| 引用本文: |
黄瑾,章家欢,饶克瑯,吴杰妍.化痰清热方联合阿奇霉素对小儿MPP痰热闭肺证气道炎症和Th1/Th2平衡的影响[J].湖南中医药大学学报,2021,41(8):1285-1289[点击复制] |
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| 化痰清热方联合阿奇霉素对小儿MPP痰热闭肺证气道炎症和Th1/Th2平衡的影响 |
| 黄瑾,章家欢,饶克瑯,吴杰妍 |
| (广州中医药大学附属深圳市宝安区中医院, 广东 深圳 518000;深圳市罗湖医院集团, 广东 深圳 518000;广州中医药大学第三附属医院芳村分院儿科, 广东 广州 510378) |
| 摘要: |
| 目的 观察化痰清热方联合阿奇霉素治疗小儿肺炎支原体肺炎（MPP）痰热闭肺证临床疗效。方法 选择广州中医药大学附属深圳市宝安区中医院2019年1月至2020年6月收治的MPP痰热闭肺证患儿70例，按照随机数字表法分为观察组（35例）和对照组（35例），对照组患儿均给予西医常规治疗和阿奇霉素。观察组在对照组治疗基础上加用化痰清热方，两组疗程均为14 d。比较两组治疗前后中医证候评分、潮气呼吸肺功能指标、呼出气一氧化氮（FENO）含量、血清嗜酸粒细胞阳离子蛋白（ECP）、可溶性B7-H3（sB7-H3）、γ干扰素（IFN-γ）、白细胞介素-4（IL-4）水平及治疗总有效率。结果 治疗后，两组中医证候评分较治疗前均降低（P<0.01）；观察组中医证候评分低于对照组（P<0.01）；两组呼吸频率较治疗前降低（P<0.01），潮气量、达峰容积比、吸气与呼气之比均升高（P<0.01）；观察组呼吸频率低于对照组（P<0.01），潮气量、达峰容积比、吸气与呼气之比均高于对照组（P<0.01）；两组FENO及血清ECP、sB7-H3、IL-4水平较治疗前均降低（P<0.01），血清IFN-γ水平较治疗前均升高（P<0.01）；观察组FENO及血清ECP、sB7-H3、IL-4水平低于对照组（P<0.01），血清IFN-γ水平高于对照组（P<0.01），治疗总有效率高于对照组（P<0.05）。结论 化痰清热方联合阿奇霉素可调节Th1/Th2平衡，减轻气道炎症，改善中医证候和肺功能，治疗小儿MPP痰热闭肺证效果显著。 |
| 关键词: 肺炎支原体肺炎 阿奇霉素 化痰清热方 痰热闭肺证 气道炎症 Th1/Th2平衡 |
| DOI：10.3969/j.issn.1674-070X.2021.08.027 |
| 投稿时间：2020-11-23 |
| 基金项目:广东省中医药局项目（20172084）。 |
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| Effect of Huatan Qingre Decoction Combined with Azithromycin in the Treatment of Pediatric MPP with Phlegm-heat Obstructing the Lung Syndrome and its Influence on Airway Inflammation and Th1/Th2 Balance |
| HUANG Jin,ZHANG Jiahuan,RAO Kelang,WU Jieyan |
| (Shenzhen Baoan District Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong 518000, China;Shenzhen Luohu Hospital Group, Shenzhen, Guangdong 518000, China;Department of Pediatrics, Fangcun Branch, The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong 510378, China) |
| Abstract: |
| Objective To observe the clinical effect of Huatan Qingre Decoction combined with azithromycin in the treatment of mycoplasma pneumoniae pneumonia (MPP) in children. Methods 70 cases of MPP children with phlegm-heat obstructing the lung syndrome in Department of Pediatrics, Shenzhen Baoan District Hospital of Traditional Chinese Medicine from January 2019 to June 2020 were selected and randomly divided into observation group (35 cases) and control group (35 cases) according to the random number table method. The control group were given conventional western medicine treatment and azithromycin, and the observation group were given Huatan Qingre Decoction based on the treatment of the control group, and the treatment course was for 14 days. The traditional Chinese medicine (TCM) syndrome scores, tidal breathing pulmonary function indexes, exhaled nitric oxide (FENO), serum eosinophil cationic protein (ECP), soluble B7-H3 (sB7-H3), interferon-γ (IFN-γ), interleukin-4 (IL-4) and total effective rate of treatment were compared between the two groups before and after treatment. Results After treatment, the scores of TCM syndromes in both groups were lower than before treatment (P<0.01); the TCM syndrome scores of the observation group were lower than those of the control group (P<0.01). After treatment, compared with before treatment, the respiratory rate of both groups was decreased (P<0.01), while the tidal volume, peak volume ratio and inspiratory to expiratory ratio were increased (P<0.01); respiratory rate of observation group was lower than that of the control group (P<0.01), tidal volume, peak volume ratio, inspiratory to expiratory ratio of observation group were higher than those of the control group (P<0.01). After treatment, the levels of FENO and serum ECP, sB7-H3 and IL-4 in both groups were decreased compared with those before treatment (P<0.01), and the level of serum IFN-γ was increased compared with before treatment (P<0.01); FeNO, serum ECP, sB7-H3, IL-4 levels of observation group were lower than those of the control group (P<0.01), serum IFN-γ level of observation group was higher than that of the control group (P<0.01). The total effective rate of observation group was higher than that of the control group (P<0.05). Conclusion Huatan Qingre Decoction combined with azithromycin can regulate Th1/Th2 balance, reduce airway inflammation, improve TCM syndrome and lung function, and it has significant effect in the treatment of children with MPP with phlegm-heat obstructing the lung syndrome. |
| Key words: mycoplasma pneumoniae pneumonia azithromycin Huatan Qingre Decoction phlegm-heat obstructing the lung syndrome airway inflammation Th1/Th2 balance |
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