穴位敷贴治疗小儿肺炎支原体肺炎临床研究

Clinical Study on Acupoint Application in Treatment of Mycoplasma Pneumoniae Pneumonia in Children

目的探讨小儿肺炎支原体肺炎应用穴位敷贴治疗的临床疗效及患儿免疫功能和炎性因子水平的变化情况。方法选取90例2019年9月—2022年9月山西省中西医结合医院收治的肺炎支原体肺炎患儿,按随机数字表法将其分为A组、B组、C组,各30例。A组患儿予以西药治疗,B组在西药治疗基础上联合甘露消毒饮治疗,C组在B组基础上予以穴位敷贴治疗。3组均连续治疗2周并随访3个月。对3组治疗后的临床疗效、治疗前后的中医证候积分、免疫功能、炎性因子水平、治疗期间的不良反应及随访3个月的复发率进行比较。结果相较于A组、B组和C组治疗后的临床总有效率均更高;相较于治疗前,3组患儿治疗后的中医证候积分、血清γ干扰素(interferon-γ,IFN-γ)、淀粉样蛋白A(amyloid A,SAA)、粒细胞集落刺激因子(granulocyte colony-stimulating factor,G-CSF)、纤维蛋白原(fibrinogen,Fbg)水平均降低,且C组<B组<A组;相较于治疗前,3组患儿治疗后的血清免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)、免疫球蛋白M(immunoglobulin M,IgM)水平均升高,且C组>B组>A组;相较于A组,B组和C组随访3个月的复发率均较低,差异有统计学意义(P<0.05)。治疗期间3组不良反应总发生率进行比较,B组和C组随访3个月的复发率进行比较,差异无统计学意义(P>0.05)。结论在西药治疗的基础上,予以肺炎支原体肺炎患儿甘露消毒饮治疗或联合穴位敷贴治疗均具有较高的临床疗效和较低的复发率,且两组疗效、安全性及复发率相当,但穴位敷贴辅助治疗对于中医证候积分的改善效果更显著,并可提升免疫功能,减轻机体炎症反应。

Objective To investigate the clinical effect of acupoint application in the treatment of mycoplasma pneumoniae pneumonia in children and the changes of immune function and inflammatory factors.Methods Ninety children with mycoplasma pneumoniae pneumonia admitted to Shanxi Hospital of Integrated Traditional and Western Medicine from September 2019 to September 2022 were selected and divided into the group A,the group B and the group C with 30 cases in each according to random number table method.The group A was treated with Western medicine,the group B was treated with Ganlu Xiaodu Yin(甘露消毒饮)on the basis of Western medicine,the group C was treated with acupoint application on the basis of group B.All the three groups were treated for 2 weeks and followed up for 3 month.The clinical efficacy after treatment,the scores of syndrome of traditional Chinese medicine,immune function,the levels of inflammatory factors before and after treatment,adverse reactions during treatment and recurrence rate of 3 month follow-up were compared among the three groups.Results Compared with that of the group A,the total clinical effective rate of the group B and the group C after treatment was higher.Compared with those before treatment,the scores of syndrome of traditional Chinese medicine,the levels of serum interferon-γ(IFN-γ),amyloid A(SAA),granulocyte colony-stimulating factor(G-CSF)in the three groups decreased after treatment,and order was the group C<the group B<the group A.Compared with those before treatment,the levels of serum immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)in the three groups increased after treatment,and the order was group C>the group B>the group A.Compared with that of the group A,the recurrence rate of the group B and the group C at 3 month follow-up was lower,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions among the three groups during treatment was compared,and the recurrence rate of the group B and the group C after 3 month of follow-up had no statistical significance(P>0.05).Conclusion On the basis of western medicine treatment,the treatment of pediatric mycoplasma pneumoniae pneumonia with Ganlu Xiaodu Yin or combined acupoint application had higher clinical efficacy and lower recurrence rate,and the efficacy,safety and recurrence rate of the two groups was similar,but the auxiliary treatment of acupoint application had more significant improvement effect on the scores of syndrome of traditional Chinese medicine,and could improve immune function and reduce inflammation of the body.