Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

Research Progress on Combined Chinese and Western Medicine Treatment of Mycoplasma pneumoniae Pneumonia in Children

With the continuous development of medical technology,combined treatment of Chinese and Western medicine has gradually become a research hotspot.As a common disease in pediatrics,the treatment of Mycoplasma pneumoniae pneumonia(MPP)in children is also being explored and improved.This article summarizes the research progress of combined Chinese and Western medicine treatment of MPP in children in recent years,aiming to provide a useful reference for the combined treatment of MPP in children.The article firstly introduces the etiology and pathogenesis of MPP in children,thereafter briefly introduces the Western anti-infective treatment and traditional Chinese medicine(TCM)diagnosis and treatment of MPP in children,and lastly introduces the methods of combined treatment of TCM and Western medicine in detail.The article points out that the combination of Chinese and Western medicine can give full play to the overall regulation of Chinese medicine and the precise treatment advantages of Western medicine,improve the therapeutic effect,reduce the use of antibiotics,and lower the recurrence rate of the disease,which is worthy of further research and promotion.

Effect of adjuvant therapy of transfer factor oral solution on the infection process of children with Mycoplasma pneumonia

Objective:To explore the effect of adjuvant transfer factor oral solution therapy on the infection process of children with mycoplasma pneumonia.Methods:A total of 164 children with mycoplasma pneumonia who were treated in our hospital between January 2017 and January 2018 were selected as the research subjects and divided into control group (n=82) and transfer factor oral solution group (n=82) by random number table method. Control group received clinical routine therapy for children with mycoplasma pneumonia, transfer factor oral solution group received both routine therapy and transfer factor oral solution therapy, and both groups were treated for consecutive 1 week. The differences in infection-related index levels were compared between the two groups before and after treatment.Results:Before treatment, the differences in serum levels of inflammatory factors, coagulation indexes and immunoglobulins were not statistically significant between the two groups. After 1 week of treatment, serum inflammatory factors IL-2, IL-13 and IL-18 contents of transfer factor oral solution group were lower than those of control group;serum coagulation index FIB level was lower than that of control group whereas PT and APTT levels were higher than those of control group;serum immunoglobulins IgG, IgA and IgM contents were lower than those of control group.Conclusion: Adjuvant transfer factor oral solution therapy can effectively relieve the systemic inflammatory response and reduce the coagulation system and humoral immune system function damage in children with mycoplasma pneumonia.

Children with infectious pneumonia caused by Ralstonia insidiosa:A case report

BACKGROUND Ralstonia is a Gram-negative non-fermentative bacterium widespread in nature,and includes four species,Ralstonia pickettii,Ralstonia solanacearum,Ralstonia mannitolilytica,and Ralstonia insidiosa,which were proposed in 2003.Ralstonia is mainly found in the external water environment,including municipal and medical water purification systems.This bacterium has low toxicity and is a conditional pathogen.It has been reported in recent years that infections due to Ralstonia are increasing.Previous studies have shown that most cases of infection are caused by Ralstonia pickettii,a few by Ralstonia mannitolilytica,and infections caused by Ralstonia insidiosa are rare.CASE SUMMARY A 2-year-old Chinese child suffered from intermittent fever and cough for 20 d and was admitted to hospital with bronchial pneumonia.Bronchoscopy and alveolar lavage fluid culture confirmed Ralstonia insidiosa pneumonia.The infection was well controlled after treatment with meropenem and azithromycin.CONCLUSION Ralstonia infections are increasing,and we report a rare case of Ralstonia insidiosa infection in a child.Clinicians should be vigilant about Ralstonia infections.

The Effect of Azithromycin in Treating Mycoplasma Pneumonia in Children

Objective:To discuss and analyze the effect of azithromycin in the treatment of mycoplasma pneumonia in children.Methods:A total of 120 children with mycoplasma pneumonia who were admitted to the Department of Pediatrics of our hospital from January 2022 to December 2022 were selected as the research subjects.They were divided into an azithromycin group and a reference group according to the random number drawing method,with 60 cases in each group.The azithromycin group was treated with azithromycin,and the reference group was treated with conventional treatment.The efficacy of treatment,laboratory indicators,platelet count and D-dimer,and adverse reactions of both groups were compared.Results:The efficacy of the azithromycin group was significantly higher than that of the reference group(P<0.05).Before treatment,there were no significant differences in the laboratory indicators like ferritin,procalcitonin(PCT),and erythrocyte sedimentation rate(ESR)between the two groups(P>0.05);after treatment,the laboratory indicators of the azithromycin group were significantly better than those of the reference group(P<0.05).Before treatment,there was no statistically significant difference in platelet count and D-dimer between the groups(P>0.05);after medication,the platelet count,and D-dimer in the azithromycin group were significantly better than those in the reference group(P<0.05).The total incidence of adverse reactions in the azithromycin group was significantly lower than that in the reference group(P<0.05).Conclusion:Azithromycin is more effective in treating mycoplasma pneumonia in children,and has certain clinical value.

