麻杏石甘汤联合电子支气管镜肺泡灌洗术治疗对儿童大叶性肺炎炎症因子和肺功能的影响  

Effect of Maxingshigan decoction combined with bronchoscopic lavage on inflammatory factors and lung function in children with lobar pneumonia

作　　者：高永伟 刘庆 胡玉玲 庞随军[1] 王栋梅[3] GAO Yong-wei;LIU Qing;HU Yu-ling;PANG Sui-jun;WANG Dong-mei(Department of Pediatrics,Affiliated Hospital of Yan'an University,Yan'an 716000,Shaanxi,CHINA;Department of Pediatrics,Traditional Chinese Medicine Hospital of Yulin,Yan'an 716000,Shaanxi,CHINA;Department of Pediatrics,Yan'an People's Hospital,Yan'an 716000,Shaanxi,CHINA)

机构地区：[1]延安大学附属医院儿科,陕西延安716000 [2]延安市中医院儿科,陕西延安716000 [3]延安市人民医院儿科,陕西延安716000

出　　处：《海南医学》2020年第16期2092-2095,共4页Hainan Medical Journal

摘　　要：目的探讨麻杏石甘汤联合电子支气管镜肺泡灌洗术治疗对儿童大叶性肺炎炎症因子和肺功能的影响。方法选择延安大学附属医院于2018年1月至2019年10月期间收治的70例大叶性肺炎患儿为研究对象,根据随机数表法将患儿随机分为观察组与对照组,每组35例,对照组患儿给予抗感染及电子支气管镜肺泡灌洗术治疗,观察组在此基础上联合麻杏石甘汤治疗,疗程均为14 d。比较两组患儿发热、咳嗽及肺部啰音消失时间、住院天数;比较两组患儿治疗前后血清中C反应蛋白(CRP)、白介素-6(IL-6)和白介素-8(IL-8)水平,以及肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、最高呼气流量(PEF)]。结果治疗后,观察组和对照组患儿的热退时间[(6.79±1.37)d vs(8.85±2.59)d]、啰音消失时间[(6.32±2.07)d vs(8.92±2.76)d]、咳嗽消失时间[(11.07±3.41)d vs(13.22±3.97)d]及住院时间[(12.28±2.88)d vs(14.79±4.08)d]比较,观察组明显短于对照组,差异均有统计学意义(P<0.05);治疗前,两组患儿的血清CRP、IL-6、IL-8水平比较差异均无统计学意义(P>0.05);治疗后,观察组和对照组患儿的血清CRP[(9.64±2.88)mg/L vs(14.36±3.16)mg/L]、IL-6[(5.36±1.73)ng/L vs(9.63±2.47)ng/L]、IL-8[(11.38±2.22)ng/L vs(13.96±3.14)ng/L]水平比较,观察组明显低于对照组,差异均有统计学意义(P<0.05);治疗前,两组患儿的FVC、FEV1及PEF比较差异均无统计学意义(P>0.05);治疗后,观察组和对照组患儿的FVC[(2.67±0.87)L vs(2.14±0.76)L]、FEV1[(2.26±0.34)L vs(1.91±0.27)L]及PEF[(5.10±1.22)L/s vs(4.06±1.19)L/s]水平比较,观察组明显高于对照组,差异均有统计学意义(P<0.05)。结论麻杏石甘汤联合电子支气管镜肺泡灌洗术治疗儿童大叶性肺炎可以有效降低患儿的炎症因子水平,改善患儿的肺功能,缩短病程。Objective To investigate the effect of Maxingshigan decoction combined with bronchoscopic lavage on inflammatory factors and lung function in children with lobar pneumonia.Methods A total of 70 children with lobar pneumonia,who admitted to the Affiliated Hospital of Yan'an University from January 2018 to October 2019,were selected and divided into the observation group and the control group according to random number table method,with 35 cases in each group.The children in the control group were given anti infection and bronchoscopic lavage treatment.On this basis,the observation group was given Maxingshigan Decoction for 14 days.The levels of CRP,IL-6,IL-8,forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)and peak expiratory flow(PEF)were compared before and after treatment.Results After treatment,the time of fever regression,rale disappearance,cough disappearance and hospitalization in the observation group were(6.79±1.37)d,(6.32±2.07)d,(11.07±3.41)d,(12.28±2.88)d,respectively,which were significantly shorter than corresponding(8.85±2.59)d,(8.92±2.76)d,(13.22±3.97)d,(14.79±4.08)d in the control group(all P<0.05).Before treatment,there was no significant difference in serum CRP,IL-6 and IL-8 between the two groups(P>0.05);after treatment,CRP,IL-6,IL-8 in the observation group were(9.64±2.88)mg/L,(5.36±1.73)ng/L,(11.38±2.22)ng/L,which were significantly lower than corresponding(14.36±3.16)mg/L,(9.63±2.47)ng/L,(13.96±3.14)ng/L in the control group(all P<0.05);before treatment,there was no significant difference in FVC,FEV1 and PEF between the two groups(all P>0.05);after treatment,FVC,FEV1,PEF in the observation group were(2.67±0.87)L,(2.26±0.34)L,(5.10±1.22)L/s,which were significantly higher than corresponding(2.14±0.76)L,(1.91±0.27)L,(4.06±1.19)L/s in the control group(all P<0.05).Conclusion Maxingshigan decoction combined with bronchoscopic lavage can effectively reduce the level of inflammatory factors,improve the lung function and shorten the course of disease.

关 键 词：麻杏石甘汤 电子支气管镜肺泡灌洗术 大叶性肺炎 炎症因子 肺功能 

分 类 号：R725.6[医药卫生—儿科]