漏芦升麻汤联合阿奇霉素对邪热壅肺型支原体肺炎患儿调节性T细胞及Foxp3 mRNA表达的影响  

Efficacy of Loulu Shengma Tang Combined with Azithromycin in Treating Children with Mycoplasma Pneumonia with Obstruction of Lung by Pathogenic Heat and Its Effect on Treg and Foxp3 mRNA

作　　者：张辉果[1] 董志巧[1] 王晓利[1] 陈团营[1] 田新磊[1] ZHANG Hui-guo;DONG Zhi-qiao;WANG Xiao-li;CHEN Tuan-ying;TIAN Xin-lei(Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou 450009,China)

机构地区：[1]河南省中医院,郑州450009

出　　处：《中国实验方剂学杂志》2020年第15期90-96,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：河南省卫生厅科技创新人才项目(172102310322)。

摘　　要：目的:探讨漏芦升麻汤联合阿奇霉素治疗小儿邪热雍肺型小儿支原体肺炎(MPP)的临床疗效,以及对患儿调节性T细胞及核转录因子叉状头/翅膀状螺旋转录因子3(Foxp3)mRNA表达的影响。方法:将274例MPP患儿随机分为观察组与对照组,每组各137例。观察组给予漏芦升麻汤联合阿奇霉素干混悬剂治疗,对照组单独给予阿奇霉素干混悬剂治疗。观察两组患儿治疗后体征、临床症状消失时间、中医邪热雍肺证评分、血清炎症因子白细胞介素-6(IL-6),白细胞介素-10(IL-10),肿瘤坏死因子-α(TNF-α),C反应蛋白(CRP),CD4^+CD25^+Treg和CD4^+Foxp3^+Treg及Foxp3 mRNA表达水平变化情况。比较两组患儿的临床疗效及不良反应发生率。结果:治疗后观察组总有效率94.16%(129/137),高于观察组(77.37%,106/137)(P<0.05);观察组患儿治疗后咳嗽、肺部啰音的消失时间、退热时间及X射线检查肺部阴影消失时间均短于对照组(P<0.05);治疗后观察组中医邪热雍肺证评分的改善情况优于对照组(P<0.05);治疗后观察组血清IL-6,IL-10,TNF-α和CRP水平较对照组降低明显(P<0.05,P<0.01),观察组CD4^+CD25^+Treg,CD4^+Foxp3^+Treg及Foxp3 mRNA表达水平明显高于对照组(P<0.05)。不良反应的发生率观察组(7/137,5.11%)低于对照组(16/137,11.68%)。结论:漏芦升麻汤联合阿奇霉素干混悬剂治疗小儿邪热雍肺型MPP的临床疗效明显,可明显改善患儿病证,对患儿调节性T细胞及Foxp3 mRNA表达的影响优于单用阿奇霉素干混悬剂,具有效性,且不良反应的发生率较单用阿奇霉素干混悬剂低。Objective:To investigate the clinical efficacy of Loulu Shengma Tang combined with azithromycin in the treatment of pediatric mycoplasma pneumoniae pneumonia(MPP)with obstruction of lung by pathogenic heat,and its effect on inflammatory factors,treg and Foxp3 mRNA.Method:Totally 274 children with MPP were divided into observation group(137 cases)and control group(137 cases).Observation group was treated with Loulu Shengma Tang combined with azithromycin dry suspension,while control group was treated with azithromycin dry suspension alone.The changes of traditional Chinese medicine(TCM)syndrome score of pathogenic-heat obstruction in the lung,serum inflammatory cytokines[interleukin-6(IL-6),interleukin-10(IL-10),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)],CD4^+CD25^+Treg,CD4^+Foxp3^+Treg and Foxp3 mRNA expressions were observed after treatment.The clinical efficacy and the incidence of adverse reactions were compared between two groups.Result:The total effective rate of observation group was 94.16%(129/137)after treatment,which was significantly higher than 77.37%(106/137)of observation group(P<0.05).The disappearance times of cough,lung rale,fever and lung shadow in observation group were shorter than that in control group(P<0.05).After treatment,TCM syndrome score of pathogenic-heat obstruction in lung was significantly higher than those in control group(P<0.05),serum IL-6,IL-10,TNF-αand CRP levels in observation group were significantly lower than those in control group(P<0.05,P<0.01),while CD4^+CD25^+Treg,CD4^+Foxp3^+Treg and Foxp3 mRNA expressions were significantly higher than those in control group(P<0.05).The incidence of adverse reactions in observation group was 7/137(5.11%),which was significantly lower than 16/137(11.68%)in control group.Conclusion:The clinical efficacy of Loulu Shengma Tang combined with azithromycin dry suspension in the treatment of pediatric MPP and its effect on serum inflammatory factors(IL-6,IL-10,TNF-α,CRP),regulatory T cells and Foxp3 mRNA expressions were bett

关 键 词：漏芦升麻汤 阿奇霉素 小儿支原体肺炎 邪热雍肺 调节性T细胞 核转录因子叉状头/翅膀状螺旋转录因子3(Foxp3)mRNA 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]