Establishment of a Predictive Diagnostic Model for Acute Mycoplasma Pneumoniae Infection in Elderly Patients with Community-acquired Pneumonia

We established a diagnostic model to predict acute Mycoplasma pneumoniae （M. pneumonia） infection in elderly Community-acquired pneumonia （CAP） patients. We divided 456 patients into acute and non-acute M. pneumoniae infection groups. Binary logistic regression and receiver operating characteristic （ROC） curves were used to establish a predictive model. The following independent factors were identified： age 〉 70 years; serum cTNT level 〉 0.0S ng/mL; lobar consolidation; mediastinal lymphadenopathy; and antibody titer in the acute phase 〉 1：40. The area under the ROC curve of the model was 0.923 and a score of 2 7 score predicted acute M. pneumoniae infection in elderly patients with CAP. The predictive model developed in this study has high diagnostic accuracy for the identification of elderly acute M. pneumoniae infection.

Using 16S rDNA Sequencing Technology to Preliminarily Analyze Intestinal Flora in Children with Mycoplasma pneumoniae Pneumonia

Objective We investigated changes in the intestinal flora of children with Mycoplasma pneumoniae pneumonia(MPP).Methods Between September 2019 and November 2019,stool samples from 14 children with MPP from The Fourth Hospital of Baotou city,Inner Mongolia Autonomous Region,were collected and divided into general treatment(AF)and probiotic(AFY)groups,according to the treatment of“combined Bifidobacterium,Lactobacillus,Enterococcus,and Bacillus cereus tablets live”.Highthroughput 16S rDNA sequencing was used to identify intestinal flora.Results Intestinal flora abundance and diversity in children with MPP were decreased.Both Shannon and Simpson indices were lower in the AF group when compared with healthy controls(P<.05).When compared with healthy controls,the proportion of Enterorhabdus was lower in the AF group,while the proportion of Lachnoclostridium was higher(P<0.05).The proportion of Bifidobacteria and Akkermansia was lower in the AFY group but Enterococcus,Lachnoclostridium,Roseburia,and Erysipelatoclostridium proportions were higher.The proportion of Escherichia coli-Shigella in the AFY group after treatment was decreased(P<0.05).Conclusions The intestinal flora of children with MPP is disturbed,manifested as decreased abundance and diversity,and decreased Bifidobacteria.Our probiotic mixture partly improved intestinal flora disorders.

Efficacy of different antibiotics in treatment of children with respiratory mycoplasma infection

BACKGROUND Respiratory infections in children are common pediatric diseases caused by pathogens that invade the respiratory system.Children are considerably susceptible to Mycoplasma pneumoniae infection.There has been widespread clinical attention on treatment strategies for this disease.AIM To analyze the clinical efficacy of different antibiotics in treating pediatric respiratory mycoplasma infections.METHODS We included 106 children with a confirmed diagnosis of respiratory mycoplasma infection who were admitted to our hospital from April 2017 to July 2019 and grouped them using a random number table.Among them,53 children each received clarithromycin or erythromycin.The clinical efficacy of both drugs was evaluated and compared.We performed the multiplex polymerase chain reaction(MP-PCR)test and determined the MP-PCR negative rate in children after the end of the treatment course.We compared the incidence of toxic and side effects,including nausea,diarrhea,and abdominal pain;further,we recorded the length of hospitalization,antipyretic time,and drug costs.Additionally,we evaluated and compared the compliance of the children during treatment.RESULTS The erythromycin group showed a significantly higher total effective rate of clinical treatment than the clarithromycin group.MP-PCR test results showed that the clarithromycin group had a significantly higher MP-PCR negative rate than the erythromycin group.Moreover,children in the clarithromycin group had shorter fever time,shorter hospital stays,and lower drug costs than those in the erythromycin group.The clarithromycin group had a significantly higher overall drug adherence rate than the erythromycin group.The incidence of toxic and side effects was significantly lower in the clarithromycin group than in the erythromycin group(P<0.05).CONCLUSION Our findings indicate that clarithromycin has various advantages over erythromycin,including higher application safety,stronger mycoplasma clearance,and higher medication compliance in children;therefore,it can be actively promoted.

