麻杏三仁汤加减治疗耐药肺炎支原体肺炎的疗效观察  

Clinical Observation on Modified Maxing Sanren Decoction in Treatment of Drug-resistant Mycoplasma Pneumoniae

作　　者：姚凤莉[1] 胡波[1] 任艳霞[1] 辛得莉[2] 

机构地区：[1]北京军区总医院附属八一儿童医院儿童内科,北京100700 [2]首都医科大学附属北京友谊医院儿科,北京100050

出　　处：《辽宁中医杂志》2013年第5期935-937,共3页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:观察麻杏三仁汤加减对耐药肺炎支原体(MP)菌株感染致肺炎支原体肺炎(MPP)的临床疗效。方法:选取2010年9月—2011年3月在本院儿科住院的确诊为MPP患儿70例,在常规肺炎治疗原则的基础上,根据是否服用加减麻杏三仁汤分为治疗组和对照组。患儿入院后取咽拭子标本应用巢式PCR和DNA测序技术直接检测MP耐药基因。分离出耐药株63例,观察两组耐药MPP患儿住院天数、发热时间、咳嗽及肺部啰音变化等。结果:治疗组和对照组在性别、治疗前热程、胸部X线、胸腔积液、咳嗽天数、有痰例数、白细胞、中性粒细胞、C反应蛋白、血沉方面的比较差异均无统计学意义(P>0.05)。治疗组退热时间、X线吸收时间均短于对照组,差异具有统计学意义(P<0.05)。治疗组总有效率84%,对照组总有效率54.8%,两组比较差异具有统计学意义(P<0.05)。治疗组咳嗽、啰音消失时间短于对照组,但无显著性差异(P>0.05)。结论:临床MP分离株对大环内酯类抗生素耐药严重。联合麻杏三仁汤加减能缩短热程、X线吸收时间、啰音吸收时间、咳嗽消失时间,对耐药MPP有一定疗效。Objective：To observe the clinical efficacy of modified Maxing Sanren Decoction in treatment of mycoplasma pneu- moniae pneumonia（MPP） infected with drug-resistant mycoplasma pneumoniae （MP） strain. Methods ： 70 cases of children with MPP in our hospital from September 2010 to March 2011 were divided into treatment group on the basis of the principles~ of con- ventional treatment for pneumonia, according to whether taking modified Maxing Sanren Decoction and the control group. Children admitted to hospital took a throat swab specimens applications by nested PCR and DNA sequencing technology was used to direct- ly detect the resistance gene of MP. Isolated from 63 cases of drug - resistant strains, two groups were observed MPP hospital stay, duration of fever, cough and pulmonary rales change. Results ： The treatment group and control group had no significant difference in gender, pre-treatment of fever, chest Xc-ray, pleural effusion, cough sputum cases the number of white blood cells, neutrophi!s, C-reactive protein, erythrocyte sedimentation rate （P 〉 0. 05）. The cooling time of the treatment group and X-ray absorption time were shorter than those in the control group,with significant differences（P 〈 0. 05 ）. The total effective rate of treatment group was 84% , and it was 54.8% in the control group and there was significant differences （P 〈 0. 05 ）. The disappeared time of cough and rales in treatment group was shorter than that in the control group, but there was no significant difference （P 〉 0. 05 ）. Conclusion： MP isolates resistant to macrolide antibiotics seriously. The combination of Maxing Sanren Decoction can shorten the duration of fever, X-ray, rales absorption time, the cough disappeared time, which has a certain effect on the drug-resistant MPP.

关 键 词：麻杏三仁汤加减 肺炎支原体 抗生素 耐药性 

分 类 号：R563.1[医药卫生—呼吸系统]