麻杏石甘汤加味联合阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎痰热闭肺证53例临床观察  

Clinical observation on 53 cases of infantile mycoplasma pneumonia with phlegm-heat blocking lung syndrome treated by modified Maxing Shigan Tang(麻杏石甘汤)combined with azithromycin sequential therapy

作　　者：周桂娟 张云沛 贾月娥 孙尤佳 ZHOU Guijuan;ZHANG Yunpei;JIA Yue'er;SUN Youjia(Department of Pediatrics,Qinhuangdao Workers'Hospital,Qinhuangdao,Hebei,066200,China;Department of Pediatrics,Qinhuangdao Hospital of Traditional Chinese Medicine,Qinhuangdao,Hebei,066000,China)

机构地区：[1]秦皇岛市工人医院儿科,河北秦皇岛066200 [2]秦皇岛市中医院儿科,河北秦皇岛066000

出　　处：《中医儿科杂志》2023年第4期42-48,共7页Journal of Pediatrics of Traditional Chinese Medicine

基　　金：河北省中医药管理局科研计划项目(2021383)。

摘　　要：目的观察麻杏石甘汤加味联合阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎(MPP)痰热闭肺证的临床疗效。方法选取2019年3月至2021年10月秦皇岛市工人医院儿科住院治疗的MPP痰热闭肺证患儿106例,按照随机数字表法分为对照组和治疗组,各53例。2组均给予祛痰止咳、退热等对症治疗,对照组予注射用阿奇霉素序贯疗法治疗,治疗组在对照组治疗方法的基础上予麻杏石甘汤加味口服。2组均连续治疗14 d后统计临床疗效。结果对照组总有效率为90.57%(48/53),治疗组为96.23%(50/53),2组比较,差异无统计学意义(P>0.05)。治疗前2组咳嗽、咳痰、发热、肺部体征、喘息、流涕、鼻塞、咽部充血等中医证候积分和总积分比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组上述中医证候积分及总积分均较同组治疗前明显降低,差异有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。治疗组退热时间、喘息消失时间、咳嗽消失时间、肺部啰音消失时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。治疗前2组第1秒用力呼气末容积(FEV1)、用力肺活量(FVC)、第1秒用力呼气末容积占用力肺活量比值(FEV1/FVC)、最大呼气流速(PEF)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组FEV1、FVC、FEV1/FVC、PEF水平较同组治疗前明显升高,差异有统计学意义(P<0.05),且治疗组升高更显著(P<0.05)。治疗前2组血清γ-干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)、白细胞介素-17A(IL-17A)、白细胞介素-13(IL-13)水平比较,差异无统计学意义(P>0.05),具有可比性;治疗后2组血清IFN-γ、TNF-α、IL-17A水平明显降低,IL-13水平明显升高,与同组治疗前比较,差异均有统计学意义(P<0.05),且治疗组降低更显著(P<0.05)。治疗前2组免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、免疫球蛋白G(lgG)水平比较,差异无统计学意义(P>0.05),具有可比性;治�Objective To explore the clinical efficacy of modified Maxing Shigan Tang(麻杏石甘汤)combined with azithromycin sequential therapy in the treatment of infantile mycoplasma pneumonia(MPP).Methods From March 2019 to October 2021,106 children with MPP hospitalized in the pediatric department of Qinhuangdao Workers'Hospital were selected and divided into a control group and a treatment group according to the random number table method,with 53 cases each.Both groups were given symptomatic treatments such as expectoration and cough suppression and fever reduction.The control group was given sequential therapy with azithromycin for injection,and the treatment group was given modified Maxing Shigan Tang on the basis of the treatment method of the control group.The clinical efficacy of both groups was counted after 14 days of continuous treatment.Results The total effective rate was 90.57%(48/53)in the control group and 96.23%(50/53)in the treatment group,and the difference was not statistically significant when comparing the 2 groups(P>0.05).Before treatment,there was no statistically significant difference(P>0.05)between the clinical symptoms,signs and total points of cough,sputum,fever,pulmonary signs,wheezing,runny nose,nasal congestion and pharyngeal congestion in the 2 groups.After treatment,the above clinical symptoms,sign points and total points of the 2 groups were significantly lower than those before treatment,and the difference was statistically significant by statistical analysis(P<0.05),and the reduction was more significant in the treatment group(P<0.05).The duration of fever reduction,wheezing disappearance,cough disappearance,lung rales disappearance and hospital stay in the treatment group were shorter than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in forced end-expiratory volume(FEV,),forced vital capacity(FVC),ratio of forced end-expiratory volume to forced vital capacity(FEV,/FVC)and max

关 键 词：肺炎支原体肺炎 小儿 痰热闭肺证 序贯疗法 麻杏石甘汤加味 临床观察 

分 类 号：R256.1[医药卫生—中医内科学]