Can the detection of IgA anti-Mycoplasma pneumoniae added to IgM increase diagnostic accuracy in patients with infections of the lower respiratory airways?

AIM To evaluate the increase in diagnostic yield, by using IgA in addition to IgM, instead of IgM alone, in relation to the age of the patients.METHODS The study considered 1067 blood samples from patients with clinical signs of lower respiratory tract infections, tested for anti-Mycoplasma IgG, IgM and IgA antibody.RESULTS The increase in diagnostic yield with IgA, compared to IgM detection alone was of 3.5% with statistically significant differences between age groups(0.8% for those equal/under 50 years of age and 4.3% for those over 50).CONCLUSION Our findings demonstrate that IgA detection lead to a twofold increase in the number of diagnoses among the older age groups, but it did not result in relevant increase among the younger age groups.

COVID-19 Coronavirus: Is Infection along with <i>Mycoplasma</i>or Other Bacteria Linked to Progression to a Lethal Outcome?

Most patients with COVID-19 disease caused by the SARS-CoV-2 virus recover from this infection, but a significant fraction progress to a fatal outcome. As with some other RNA viruses, co-infection or activation of latent bacterial infections along with pre-existing health conditions in COVID-19 disease may be important in determining a fatal disease course. Mycoplasma spp. (M. pneumonaie, M. fermentans, etc.) have been routinely found as co-infections in a wide number of clinical conditions, and in some cases this has progressed to a fatal disease. Although preliminary, Mycoplasma pneumoniae has been identified in COVID-19 disease, and the severity of some signs and symptoms in progressive COVID-19 patients could be due, in part, to Mycoplasma or other bacterial infections. Moreover, the presence of pathogenic Mycoplasma species or other pathogenic bacteria in COVID-19 disease may confer a perfect storm of cytokine and hemodynamic dysfunction, autoimmune activation, mitochondrial dysfunction and other complications that together cannot be easily corrected in patients with pre-existing health conditions. The positive responses of only some COVID-19 patients to antibiotic and anti-malaria therapy could have been the result of suppression of Mycoplasma species and other bacterial co-infections in subsets of patients. Thus it may be useful to use molecular tests to determine the presence of pathogenic Mycoplasma species and other pathogenic bacteria that are commonly found in atypical pneumonia in all hospitalized COVID-19 patients, and when positive results are obtained, these patients should treated accordingly in order to improve clinical responses and patient outcomes.

New Research Progress in Mycoplasma pneumoniae Infection

As an important pathogen of respiratory tract infection, Mycoplasma pneumoniae (MP) may not only lead to primary atypical pneumonia but also cause systemic organ conditions.MP causes respiratory tract infection among school-age children and is also an important infectious agent for adult respiratory tract infection. Intensive studies on roles of MP infection on the innate immune system significantly aid development of targeted therapy drugs. Epidemic studies on associated symptoms also help in clinical prevention and diagnosis and show importance to personalized treatment utilizing different drugs for different patients. This study summarizes the abovementioned three points based on MP studies in recent years.

Status of <i>Mycoplasma pneumoniae</i>Pneumonia in Chinese Children: A Systematic Review

Mycoplasma pneumoniae pneumonia (MPP) becomes one of the most important health problems in China recently. Date for MPP inChinais scarce. Although macrolides and/or cortical steroids had been reported to be effective treatment for MPP, the long-term outcome remained uncertain. A study on status of MPP in China was conducted via a systematic review of published studies which have the Chinese data and collected from published PubMed and core journals of China Knowledge Resource Integrated Database (CNKI). The analysis was based on epidemiology, clinical characteristics, treatment, drug resistance and prognosis. Twenty five articles concerned about MPP in Chinese children and adolescent were enrolled, including 11 studies on epidemiology/etiology, 11 studies on clinical characteristics, 7 studies on drug resistance, 5 studies on treatment from China's Mainland respectively. The overall incidence of MPP ranged from 7.1% to 54.4%. Fever and cough were most frequently identified in manifestations. Drug resistance to macrolides ranged from 18.9% to 90%. The outcome of treatment in patients who received combined treatment of macrolides, cephalosporin antibiotics and/or cortical steroid seems to be better than those who received macrolides only. Macrolide combined with cephalosporin or cortical steroid both may decrease the severity of MPP in the past decade. There was not enough evidence to suggest that cortical steroid can decrease the mortality of MPP in children. And a multi-center, randomized double blind research on the effect of cortical steroid was encouraged.

