葶苈大枣泻肺汤加减治疗儿童支气管肺炎疗效及相关实验室指标的检测

Clinical efficacy and related laboratory indexes of modified tingladaozxiefei decoction in the treatment of children's bronchopneumonia

目的分析葶苈大枣泻肺汤加减治疗儿童支气管肺炎疗效及对患儿肿瘤坏死因子⁃α(TNF⁃α)、白细胞介素⁃10(IL⁃10)、C反应蛋白(CRP)、降钙素原(PCT)和免疫功能影响。方法纳入安徽中医药大学第一附属医院涡阳分院涡阳中医院2021年6月至2023年9月收治的116例支气管肺炎患儿,分别纳入研究组(n=58)、对照组(n=58)。2组均接受常规止咳化痰和抗生素治疗,研究组加用葶苈大枣泻肺汤加减,持续1周。对比2组患儿治疗前后血清炎症因子、外周血T淋巴细胞亚群、肺功能变化,记录2组症状体征恢复时间并评估2组患儿治疗后临床疗效。结果与治疗前相比,两组治疗1周后FVC、FEV1、PEF均有所上升,研究组比对照组更为明显,差异有统计学意义(t=3.197、10.144、2.415,P均<0.05)。完全退热、咳嗽消失、喘促消失、肺啰音消失及住院时间方面,研究组均较对照组更低,差异有统计学意义(t=10.086、6.588、6.739、12.138、10.260,P均<0.05)。治疗1周后,研究组总有效率为94.83%,较对照组的79.31%更高,差异有统计学意义(χ^(2)=6.202,P<0.05)。两组治疗1周后TNF⁃α、IL⁃10、CRP、PCT均较治疗前下降;与对照组相比较,研究组更低,差异有统计学意义(t=3.309、4.780、4.524、18.385,P均<0.05)。两组治疗1周后CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)较治疗前升高,比对照组高,差异有统计学意义(t=2.903、2.415、P均<0.05)。CD_(8)^(+)较治疗前下降,观察组比对照组低,差异有统计学意义(t=2.125,P<0.05)。结论在儿童支气管肺炎的治疗中,葶苈大枣泻肺汤加减能够表现出更为显著的疗效。

Objective To analyze the curative effect of modified tingladaozxiefei decoction on chil⁃dren with bronchopneumonia and its influence on TNF⁃α,IL⁃10,CRP,PCT and immune function.Methods One hundred and sixteen children with bronchopneumonia were admitted to The First Affiliated Hospital of An⁃hui University of Traditional Chinese Medicine Guoyang Branch Guoyang Traditional Chinese Medicine Hospi⁃tal from June 2021 to September 2023.They were divided into a study group(n=58)and a control group(n=58).Both groups received routine cough relief,expectorants and antibiotic treatments,while the study group was treated with modified tingladaozxiefei decoction for one week.The changes of serum inflammatory factors,T lymphocyte subsets in peripheral blood and lung function were compared between the two groups before and after treatment.The recovery time of symptoms and signs in the two groups was recorded and the clinical effi⁃cacy of the two groups was evaluated after treatment.Results Compared to before treatment,FVC,FEV1 and PEF in the two groups increased significantly after one week of treatment,and the difference was statistically significant(t=3.197,10.144 and 2.415,P<0.05).The total fever,cough,wheezing,lung rales and hospitaliza⁃tion time in the study group were lower than those in the control group,and the differences were statistically sig⁃nificant(t=10.086,6.588,6.739,12.138,10.260,P<0.05).After one week of treatment,the total effective rate of the study group was 94.83%,which was higher than that of the control group(79.31%),with statistical significance(χ^(2)=6.202,P<0.05).After one week of treatment,TNF⁃α,IL⁃10,CRP and PCT in both groups decreased compared with those before treatment.Compared with the control group,the study group was lower,and the difference was statistically significant(t=3.309,4.780,4.524,18.385,P<0.05).After one week of treatment,CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)in the two groups were higher than those before treatment and higher than those in the control group,with statistical significance(t=2.903,2.415,P<0.05).CD8+decreased compared with before treatment,and the observation group was lower than the control group,with statistical significance(t=2.125,P<0.05).Conclusion In the treatment of children's bronchopneumonia,the addition and subtrac⁃tion of Keli Dazao Xiefei Decoction can lead to a more significant curative effect.