解毒清肺合剂联合孟鲁司特钠治疗支气管哮喘合并肺炎支原体感染的疗效  

Effect of Jiedu Qingfei mixture combined with Montelukast sodium on treatment of bronchial asthma patients complicated with Mycoplasma pneumoniae infection

作　　者：段伟静 吴海燕 刘艳萍 吕秀华 杨逢永 DUAN Wei-jing;WU Hai-yan;LIU Yan-ping;LYU Xiu-hua;YANG Feng-yong(Shandong First Medical University Affiliated People's Hospital,Jinan,Shandong 271199,Chi)

机构地区：[1]山东第一医科大学附属人民医院药剂科,山东济南271199 [2]山东第一医科大学附属人民医院急诊科,山东济南271199

出　　处：《中华医院感染学杂志》2024年第17期2631-2636,共6页Chinese Journal of Nosocomiology

基　　金：山东省医学会舒适化医疗科研基金(YXH2020ZX037)。

摘　　要：目的探讨解毒清肺合剂联合孟鲁司特钠治疗支气管哮喘合并肺炎支原体感染疗效及对Toll样受体4(TLR4)/核因子-κB(NF-κB)信号通路的影响。方法选取2020年6月-2023年6月山东第一医科大学附属人民医院收治的94例支气管哮喘合并肺炎支原体感染患者,随机分为研究组(n=47)和对照组(n=47),对照组在常规对症治疗基础上予以孟鲁司特钠治疗,研究组在对照组基础上加用解毒清肺合剂治疗,检测治疗4周后外周血TLR4、NF-κB mRNA相对水平,对比两组患者临床疗效、相关症状缓解时间、炎性因子、肺功能、哮喘控制测试(ACT)评分、哮喘生活质量量表(AQLQ)评分。结果治疗4周后,研究组治疗的有效率为91.49%,对照组治疗的有效率为74.47%,两组比较差异有统计学意义(χ^(2)=4.821,0.028);研究组体温缓解时间、咳嗽缓解时间、气促/喘息缓解时间、咽痛缓解时间均短于对照组(P<0.05);与治疗前比较,治疗后两组外周血TLR4、NF-κB mRNA相对水平、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平、痰嗜酸粒细胞(EOS)占比均降低(P<0.05),且研究组降低幅度更大(P<0.05);第1秒用力肺活量(FEV_(1))、第1秒用力呼气容积占预计值百分比[(FEV_(1)/FVC)%]、呼气峰流速值(PEF)均升高(P<0.05),且研究组升高幅度更大(P<0.05);ACT评分、AQLQ评分均增加(P<0.05),且研究组评分增加幅度更大(P<0.05);治疗期间两组患者均未见明显不良反应。结论支气管哮喘合并肺炎支原体感染患者应用解毒清肺合剂联合孟鲁司特钠治疗效果确切,可以改善肺功能,有效控制哮喘,其作用机制可能与抑制TLR4/NF-κB信号通路的激活,调控炎性因子水平的表达相关。OBJECTIVE To explore the effect of Jiedu Qingfei mixture combined with Montelukast sodium on treatment of bronchial asthma patients complicated with Mycoplasma pneumoniae infection and observe the impact on Toll like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathways.METHODS A total of 94 bronchial asthma patients who were complicated with M.pneumoniae infection and were treated in Shandong First Medical University Affiliated People′s Hospital from Jun 2020 to Jun 2023 were enrolled in the study and randomly divided into the study group with 47 cases and the control group with 47 cases.The control group was treated with Montelukast sodium on basis of the routine symptomatic therapy,while the study group was given additional Jiedu Qingfei mixture on basis of the treatment of the control group.The relative expression levels of peripheral blood TLR4 and NF-κB mRNA were detected after the treatment for 4 weeks.The clinical therapeutic effect,relief of related symptoms,inflammatory factors,lung function,score of asthma control test(ACT)and score of asthma quality of life questionnaire(AQLQ)were observed and compared between the two groups of patients.RESULTS The effective rate of treatment was 91.49%in the study group after the treatment for 4 weeks,74.47%in the control group,and there was significant difference between the two groups(χ^(2)=4.821,0.028).The time of recovery of body temperature,time of remission of cough,time of relief of shortness of breath/wheezing and time of relief of sore throat were shorter in the study group than in the control group(P<0.05).The relative expression levels of peripheral blood TLR4,NF-κB mRNA and the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)as well as the percentage of eosinophils(EOS)of the two groups were lower after the treatment than before the treatment(P<0.05),and the above indexes were reduced more remarkably in the study group than in the control group(P<0.05).The forced expiratory volume in one second(FEV_(1)

关 键 词：解毒清肺合剂 孟鲁司特钠 支气管哮喘 肺炎支原体感染 Toll样受体4信号通路 

分 类 号：R285.5[医药卫生—中药学]