Serum inflammatory markers in children with Mycoplasma pneumoniae pneumonia and their predictive value for mycoplasma severity

BACKGROUND Mycoplasma pneumoniae pneumonia(MPP)significantly impacts pediatric health,necessitating markers for early severe disease identification.AIM To investigate the correlation between serum inflammatory marker and the severity of MPP in children.METHODS A prospective study was carried out from January 2023 to November 2023.A total of 160 children with MPP who underwent treatment were selected:80 had severe MPP and 80 had mild MPP.Clinical and laboratory data were collected at the time of hospital admission and during hospitalization.Receiver operating characteristic curves were utilized to assess the diagnostic and prognostic for severe MPP.RESULTS Fever duration and length of hospitalization in pediatric patients with severe MPP exceeded those with mild MPP.The incidence of pleural effusion,lung consolidation,and bronchopneumonia on imaging was markedly elevated in the severe MPP cohort compared to the mild MPP cohort.In contrast to the mild cohort,there was a notable increase in C-reactive protein(CRP),procalcitonin(PCT),erythrocyte sedimentation rate,lactic dehydrogenase,D-dimer,and inflammatory cytokines[interleukin(IL)-6,IL-8,IL-10 and tumor necrosis factor(TNF)-α]in the severe MPP group were significantly higher.CONCLUSION Serum inflammatory markers(CRP,PCT,IL-6,D-dimer,IL-10 and TNF-α)were considered as predictors in children with severe MPP.

Association between gastrointestinal heat retention syndrome and respiratory tract infections in children:A prospective cohort study

Objective:To explore the relationship between gastrointestinal heat retention syndrome and the incidence of pneumonia and recurrent respiratory tract infections(RRTIs)in children.Methods:A prospective cohort study was conducted in the pediatric outpatient department of Beijing Dongfang Hospital.Children without respiratory tract infections(RTIs)were consecutively recruited according to the selection criteria.A semi-structured questionnaire was used to record traditional Chinese medicine(TCM)symptoms and demographic and physiological characteristics.Gastrointestinal heat retention syndrome was considered to be a predisposing factor and was diagnosed according to a scale with reliability and validity.The participants were followed up for 12 months.Participants and their parents or guardians were contacted via clinical interviews and telephone every 6 months.Episodes of pneumonia and RTIs were recorded in detail.Results:A total of 420 children were included.Of participants,370(88.10%)were followed up for 12 months.The mean number of RTI episodes per participant was 5.37(95%CI:5.14 to 5.60).In total,186 participants in the gastrointestinal heat retention syndrome group and 184 participants in the nongastrointestinal heat retention syndrome group completed the 12-month follow-up period.The baseline of both groups was comparable.The incidence of RRTIs in children with gastrointestinal heat retention syndrome was 1.27(95%CI:1.01 to 1.59)times that in children without gastrointestinal heat retention syndrome.Logistic regression analysis revealed that abnormally increased appetite with frequent hunger,foul breath,dry stools,and dark red or purple fingerprints were positively correlated with the incidence of pneumonia.Irascibility and feverish feelings in the palms and soles were positively correlated with the occurrence of RRTI.Conclusions:Gastrointestinal heat retention syndrome is a risk factor for RRTIs in children.Studies with larger sample sizes and longer follow-up time are warranted to confirm the degree of causal risk associated with RTIs.

