五虎汤加减联合阿奇霉素序贯疗法治疗痰热闭肺型小儿支原体肺炎疗效及对抗炎、促炎因子及呼吸功能的影响  

Clinical Efficacy of Modified Wuhutang Combined with Azithromycin Sequential Therapy on Anti-inflammatory,Proinflammatory Cytokines and Respiratory Function of Mycoplasmal Pneumoniae Pneumonia Children with Symptom of Phlegm-heat Obstructing Lung

作　　者：王勤[1] 张小方[2] 张爱娥 WANG Qin;ZHANG Xiao-fang;ZHANG Ai-e(Henan Province Hospital of Traditional Chinese Medicine, Zhengzhou 450002, China;Huanghuai University, Zhumadian 463000, China;Henan Medical College, Zhengzhou 451191, China)

机构地区：[1]河南中医药大学第二附属医院,郑州450002 [2]黄淮学院,河南驻马店463000 [3]河南医学高等专科学校,郑州451191

出　　处：《中国实验方剂学杂志》2018年第8期154-158,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省科技攻关计划项目(0324420083,122102310472);河南中医学院科技创新团队支持计划项目(2010XCXTD11)

摘　　要：目的：探讨五虎汤加减联合阿奇霉素序贯疗法治疗痰热闭肺型小儿支原体肺炎（mycoplasmal pneumoniae pneumonia,MPP）临床疗效及安全性。方法：以河南中医药大学第二附属医院在2015年3月—2016年12月收治的135例MPP患儿作为研究对象,随机数字表法分为治疗组（67例）、对照组（68例）。对照组MPP患儿应用阿奇霉素序贯疗法进行治疗,治疗组联合五虎汤加减进行治疗,清水煎煮,每日1剂,连续治疗14 d后,对比两组患儿临床疗效及治疗前后抗炎、促炎因子及呼吸功能的变化情况。结果：治疗组患者总有效率为94.03%,对照组为85.29%,治疗组高于对照组（P〈0.05）;与治疗前比较,治疗后,两组患儿血清中白细胞介素-2（interleukin-2,IL-2）水平明显升高,且治疗组明显高于对照组（P〈0.05）,白细胞介素-4（interleukin-4,IL-4）,白细胞介素-10（interleukin-10,IL-10）水平明显降低,且治疗组低于对照组（P〈0.05）;与本组治疗前比较,治疗后两组患儿血清中肿瘤坏死因子（tumor necrosis factor,TNF）-α,白细胞介素-6（interleukin-6,IL-6）与白细胞介素-8（interleukin-8,IL-8）水平均明显降低,且治疗组低于对照组（P〈0.05）;与本组治疗前比较,治疗后两组患儿动脉氧分压（arterial oxygen partial pressure,Pa O2）,氧合指数（Pa O2/Fi O2）水平明显升高,且治疗组高于对照组（P〈0.05）,呼吸频率（respiratory rate,RR）明显降低,且治疗组低于对照组（P〈0.05）;两组不良反应比较差异无统计学意义。结论：五虎汤加减联合阿奇霉素治疗痰热闭肺型MPP患儿疗效显著,可明显改善患儿抗炎/促炎因子失衡情况与呼吸功能,安全性较好。Objective： To study the clinical efficacy and safety of modified Wuhutang combined with azithromycin sequential therapy on anti-inflammatory, proinflammatory cytokines and respiratory function of mycoplasmal pneumoniae pneumonia children（MPP） with symptom of phlegm-heat obstructing lung. Method：Totally 135 cases MPP children treated in our hospital from March 2015 to December 2016 were selected and divided into two groups according to the admitted order,with 67 cases in clinical group and 68 cases in control group. Patients in control group were treated with azithromycin sequential therapy,while the clinical group was additionally given Wuhutang,which was decocted with clear water,one dose a day. Then the clinical efficacy,anti-inflammatory cytokines,proinflammatory cytokines and respiratory function of the two groups were compared after treatment for 14 days. Result： Compared with 85. 29% in control group,the total effective rate of clinical group was 94. 03%,with significant differences（P〈0. 05）. Compared with before treatment,interleukin（IL）-4 and IL-10 of two groups decreased after treatment,while IL-2 increased（P〈0. 05）. Compared with control group,the levels of IL-4 and IL-10 in patients of experimental group were lower after treatment,while IL-2 was higher（P〈0. 05）. Comparison of the levels of IL-6,tumor necrosis factor（TNF）-α and IL-8 before and after treatment between the two groups showed significant differences. The levels of inflammatory factors in treatment group were lower than those in control group（P〈0. 05）. Compared with before treatment,RR of two groups decreased after treatment,while arterial oxygen partial pressure（Pa O2） and Pa O2/Fi O2 increased（P〈0. 05）.Compared with control group, the respiratory rate（RR） in patients of experimental group was lower after treatment,while Pa O2 and Pa O2/Fi O2 were higher（P〈0. 05）. Conclusion： Modified Wuhutang is very effective in treating MPP. It can significantly improve the serum inflammato

关 键 词：五虎汤加减 小儿支原体肺炎 抗炎因子 促炎因子 呼吸功能 痰热闭肺型 

分 类 号：R22[医药卫生—中医基础理论] R24[医药卫生—中医学]