体外培育牛黄联合甲泼尼龙琥珀酸钠注射剂治疗难治性支原体肺炎的临床观察  

Clinical Obervation of In-vitro Cultured Calculus Bovis Combined with Methylprednisone Sodium Succinate Injection in the Treatment of Refractory Mycoplasma Pneumonia

作　　者：刘小雪 王莹[1] 陈鹏[1] 徐佳莉[1] 刘优靖 LIU Xiao-xue;WANG Ying;CHEN Peng;XU Jia-li;LIU You-jing(Respiratory Medicine,Wuhan Children's Hospital(Wuhan Maternal and Child Healthcare Hospital),Tongji Medical College,Huazhong University of Science&Technology,Wuhan,430016)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院(武汉市妇幼保健院)呼吸内科

出　　处：《中国中西医结合杂志》2019年第8期960-964,共5页Chinese Journal of Integrated Traditional and Western Medicine

摘　　要：目的探讨体外培育牛黄联合甲泼尼龙琥珀酸钠注射剂治疗小儿难治性支原体肺炎的作用及机制。方法采用回顾性研究方法,选取2016年6月-2017年10月于武汉市儿童医院呼吸内科治疗的96例难治性支原体肺炎患儿,根据患儿是否联合使用体外培育牛黄治疗分为对照组和试验组,每组48例。在常规抗感染等治疗及阿奇霉素干混悬剂口服治疗基础上[10 mg/(kg·d),每天1次,口服3天停4天,7天为1个治疗周期,共4个周期]对照组热程满7天联合应用甲泼尼龙琥珀酸钠注射剂[2 mg/(kg·d),每天1次,连续用药5天]治疗;试验组予体外培育牛黄(每次0.15 g,每天2次,疗程5天)联合甲泼尼龙琥珀酸钠注射剂治疗。观察两组治疗前后临床疗效体温恢复时间及住院天数、炎症因子[包括血清白细胞计数(WBC)、超敏C反应蛋白(CRP)、降钙素原(PCT)]及免疫学指标[包括免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、CD4、CD8、CD4/CD8)]水平变化。结果试验组治疗有效率[87.50%(42/48)]明显高于对照组[70.83(34/48),χ^2=5.12,P<0.05],试验组体温恢复时间及住院天数均少于对照组(P<0.05);与本组治疗前比较,两组患儿血清WBC、CRP、PCT、IgG、IgM、IgA及CD4、CD8、CD4/CD8水平均明显降低(P<0.05),且试验组各血清指标较对照组下降更明显(P<0.05)。结论体外培育牛黄联合甲泼尼龙琥珀酸钠注射剂治疗可提高难治性支原体肺炎患儿临床疗效。Objective To investigate the effect and mechanism of in-vitro cultured calculus bovis combined with methylprednisone sodium succinate injection in the treatment of refractory mycoplasma pneumonia in children.Methods A retrospective study method was used,96 cases of children with refractory mycoplasma pneumoniae pneumonia treated in the respiratory department of Children’s hospital of Wuhan from June 2016 to October 2017 were recruited and according to whether the child was treated with in-vitro cultured bezoar or not assigned control group and experimental group,48 cases in each group.On the basis of conventional anti-infection treatment and oral treatment of azithromycin dry suspension[10 mg/(kg·d)once daily,7 days as a treatment cycle with 3 days of oral administration followed by 4 days of discontinuation,4 cycles in total],patients in the control group were injected with methylprednisolone sodium succinate after 7 days of fever[2 mg(kg·d),once daily,use continuously for 5 days].Patients in the experimental group were treated with in-vitro cultured calculus bovis(0.15 g each time,2 times per day)combined with methylprednisolone sodium succinate.The clinical effect,temperature recovery time,hospitalization duration,inflammatory factors level changes[including serum white blood cell count(WBC),hypersensitive c-reactive protein(CRP),procalcitonin(PCT)]and Immunological indicators level changes[including immunoglobulin G(IgG),immunoglobulin M(IgM),immunoglobulin A(IgA),CD4,CD8,CD4/CD8)]were observed before and after treatment of the two groups.Results The treatment efficiency of the experimental group[87.50%(42/48)]was significantly higher than the control group[70.83(34/48),χ^2=5.12,P<0.05],the temperature recovery time and hospitalization duration of the experimental group were shorter than the control group(P<0.05).The Serum WBC,CRP,PCT,IgG,IgM,IgA,CD4,CD8,CD4/CD8 level of the children were significantly decreased after treatment in both groups(P<0.05),while the serum indexes of the experimental group decr

关 键 词：难治性支原体肺炎 体外培育牛黄 甲泼尼龙琥珀酸钠 

分 类 号：R72[医药卫生—儿科]