血清PCT、CRP及IL-4水平预测小儿支原体肺炎病情严重程度的价值

目的:探讨血清降钙素原(PCT)、C反应蛋白(CRP)及白细胞介素-4(IL-4)水平预测支原体肺炎患儿病情严重程度的价值。方法:选取2019年1月—2023年1月淮安市第二人民医院儿科收治的102例支原体肺炎患儿作为研究对象,根据病情将患儿分为轻症组59例和重症组43例。比较两组临床资料及基质细胞衍生因子(CXCL12)、γ干扰素(IFN-γ)、硫化氢(H_(2)S)、超氧化物歧化酶(SOD)、基质金属蛋白酶-9(MMP-9)、PCT、CRP及IL-4水平,多因素分析采取非条件logistic逐步回归分析,采用ROC曲线分析PCT、CRP及IL-4水平对重症支原体肺炎的预测价值。结果:两组性别、年龄、病程及CXCL12、IFN-γ、H_(2)S、SOD、MMP-9水平比较,差异无统计学意义(P>0.05);重症组PCT、CRP、IL-4水平显著高于轻症组,差异有统计学意义(P<0.05)。logistic逐步回归分析结果显示,PCT、CRP及IL-4为重症支原体肺炎独立危险因素(P<0.05)。ROC分析显示,PCT、CRP及IL-4预测重症支原体肺炎的曲线下面积分别为0.896、0.851、0.787。结论:血清PCT、CRP及IL-4水平均参与支气管肺炎患儿的病情进展,且可作为重症支气管肺炎的诊断指标。

金花清感颗粒联合布地奈德、沙丁胺醇、异丙托溴铵三联雾化吸入疗法在儿童肺炎支原体肺炎中的应用观察

目的分析金花清感颗粒联合布地奈德、沙丁胺醇、异丙托溴铵三联雾化吸入治疗儿童肺炎支原体肺炎(MPP)的效果。方法前瞻性选取2022年2月—2023年2月常熟市第二人民医院收治的114例MPP患儿为研究对象,按照随机数字表法分为对照组、研究组,每组57例。对照组给予布地奈德、沙丁胺醇、异丙托溴铵三联雾化吸入治疗,研究组在对照组基础上给予金花清感颗粒,连续治疗10 d评估效果。比较两组症状改善情况、肺功能、临床疗效、气道重塑指标、炎症因子、T淋巴细胞亚群及药物不良反应发生情况。结果研究组发热消退时间、咳嗽消失时间、肺部啰音消失时间均短于对照组(P<0.05)。研究组治疗前后的达峰时间比、达峰容积比、呼吸频率的差值均高于对照组(P<0.05)。研究组总有效率高于对照组(P<0.05)。研究组治疗前后的气道壁厚度/外径比值、气道面积/总横截面积比值的差值均高于对照组(P<0.05)。研究组治疗前后的超敏C反应蛋白、白细胞介素-6、肿瘤坏死因子-α的差值均高于对照组(P<0.05)。研究组治疗前后的CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)的差值均高于对照组(P<0.05)。两组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论金花清感颗粒联合布地奈德、沙丁胺醇、异丙托溴铵三联雾化吸入治疗儿童MPP疗效显著,可改善肺功能,抗气道重塑,抑制炎症反应,改善T淋巴细胞亚群,且安全性良好。

膳食模式与学龄期肺炎支原体肺炎患儿疾病复发的关系

目的:探讨学龄期肺炎支原体肺炎患儿膳食模式与疾病复发的关系。方法:选取2018年7月—2024年3月在本院确诊的学龄期肺炎支原体肺炎患儿160例,并定期在营养科进行营养咨询,均进行问卷调查、体格检查和实验室检测,采用因子分析提取膳食模式,采用多因素Logistic回归模型分析膳食模式与反复呼吸道感染的关系。结果:复发与未复发患儿在年龄、BMI、MP抗体阳性比例、用免疫增强剂比例、CD4+/CD8+、IgA方面比较,P<0.05,在性别、用抗过敏药比例、用锌剂比例、CD3+、IgG、IgM方面比较,P>0.05;高水平的肉食模式、高水平的素食模式与反复呼吸道感染复发相关,在调整混杂因素以后,高水平肉食模式是反复呼吸道感染复发的危险因素(OR=2.52,95%CI:1.17~5.21),同时高水平的素食模式是反复呼吸道感染复发的保护因素(OR=0.37,95%CI:0.19~0.86)。结论:学龄期肺炎支原体肺炎患儿的膳食模式与疾病复发之间存在着关联性,在学龄期肺炎支原体肺炎患儿的治疗和预防中,应当重视膳食的合理搭配和调节,尤其需要控制肉类的摄入量,适当增加蔬果、谷物、豆类等植物性食物的比例,以提高免疫力,降低呼吸道感染的风险。

