P <0.05)。中药组不良反应发生率显著低于对照组(P <0.05)。结论 银翘散合麻杏石甘汤加减方治疗MMP患儿可调节Th1/Th2、Th17/Treg细胞因子水平,改善肺功能,提高疗效与安全性。

Objective To explore the clinical efficacy and effect of Yinqiao powder combined with Maxing Shigan decoction modified formula on Th1/Th2 and Th17/Treg cytokines on mycoplasma pneumonia(MPP).Methods MMP wind heat invading lung children hospitalized in Changshu Hospital Affiliated to Nanjing Universityof Chinese Medicine from October 2021 to June 2023 were selected as the study subjects.According to the random number method,they were divided into TCM group(azithromycin dry suspension+Yinqiao powder combined with Maxing Shigan decoction modified formula)and control group(azithromycin dry suspension).Before and 7 d after treatment,the clinical outcomes,TCM syndrome points(fever,cough,sputum,and wheezing points),lung function[forced vital capacity(FVC),maximum expiratory volume at 1 second(FEV 1),peak expiratory flow rate(PEF)],Th1/Th2 cytokines(IFN-γand IL-4),and Th17/Treg cytokines(IL-17 and IL-10)were compared.The occurrence of adverse reactions during the treatment process were observed and recorded.Results A total of 106 MMP patients were included in the study,including 53 patients in each group.Before treatment,there was no significant difference between TCM group and control group in TCM syndrome integration,lung function,serum Th1/Th2 cytokkines and serum Th17/Treg cytokines(P>0.05).After treatment,TCM was significantly better than the control group(P<0.05);fever,asthma,cough,sputum,serum INF-γlevels and serum IL-17 levels were significantly lower(P<0.05),while FVC,FEV 1,PEF,IL-4 and IL-10 levels were significantly higher(P<0.05).The incidence of adverse reactions in the TCM group was significantly lower than that in the control group(P<0.05).Conclusion Yinqiao powder combined with Maxing Shigan decoction modified formula can regulate Th1/Th2 and Th17/Treg cytokine levels,improve lung function,and increase efficacy and safety in children with MMP.