麻甘合剂联合纤维支气管镜治疗儿童支原体肺炎临床观察

Clinical Observation of Magan Mixture(麻甘合剂)Combined with Fiberoptic Bronchoscopy in Treatment of Mycoplasma Pneumonia in Children

目的观察麻甘合剂联合纤维支气管镜(简称:纤支镜)治疗儿童支原体肺炎临床效果及安全性。方法研究纳入支原体肺炎儿童合计63例(2023年1月-10月收治),采取随机数字表法将儿童分为常规组(31例)以及治疗组(32例),给予常规组儿童常规治疗及纤支镜治疗,治疗组儿童在常规组治疗基础上结合麻甘合剂治疗,观察两组儿童治疗相关指标:疗效、中医证候(高热不退、面赤口渴、痰稠色黄、呼吸急促等)积分变化及肺泡灌洗液中白细胞介素8(interleu kin,IL-8)及白细胞介素12(interleu kin,IL-12)、干扰素-γ(interferon-gamma,IFN-γ)等炎症指标水平变化、用力肺活量(forced vital capacity,FVC)及第一秒用力呼气容积(forced expiratory volume in one second,FEV1)、FEV1/FVC等肺功能指标变化、T淋巴细胞(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+))指标变化、高热消退时间及咳嗽消失时间、血象恢复时间、炎症消失时间以及罗音消失时间、治疗不良反应。结果治疗组儿童治疗总有效率比常规组儿童更高,P<0.05;各组儿童治疗前中医证候(高热不退、面赤口渴、痰稠色黄、呼吸急促等)积分、IL-8及IL-12、IFN-γ水平、肺功能指标(FVC、FEV1、FEV1/FVC)、T淋巴细胞(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+))指标比较,P>0.05,治疗后各组儿童中医证候(高热不退、面赤口渴、痰稠色黄、呼吸急促等)积分、IL-8及IL-12、IFN-γ水平、肺功能指标(FVC、FEV_(1)、FEV_(1)/FVC)、T淋巴细胞(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+))指标均改善,而治疗组儿童治疗后中医证候(高热不退、面赤口渴、痰稠色黄、呼吸急促等)积分、IL-8及IL-12、IFN-γ水平、肺功能指标(FVC、FEV_(1)、FEV_(1)/FVC)、T淋巴细胞(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+))指标均优于常规组,P<0.05;较对照组儿童,治疗组儿童的高热消退时间及咳嗽消失时间、血象恢复时间、炎症消失时间以及啰音消失时间均更短,P<0.05;各组儿童不良反应率均较低,P>0.05。结论麻甘合剂联合纤支镜治疗儿童支原体肺炎临床效果甚佳,患儿炎症消退,肺功能以及免疫功能均改善,且患儿恢复快,不良反应少,安全性较高。

Objective To observe the clinical effect and safety of Magan Mixture(麻甘合剂)combined with fiberoptic bronchoscope in the treatment of mycoplasma pneumonia in children.Methods A total of 63 children with mycoplasma pneumonia admitted from January 2023 to October 2023 were included in the study.The children were divided into routine group(31 cases)and treatment group(32 cases)by random number table method.The children in the routine group were given routine treatment and bronchoscopy treatment.Therapeutic related indexes of children in each group were observed,including the therapeutic effect,integral changes of TCM syndromes(high fever,red and thirsty face,thick yellow sputum,shortness of breath,etc.),the levels of interleukin-8(IL-8),interleukin-12(IL-12),interferon-gamma(interferon-γ)in alveolar lavage fluid,the values of forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC and other pulmonary function indicators,the levels of T lymphocytes(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+)),high fever resolution time,cough disappearance time,blood image recovery time,inflammation disappearance time and rale disappearance time and adverse reactions.Results The total effective rate of the treatment group was higher than that of the routine group(P<0.05).The scores of TCM syndromes(high fever,red and thirsty face,thick and yellow phlegm,shortness of breath,etc.),the levels of IL-8,IL-12 and IFN-γ,lung function indexes(FVC,FEV1,FEV1/FVC)and T lymphocytes(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+))were not significant in both groups before treatment(P>0.05).After treatment,The scores of TCM syndromes(high fever,red and thirsty face,thick and yellow phlegm,shortness of breath,etc.),the levels of IL-8,IL-12 and IFN-γ,lung function indexes(FVC,FEV_(1),FEV_(1)/FVC)and T lymphocytes(CD_(3)^(+),CD_(4)^(+),CD_(8)^(+))in both groups were improved.And,the scores and the indexes in the treatment group were all better than those in the conventional group(P<0.05).Compared with those of the routine group,the time of hyperthermia resolution,cough disappearance,blood image recovery time,inflammation disappearance time and rales disappearance time in the treatment group were shorter(P<0.05).The adverse reaction rate was lower in both groups(P>0.05).Conclusion The clinical effect of Magan Mixture combined with fiberoptic bronchoscopy in the treatment of mycoplasma pneumonia in children is very good.The inflammation of children is subsided,the lung function and immune function are improved,and the children recover quickly.The adverse reactions are less,and the safety is higher.