五味沙棘散联合阿奇霉素治疗小儿支原体肺炎痰热闭肺证临床疗效及对肺功能、血清嗜酸性细胞阳离子蛋白、巨噬细胞衍生趋化因子的影响  

Clinical efficacy of Wuwei Shaji Powder combined with azithromycin for children with mycoplasma pneumonia of phlegm-heat blocking lung syndrome and its influences on lung function,serum eosinophil cationic protein,macrophage-derived chemokine expression

作　　者：丘婧 查青山 刘书平 QIU Jing;CHA Qingshan;LIU Shuping(Department of Pediatrics,Miyun District of Beijing Chinese Medicine Hospital,Beijing 101500;Department of Traditional Chinese Medicine,Seventh Medical Center of PLA General Hospital,Beijing 100700;Department of Laboratory Medicine,Miyun District of Beijing Chinese Medicine Hospital,Beijing 101500)

机构地区：[1]北京市密云区中医医院儿科,北京101500 [2]中国人民解放军总医院第七医学中心中医科,北京100700 [3]北京市密云区中医医院检验科,北京101500

出　　处：《河北中医》2023年第8期1318-1322,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察五味沙棘散联合阿奇霉素治疗小儿支原体肺炎痰热闭肺证的临床疗效及对肺功能、血清嗜酸性细胞阳离子蛋白(ECP)、巨噬细胞衍生趋化因子(MDC)的影响。方法将100例小儿支原体肺炎痰热闭肺证患者按照随机数字表法分为2组,对照组50例予阿奇霉素治疗,治疗组50例在对照组治疗基础上予五味沙棘散治疗。2组均治疗10天。比较2组治疗前后中医证候评分、肺功能指标[第1 s用力呼气容积(FEV 1)、FEV 1占预计值的百分比(FEV 1%pred)、FEV 1占用力肺活量比值(FEV 1/FVC)、呼气峰值流速(PEF)]及血清嗜酸性细胞阳离子蛋白(ECP)、巨噬细胞衍生趋化因子(MDC)水平,并统计2组发热、气喘、咳嗽、痰鸣消失时间及疗效。结果治疗组总有效率96.00%(48/50),对照组总有效率84.00%(42/50),治疗组临床疗效优于对照组(P<0.05)。治疗组发热、气喘、咳嗽、痰鸣消失时间均短于对照组(P<0.05)。2组治疗后中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后FEV 1、FEV 1%pred、FEV 1/FVC、PEF均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后血清ECP、MDC水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论采用五味沙棘散联合阿奇霉素治疗支原体肺炎痰热闭肺证患儿临床疗效显著,中医证候评分和血清ECP、MDC水平均明显降低,肺功能明显改善,未增加不良反应发生情况,较阿奇霉素单独治疗优势更加明显。Objective To explore the clinical efficacy of Wuwei Shaji Powder combined with azithromycin for children with mycoplasma pneumonia(MP)of phlegm-heat blocking lung syndrome and its influences on lung function,serum eosinophil cationic protein(ECP),macrophage-derived chemokine(MDC)expression.Methods Totally 100 children with MP(phlegm-heat blocking lung syndrome)were randomized 1∶1 to receive either azithromycin(the control group)or Wuwei Shaji Powder combined with azithromycin(the treatment group).Treated for 10 days,the aim was to compare traditional Chinese medicine(TCM)syndrome score,pulmonary function indexes(forced expiratory volume in the first second[FEV 1],FEV 1 in percent predicted values[FEV 1%pred],FEV 1/forced vital capacity[FVC]ratio[FEV 1/FVC],peak expiratory flow[PEF]),ECP,MDC.The curative effect was assessed.Results After treatment,the overall effective rate in the treatment group was significantly higher than that in the control group(96.00%[48/50]vs 84.00%[42/50],P<0.05).The disappearing time of fever,asthma,cough,phlegm in the treatment group was obviously shorter than that in the control group(P<0.05).TCM symptom scores in the both groups were significantly decreased(P<0.05),which in the treatment group were more pronounced(P<0.05).FEV 1,FEV 1%pred,FEV 1/FVC,PEF in groups were significantly increased(P<0.05),the treatment group was more prevalent(P<0.05).ECP and MDC in the both groups were significantly decreased(P<0.05),the reduction in the treatment group was more common(P<0.05).The difference was not statistically significant in the incidence of adverse reactions between groups(P>0.05).Conclusion For children with MP(phlegm-heat blocking lung syndrome),Wuwei Shaji Powder combined with azithromycin has more clinical curative effect than azithromycin alone,which can significantly reduce TCM syndrome scores,serum ECP,MDC levels,improve lung function,and without increased adverse reactions.

关 键 词：肺炎 支原体 痰热闭肺 中西医结合疗法 

分 类 号：R725.631.305.8[医药卫生—儿科]