摘要
目的:探讨痰热浓煎剂联合阿奇霉素治疗儿童肺炎支原体肺炎(mycoplasmal pneumoniae pneumonia,MPP)痰热闭肺证的临床效果。方法:选取2018年1月至2019年6月南京市中西医结合医院收治的94例MPP痰热闭肺证患儿,采取简单随机数字表法分为观察组和对照组,每组47例。对照组患儿给予阿奇霉素治疗,观察组患儿在对照组基础上内服痰热浓煎剂治疗,均治疗10 d。比较两组患儿的临床疗效及主要症状、体征改善情况,观察治疗前后咳嗽症状积分、外周血中性粒细胞绝对值与淋巴细胞绝对值比值(NLR)和血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、丙二醛(MDA)及超氧化物歧化酶(SOD)水平变化情况,记录不良反应发生情况。结果:观察组患儿的总有效率为95.74%(45/47),明显高于对照组的82.98%(39/47),差异有统计学意义(P<0.05)。治疗后,观察组患儿的主要症状、体征(发热、咳嗽及肺部啰音)改善时间均明显短于对照组,胸部X线检查阴影消失率明显高于对照组,差异均有统计学意义(P<0.05);两组患儿的日间、夜间咳嗽积分均较治疗前明显降低,且观察组患儿降低更明显,差异均有统计学意义(P<0.05);两组患儿外周血NLR和血清TNF-α、IL-6及MDA水平均较治疗前明显降低,血清SOD水平均较治疗前明显升高,且观察组患儿上述指标改善情况均明显优于对照组,上述差异均有统计学意义(P<0.05)。所有患儿均未见严重不良事件发生。结论:痰热浓煎剂联合阿奇霉素治疗儿童MPP痰热闭肺证的整体疗效确切,可明显缩短患儿相关症状、体征的缓解时间,其可能通过下调患儿血中相关炎症因子表达水平、纠正机体氧化/抗氧化失衡的方式来发挥作用。
OBJECTIVE:To probe into the clinical effects of phlegm-heat concentrated decoction combined with azithromycin in the treatment of Mycoplasmal pneumoniae pneumonia(MPP)in children with phlegm-heat closed lung syndrome.METHODS:Totally 94 children with MPP and phlegm-heat closed lung syndrome admitted into Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine from Jan.2018 to Jun.2019 were extracted to be divided into the observation group and the control group via the random number table,with 47 cases in each group.The control group was treated with azithromycin,while the observation group received phlegm-heat concentrated decoction on the basis of the control group.Both groups were treated for 10 d.Clinical efficacy and improvement of main symptoms and signs of two groups were compared,cough symptom score,absolute ratio of neutrophils to lymphocytes(NLR)in peripheral blood,and serum TNF-αlevels,interleukin 6(IL-6),malondialdehyde(MDA)and superoxide dismutase(SOD)levels of two groups were observed.The incidence of adverse drug reactions were recorded.RESULTS:The total effective rate of children in the observation group was 95.74%(45/47),significantly higher than 82.98%(39/47)in the control group,and the difference was statistically significant(P<0.05).After treatment,the improvement time of main symptoms and signs(fever,cough and lung rales)in the observation group was significantly shorter than that in the control group,and the disappearance rate of the shadow in the chest X-ray examination was significantly higher than that in the control group,with statistically significant differences(P<0.05).The scores of daytime and nighttime cough in two groups were significantly lower than those before treatment,and those in the observation group were significantly lower,with statistically significant difference(P<0.05).The NLR,serum TNF-α,IL-6 and MDA levels in peripheral blood of two groups were significantly lower than those before treatment,while the serum SOD levels were significantly higher than those before treatment,the improvement of these indicators in the observation group was significantly better than that in the control group,with statistically significant differences(P<0.05).None of the children had severe adverse drug reactions.CONCLUSIONS:The efficacy of phlegm-heat concentrated decoction combined with azithromycin in the treatment of MPP is significant,which can significantly reduce the remission time of children’s related symptoms and signs,and may play a role by reducing the expression level of related inflammatory factors in the blood of children and correcting the imbalance of oxidation/anti-oxidation in the body.
作者
刘坤
陈超
LIU Kun;CHEN Chao(Dept.of Pediatrics,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu Nanjing 210014,China)
出处
《中国医院用药评价与分析》
2020年第2期186-189,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
南京市卫计委一般课题(No.YKK17193).
关键词
肺炎支原体肺炎
儿童
痰热闭肺证
痰热浓煎剂
阿奇霉素
炎症因子
氧化应激
Mycoplasma pneumoniae pneumonia
Children
Phlegm-heat closed lung syndrome
Phlegm-heat concentrated decoction
Azithromycin
Inflammatory factor
Oxidative stress
作者简介
刘坤,主治医师,硕士。研究方向:小儿肺脾系疾病。E-mail:shdjok108@tom.com;通信作者:陈超,副主任医师,博士。研究方向:小儿肺系疾病。E-mail:ZCHcjcc@163.com