槐杞黄颗粒联合甲泼尼龙琥珀酸钠对肺炎支原体感染致大叶性肺炎患儿临床症状、炎症因子及免疫功能的影响

目的:观察槐杞黄颗粒联合甲泼尼龙琥珀酸钠对肺炎支原体感染致大叶性肺炎患儿临床症状、炎症反应及免疫功能的影响。方法:选取2020年1月~2022年12月某院收治的150例肺炎支原体感染致大叶性肺炎患儿为研究对象,采用随机数字表法分为对照组和观察组,每组75例。对照组在常规治疗基础上加用甲泼尼龙琥珀酸钠,观察组在对照组治疗基础上加用槐杞黄颗粒。比较两组患儿中医证候积分、炎症因子[高迁移率族蛋白B1(HMGB1)、降钙素原(PCT)、白细胞介素-17(IL-17)、IL-35]、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、临床症状(发热、咳喘、肺部阴影)改善时间以及临床疗效。结果:治疗前,两组中医证候积分比较无统计学差异(P>0.05);治疗后,两组中医证候主症积分、次症积分和总积分均降低,且观察组各项积分均低于对照组(P<0.05)。治疗前,两组HMGB1、PCT、IL-17、IL-35等炎症因子水平比较均无统计学差异(P>0.05);治疗后,两组HMGB1、PCT、IL-17均降低,IL-35均升高(P<0.05),且观察组HMGB1、PCT、IL-17低于对照组,IL-35高于对照组(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较无统计学差异(P>0.05);治疗后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均升高,且观察组各指标高于对照组(P<0.05)。观察组退热、咳喘消失、肺部阴影消失时间均短于对照组(P<0.05),且临床治疗总有效率高于对照组(P<0.05)。结论:槐杞黄颗粒联合甲泼尼龙琥珀酸钠可有效减轻肺炎支原体感染致大叶性肺炎患儿的炎症反应,提高免疫功能,加快临床症状的改善和消失。

辨证推拿辅助治疗小儿难治性支原体肺炎的效果观察

目的分析辨证推拿辅助治疗小儿难治性支原体肺炎(RMPP)对炎症指标、肺功能的影响。方法选择河北省第七人民医院2022年9月—2023年8月就诊的320例RMPP患儿为研究对象,根据治疗方法不同将其分为2组,每组160例。西医组给予常规抗炎等对症治疗,推拿组在西医组基础上给予辨证推拿治疗。比较2组临床疗效、临床症状消失时间、肺功能指标、血清炎症因子、免疫功能指标、不良反应总发生率。结果推拿组临床总有效率高于西医组,差异有统计学意义(P<0.05)。推拿组发热、咳嗽、咳痰、肺部湿啰音消失时间均较西医组更短,差异有统计学意义(P<0.05)。推拿组治疗后最大呼气流量(PEF)、最大呼气中期流量(MMEF)、用力肺活量(FVC)均较西医组更高,血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平均较西医组更低,差异有统计学意义(P<0.05)。推拿组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较西医组更高,CD8^(+)较西医组更低,差异有统计学意义(P<0.05)。推拿组不良反应总发生率与西医组比较,差异无统计学意义(P>0.05)。结论辨证推拿联合西药可有效缓解RMPP患儿发热、咳嗽等症状,减轻炎症反应,改善肺功能及免疫功能,且不良反应较少。

儿童肺炎支原体肺炎的病理及影像学表现特点

肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)是我国儿童社区获得性肺炎中最常见的类型,早期识别危重症病例、合理救治、减少后遗症是MPP诊治的关键。MPP发病机制在于肺炎支原体对呼吸道的直接损伤和宿主异常免疫应答,病理表现包括肺气道及肺间质炎、塑形性支气管炎、肺泡炎性渗出、坏死性肺炎、肺栓塞及胸腔积液等。影像学对MPP病情严重程度判断和预后评估有重要作用。MPP影像学表现主要有塑形性支气管炎、树芽征、小叶中心结节、树雾征、肺实变、肺坏死、肺栓塞、胸腔积液等。其中,肺坏死和肺栓塞是诊断重症MPP的重要指征。肺坏死临床症状以持续高热和C反应蛋白明显升高为特点。肺栓塞表现包括胸痛和/或咯血、D-二聚体升高和血性胸腔积液。本文结合相关研究进展,通过图文解析MPP影像学表现、相关的发病机制及病理表现,总结各影像学征象与MPP临床特点的关系,旨在提高儿科医生和放射科医生对儿童MPP的认识。