加味葶苈大枣泻肺汤联合西医常规治疗对小儿支原体肺炎合并支气管哮喘急性发作患儿肠道菌群的影响  

Effect of modified Tingli Dazao Xiefei Decoction combined with conventional western medicine on intestinal flora of children with mycoplasma pneumonia of acute asthma exacerbation

作　　者：李霞[1] 白晓红[1] LI Xia;BAI Xiaohong(Department of Pediatrics,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Liaoning,Shenyang 110032)

机构地区：[1]辽宁中医药大学附属医院儿科,辽宁沈阳110032

出　　处：《河北中医》2021年第5期806-810,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划课题(编号:2017YFC1703202)。

摘　　要：目的观察加味葶苈大枣泻肺汤联合西医常规治疗对小儿支原体肺炎合并支气管哮喘急性发作肠道菌群的影响。方法将110例小儿支原体肺炎合并支气管哮喘急性发作患儿按照随机数字表法分为2组。对照组55例予常规西医治疗,治疗组55例在对照组治疗基础上予加味葶苈大枣泻肺汤治疗。2组均治疗2周。比较2组患儿治疗前后气喘、咳嗽、哮鸣音、憋喘症状消失时间及肠道菌群、炎症指标[嗜酸性粒细胞阳离子蛋白(ECP)、白细胞介素2(IL-2)、IL-4、IL-5、干扰素γ(IFN-γ)]、免疫功能指标(CD4+、CD8+、CD4+/CD8+),并统计2组疗效。结果治疗组总有效率97.78%(44/45),对照组总有效率55.32%(26/47),治疗组疗效优于对照组(P<0.05)。治疗组气喘、咳嗽、哮鸣音、憋喘症状消失时间均短于对照组(P<0.05)。治疗后2组粪便双歧杆菌、乳酸杆菌、双歧杆菌/肠杆菌均较本组治疗前升高(P<0.05),肠杆菌均降低(P<0.05),且治疗后治疗组双歧杆菌、乳酸杆菌、双歧杆菌/肠杆菌均高于对照组(P<0.05),肠杆菌低于对照组(P<0.05)。治疗后2组ECP、IL-4、IL-5均较本组治疗前降低(P<0.05),IL-2、IFN-γ均升高(P<0.05),且治疗后治疗组ECP、IL-4、IL-5均低于对照组(P<0.05),IL-2、IFN-γ均高于对照组(P<0.05)。治疗后2组CD4+、CD4+/CD8+均较本组治疗前升高(P<0.05),CD8+降低(P<0.05),且治疗后治疗组CD4+、CD4+/CD8+均高于对照组(P<0.05),CD8+低于对照组(P<0.05)。结论加味葶苈大枣泻肺汤联合西医常规治疗对小儿支原体肺炎合并支气管哮喘急性发作有着很好的临床疗效,且有着很好的调节肠道菌群、改善免疫功能的作用。Objective To observe the effect of modified Tingli Dazao Xiefei Decoction combined with conventional western medicine on intestinal flora of children with mycoplasma pneumonia of acute asthma exacerbation.Methods Totally 110 children with mycoplasma pneumonia of acute asthma exacerbation were randomly divided into two groups,55 cases in control group were treated with conventional western medicine,and 55 cases in treatment group were treated with modified Tingli Dazao xiefei Decoction on the basis of control group,treated for 2 weeks.The key observation was clinical symptoms(wheeze,cough,wheezing sound,time to symptoms disappear,intestinal flora),inflammatory index[eosinophil cationic protein(ECP),interleukin 2(IL-2),IL-4,IL-5,Interferonγ(IFN-γ)],immune function index[CD4+,CD8+,CD4+/CD8+],as well as clinical efficacy.Results The total effective rates were better in treatment group than in control group[97.78%(44/45)vs 55.32%(26/47),(P<0.05),respectively].The time to symptoms disappear(wheezing,cough,wheezing sound,asthma)was shorter in treatment group than in control group(P<0.05).Compared with before treatment,intestinal flora(bifidobacterium,lactobacillus,and bifidobacterium/escherichia coli)in groups were higher after treatment(P<0.05),which in treatment group were significantly increased(P<0.05);while escherichia coli in groups was lower after treatment(P<0.05),which in treatment group was significantly decreased(P<0.05);ECP,IL-4 and IL-5 in groups were lower after treatment(P<0.05),which in treatment group were significantly decreased(P<0.05);while IL-2 and IFN-γin groups were higher after treatment(P<0.05),which in treatment group were significantly increased(P<0.05);CD4+and CD4+/CD8+in groups were higher after treatment(P<0.05),which in treatment group were significantly increased(P<0.05);while CD8+in groups was lower after treatment(P<0.05),which in treatment group was significantly decreased(P<0.05).Conclusion For children with mycoplasma pneumonia of acute asthma exacerbation,modified Tingli Dazao Xi

关 键 词：葶苈大枣泻肺汤 肺炎 支原体 哮喘 儿童 胃肠道微生物组 

分 类 号：R563.13[医药卫生—呼吸系统] R256.12[医药卫生—内科学]