热咳散联合穴位贴敷治疗儿童肺炎支原体肺炎(痰热闭肺证)的疗效及对血清炎症因子及免疫功能的影响  

Clinical effect of Reke teabag combined with acupoint application on mycoplasma pneumoniae pneumonia in children(accumulation of phlegm-heat syndrome) and its influence on serum inflammatory factors and immune function

作　　者：陈慧[1] 何德根[1] 张琳[1] 郑敏斯 王信芳[1] 黄钦海 CHEN Hui;HE De-gen;ZHANG Lin(Zhongshan Hospital of Traditional Chinese Medicine,Zhongshan 528400,China)

机构地区：[1]中山市中医院,528400

出　　处：《中国实用医药》2024年第22期11-15,共5页China Practical Medicine

基　　金：中山市医学科研项目(项目编号:2022A020451)。

摘　　要：目的 探讨热咳散与穴位贴敷联合应用对儿童肺炎支原体肺炎(MPP)(痰热闭肺证)的治疗效果以及对免疫功能、血清炎症因子的影响。方法 80例确诊为MPD(痰热闭肺证)的患儿,随机分为对照组与观察组,每组40例。对照组给予阿奇霉素干混悬剂治疗,观察组在对照组基础上加用热咳散和穴位贴敷疗法。对比两组治疗效果,症状消失时间(发热消失时间、咳嗽消失时间、肺部啰音消失时间),中医证候积分,血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、血清淀粉样蛋白A(SAA)],补体3(C3)、补体4(C4)与免疫球蛋白[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)],不良反应发生情况。结果 观察组总有效率97.5%明显高于对照组的82.5%,差异有统计学意义(P<0.05)。观察组发热消失时间(1.17±0.31)d、咳嗽消失时间(3.50±0.55)d、肺部啰音消失时间(3.77±0.42)d均短于对照组的(2.48±0.49)、(4.33±0.70)、(5.07±0.36)d,差异有统计学意义(P<0.05)。治疗后,两组的发热、咳嗽、气急、痰鸣积分及总分均低于治疗前,且观察组明显低于对照组,差异有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-6、IL-10、SAA均明显低于治疗前,且观察组TNF-α(15.66±1.57)ng/L、IL-6(17.30±3.04)ng/L、IL-10(18.91±1.30)ng/L、SAA(30.69±7.78)mg/L均较对照组的(17.89±1.81)ng/L、(24.34±2.88)ng/L、(23.96±1.07)ng/L、(37.30±7.15)mg/L明显偏低(P<0.05)。治疗后,两组IgA、IgG均升高,IgM与C3、C4均降低,且观察组IgA(0.84±0.09)g/L、IgG(8.27±1.30)g/L较对照组的(0.74±0.10)、(7.11±1.30)g/L明显更高,IgM(1.03±0.10)g/L与C3(0.84±0.24)g/L、C4(0.23±0.11)g/L较对照组的(1.28±0.11)、(1.16±0.26)、(0.30±0.13)g/L明显更低(P<0.05)。两组不良反应发生率均为2.5%,组间对比无明显差异(P>0.05),无特殊不适,无需特殊处理。结论 热咳散联合穴位贴敷治疗MPP(痰热闭肺证)患儿的临床疗Objective To explore the effect of Reke teabag combined with acupoint application on mycoplasma pneumoniae pneumonia(MPP) in children(accumulation of phlegm-heat syndrome) and its influence on serum inflammatory factors and immune function.Methods A total of 80 children patients with MPP(accumulation of phlegm-heat syndrome) were randomly divided into an observation group and a control group,each consisting of 40 patients.The control group was treated with azithromycin for suspension,and the observation group was treated with Reke teabag and acupoint application on the basis of the control group.Comparison was made on therapeutic effect,symptom disappearance time(disappearance time of fever,disappearance time of cough,disappearance time of lung rales),traditional Chinese medicine syndrome score,serum inflammatory factors [tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-10(IL-10),serum amyloid A(SAA)],complement 3(C3),complement 4(C4) and immunoglobulin [immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)],and occurrence of adverse reactions.Results The total effective rate of 97.5% in the observation group was significantly higher than 82.5% in the control group,and the difference was statistically significant(P<0.05).In the observation group,the disappearance time of fever was(1.17±0.31) d,the disappearance time of cough was(3.50±0.55) d,and the disappearance time of lung rales was(3.77±0.42) d,which were shorter than(2.48±0.49),(4.33±0.70),and(5.07±0.36) d in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of fever,cough,shortness of breath and gurgling with sputum and total score in both groups were lower than those before treatment,and the observation group was significantly lower than the control group.The difference was statistically significant(P<0.05).After treatment,TNF-α,IL-6,IL-10,and SAA in both groups were significantly lower than those before treatment;the observation group had TNF-α of(15.66±1.57) ng/L,IL-

关 键 词：热咳散 穴位贴敷 肺炎支原体肺炎 儿童 痰热闭肺证 炎症因子 免疫 

分 类 号：R272[医药卫生—中医儿科学]