清热解毒方联合纤维支气管镜治疗儿童难治性肺炎支原体肺炎痰热闭肺证的效果及对肺功能、炎性因子和免疫功能的影响  

Effect of Qingre Jiedu Formula Combined with Fiberoptic Bronchoscope in the Treatment of Refractory Mycoplasma Pneumoniae Pneumonia in Children with Phlegm-heat Obstructing the Lung Syndrome,and Its Impact on Pulmonary Function,Inflammatory Factors and Immune Function

作　　者：张思源 ZHANG Siyuan(Department of Pediatrics,People's Hospital of Daxing District,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院儿科,北京102600

出　　处：《临床误诊误治》2025年第2期90-95,共6页Clinical Misdiagnosis & Mistherapy

基　　金：2022年度首都卫生发展科研专项项目(首发2022-4-7016)。

摘　　要：目的探究清热解毒方联合纤维支气管镜治疗难治性肺炎支原体肺炎(RMPP)痰热闭肺证患儿的效果及对肺功能、炎性因子和免疫功能的影响。方法选取2024年1月至2024年8月收治的106例RMPP痰热闭肺证患儿,依据不同治疗方案分为观察组(清热解毒方联合纤维支气管镜治疗)和对照组(纤维支气管镜治疗)各53例。2组治疗2周后评估治疗效果和支气管黏膜损伤修复情况,比较2组治疗前、治疗2周后肺功能指标、中医证候积分、炎性因子、免疫功能指标以及不良反应发生情况。结果治疗2周后,观察组愈显率高于对照组(P<0.05),且观察组治疗后支气管黏膜修复效果优于对照组。治疗2周后,2组最大呼气流量、第一秒用力呼气容积、用力肺活量较治疗前升高,且观察组高于对照组(P<0.05)。2组治疗2周后咳嗽、发热、咳黄黏痰、气喘积分低于治疗前,且观察组各项积分均低于对照组(P<0.05,P<0.01)。治疗2周后,2组血清肿瘤坏死因子-α、淀粉样蛋白A/C反应蛋白、白细胞介素-23、γ-干扰素水平较治疗前降低,且观察组较对照组低(P<0.05,P<0.01)。2组治疗2周后CD3+、免疫球蛋白A、CD4+/CD8+、免疫球蛋白G水平高于治疗前,且观察组高于对照组(P<0.05,P<0.01)。2组治疗期间不良反应总发生率比较差异无统计学意义(P>0.05)。结论清热解毒方联合纤维支气管镜治疗能抑制RMPP痰热闭肺证患儿体内炎症反应,改善临床症状及免疫功能,增强肺功能,且安全较好。Objective To explore the effect of Qingre Jiedu formula combined with fiberoptic bronchoscopy on children with refractory mycoplasmal pneumonia pneumonia(RMPP)with phlegm-heat obstructing the lung syndrome,as well as its impact on pulmonary function,inflammatory factors and immune function.Methods Medical records of 106 children with RMPP admitted from January 2024 to August 2024 were selected.According to different treatment plans,they were divided into the observation group(treated with Qingre Jiedu formula combined with fiberoptic bronchoscopy)and the control group(treated with fiberoptic bronchoscopy),with 53 patients in each group.The therapeutic effect and the repair of bronchial mucosal injury were evaluated at 2 weeks after treatment in both groups.The pulmonary function indicators,traditional Chinese medicine(TCM)syndrome scores,inflammatory factors,immune function indicators before and at 2 weeks after treatment,and adverse reactions were compared between the two groups.Results At 2 weeks after treatment,the recovery rate of observation group was higher than that of control group(P<0.05),and the observation group also had a better effect on the repair of bronchial mucosa after treatment than the control group.At 2 weeks after treatment,the maximum expiratory flow rate,forced expiratory volume in one second,and forced vital capacity in both groups increased compared with those before treatment,with the observation group showing higher values than the control group(P<0.05).At 2 weeks after treatment,the scores for cough,fever,yellow phlegm,and asthma in both groups were lower than those before treatment,and the scores for each item in the observation group were lower than those in the control group(P<0.05,P<0.01).At 2 weeks after treatment,the levels of serum tumor necrosis factor-α,amyloid A/C reactive protein,interleukin-23,and interferon-γin the observation group decreased compared with those before treatment,which were lower in the observation group than in the control group(P<0.05,P<0.01).At 2 week

关 键 词：支原体肺炎 难治性 儿童 清热解毒方 纤维支气管镜 用力肺活量 肿瘤坏死因子-α 免疫球蛋白 

分 类 号：R725.6[医药卫生—儿科]