大剂量维生素C辅助治疗儿童支原体肺炎的临床疗效观察

Clinical Efficacy of High-Dose Vitamin C in Adjuvant Treatment of Mycoplasma Pneumonia in Children

目的探讨大剂量维生素C辅助治疗儿童支原体肺炎临床疗效。方法将瑞安市人民医院儿科2016年3月—2018年3月收治的80例支原体肺炎患儿按随机数表法分为两组(各40例)。对照组给予阿奇霉素治疗,研究组给予阿奇霉素联合大剂量维生素C治疗,对比分析两组患儿的临床疗效、治疗后症状体征改善情况、血清白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)、超敏C反应蛋白(CRP)等炎性因子水平的变化情况。结果治疗后,研究组患儿总有效率(95.0%)显著高于对照组(77.5%),差异具有统计学意义(P<0.05)。治疗前,两组患儿血清IL-6、TNF-α和CRP比较,差异无统计学意义(P>0.05)。治疗后,对照组与研究组患儿上述血清指标水平较治疗前明显下降(P<0.05),且研究组患儿的血清IL-6、TNF-α和CRP水平下降值显著优于对照组(P<0.05)。治疗后,研究组患儿的退热时间、咳嗽憋喘消失时间、肺部啰音消失时间、血常规恢复时间及平均住院时间较对照组而言显著缩短(P<0.05)。治疗过程中两组均未见不良反应。结论使用大剂量维生素C辅助治疗小儿MPP临床疗效较佳,安全性高,较单一阿奇霉素治疗能够优先改善患儿临床症状及体征,同时对于血清IL-6、TNF-α和CRP等炎性因子水平也具有明显降低效果,值得临床运用与推广。

Objective To explore the Clinical efficacy of high-dose vitamin C in adjuvant treatment of mycoplasma pneumonia in children.Methods 80 children with mycoplasma pneumonia admitted to the Department of Pediatrics,Rui’an People’s Hospital from March 2016 to March 2018 were divided into two groups by random number table method,40 cases in each group.The treatment group was given Azithromycin combined with high-dose vitamin C,and the control group was given Azithromycin.The clinical efficacy,improvement of symptoms and signs,serum interleukin-6(IL-6),tumor necrosis factoralpha(TNF-α)and hypersensitive C-reactive protein(CRP)in the two groups were compared.Results After treatment,the effective rate in the treatment group(95.0%)was significantly higher than that in the control group(77.5%,P<0.05).Before treatment,there was no significant difference in the levels of serum IL-6,TNF-αand CRP between the two groups(P>0.05).After treatment,the levels of serum IL-6,TNF-αand CRP in the treatment group and the control group were lower than those before treatment(P<0.05),and the levels of serum IL-6,TNF-αand CRP in the treatment group were significantly lower than that of the control group(P<0.05).After treatment,the time of fever abatement,cough and wheeze disappearance,lung rale disappearance,blood routine recovery time and average hospital stay in the study group were shorter than those in the control group(P<0.05).There were no adverse reactions in both groups during the treatment.Conclusion High-dose vitamin C adjuvant therapy for MPP in children has better clinical efficacy and safety.Compared with single azithromycin therapy,it can improve the clinical symptoms and signs of children.At the same time,it can significantly reduce the levels of inflammatory factors such as serum IL-6,TNF-αand CRP,which is worthy of clinical application and promotion.