加味五虎汤联合阿奇霉素干混悬剂治疗痰热闭肺型小儿支原体肺炎临床研究  

Modified Wuhu Decoction Combined with Azithromycin in Treatment of Mycoplasma Pneumonia in Children with Phlegm-Heat Obstructing Lung Syndrome

作　　者：刘玲[1] 姚宝珍[1] 

机构地区：[1]武汉大学人民医院,湖北武汉430060

出　　处：《中医学报》2017年第3期352-356,共5页Acta Chinese Medicine

基　　金：武汉大学人民医院青年孵化基金项目(RMFH0001)

摘　　要：目的:观察加味五虎汤联合阿奇霉素干混悬剂对痰热闭肺型小儿支原体肺炎临床疗效及血清炎性因子的影响。方法:76例小儿支原体肺炎随机平均分为对照组和观察组。对照组给予阿奇霉素干混悬剂口服治疗,观察组在对照组治疗基础上给予加味五虎汤治疗。比较两组治疗前后免疫因子、细胞因子水平,主要症状体征消失时间,临床疗效。结果:与治疗前比较,两组外周血CD_4^+、CD_4^+/CD_8^+水平升高(P<0.05),CD_8^+水平降低(P<0.05),免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白A(immunoglobulin A,IgA)以及免疫球蛋白M(Immunoglobulin M,IgM)水平升高(P<0.01),白细胞介素-6(interleukin-6,IL-6)、IL-8、干扰素-γ(interferon-γ,IFN-γ)以及肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)水平降低(P<0.01);与对照组比较,观察组外周血CD_4^+、CD_4^+/CD_8^+水平较高(P<0.05),CD_8^+水平较低(P<0.05),IgG、IgA以及IgM水平较高(P<0.01),IL-6、IL-8、IFN-γ以及TNF-α水平较低(P<0.01);与对照组比较,发热、咳嗽、喘息以及肺部干湿啰音等症状体征消失时间均较短(P<0.01);观察组临床疗效显著高于对照组(P<0.01)。结论:加味五虎汤联合阿奇霉素干混悬剂治疗痰热闭肺型小儿支原体肺炎疗效显著,能明显改善症状体征,降低促炎因子表达,提高机体免疫能力。Objective：To investigate the clinical efficacy of modified Wuhu Decoction combined with azithromycin in treatment of mycoplasma pneumonia in children with Phlegm-Heat Obstructing Lung Syndrome and the effect on serum inflammatory factors. Methods：Seventy-six children with mycoplasma pneumonia were selected and randomly divided into 2 groups, with 38 cases in each group. Azithromycin was administered orally in the control group, and the observation group was treated with modified Wuhu Decoction in addition to that of the control group. The levels of immune factors, cytokines, the time of disappearance of main symptoms and signs as well as the clinical curative efficacy of both groups were compared before and after treatment. Results ： Compared with that before treatment,levels of peripheral blood CD4^＋ and CD4^＋/CD8^＋ in both groups increased （P 〈 0.05 ） ,levels of CD8^＋ decreased （P 〈0.05） ,levels of IgG,IgA and IgM increased （P 〈0.01 ） ,levels of IL-6,IL-8 ,IFN-γ and TNF-α decreased （P 〈 0.01 ）. Compared with that of the control group,levels of serum CD4^＋ and CD4^＋/CD8^＋ of the experiment group were higher afterthe treatment,levels of CD8^＋ were lower （ P 〈 0.05 ） ,levels of IgG, IgA and IgM were higher （ P 〈 0.01 ）, levels of IL-6, IL-8, IFN-γ, and TNF-α were lower （ P 〈 0.01 ）, The disappearance time fever, cough, wheezing, pulmonary rales and other symptoms was shorter （P 〈 0.01 ）. The clinical efficacy was higher （ P 〈 0.01 ）. Conclusion ： Modified Wuhu Decoction combined with azithromycin in treatment of mycoplasma pneumonia in children with Phlegm-Heat Obstructing Lung Syndrome were effective, which can significantly improve the symptoms and signs, reduce the expression of inflammatory factor and improve immunity.

关 键 词：支原体肺炎 痰热闭肺证 阿奇霉素干混悬剂 加味五虎汤 炎性因子 中西医结合 

分 类 号：R259.631[医药卫生—中西医结合]