麻杏石甘汤联合纤支镜治疗儿童支原体肺炎的疗效及对免疫球蛋白、凝血酶调节蛋白水平的影响
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摘要
目的:分析麻杏石甘汤联合纤支镜治疗儿童支原体肺炎的疗效及对免疫球蛋白、凝血酶调节蛋白水平的影响。方法:支原体肺炎患儿122例,根据治疗方法不同分为对照组和观察组。两组患儿均给予抗感染、止咳、退热、祛痰、补液、体位引流等常规治疗,对照组患儿在常规治疗联合纤支镜治疗,观察组患儿在对照组治疗基础上联合麻杏石甘汤加减治疗,分析两组患儿治疗后的临床疗效。结果:治疗前,两组患儿咳嗽喘息、发热、痰黄而多、舌红苔黄、咽红肿积分比较无统计学差异(P>0.05)。治疗后,观察组患儿咳嗽喘息、发热、痰黄而多、舌红苔黄、咽红肿积分均低于对照组(P<0.05)。治疗前,两组患儿免疫球蛋白水平比较无统计学差异(P>0.05)。治疗后,观察组患儿IgM、IgG水平低于对照组,但IgA水平与对照组比较无统计学差异(P>0.05)。治疗前,两组患儿PCT、IL-10、IL-25、IL-35、凝血酶调节蛋白、MDA、SOD水平比较无统计学差异(P>0.05)。治疗后,观察组患儿IL-35、SOD水平高于对照组,PCT、IL-10、IL-25、凝血酶调节蛋白、MDA水平低于对照组(P<0.05)。结论:麻杏石甘汤联合纤支镜治疗儿童支原体肺炎疗效显著,可提高患者免疫功能,降低患者血清中凝血酶调节蛋白、MDA的表达水平。
Objective:To analyze the effect of Maxing Shigan Decoction combined with bronchoalveolar lavage(bronchoalveolar lavage) on the levels of immunoglobulin and thrombin regulatory protein in children with mycoplasma pneumonia. Methods:122 cases of mycoplasma pneumonia were divided into two groups: control group and observation group. Antipyretic, expectorant, fluid filling, body position drainage and other routine treatment were used in both two groups. The control group combined fiberoptic bronchoscope treatment and the observation group on the basis combined Mashing Shigan Decoction. We analyzed the clinical effect of two groups of children after treatment. Results:Before treatment, two groups' cough wheezing, fever, yellow phlegm, red tongue with yellow fur and pharynx red swelling score had no statistical difference(P>0.05). After treatment, the observation group's were lower than those of the control group. Before treatment, there was no significant difference in the levels of immunoglobulin between the two groups(P>0.05). After treatment, the IgM in the observation group was lower than that in the control group(P<0.05). The level of IgG was lower than that of the control group, but there was no significant difference of the IgA level(P>0.05). There was no significant difference in the levels of IL-35 and MDA-SOD between the two groups(P>0.05). After treatment, the level of IL-35 SOD in the observation group was higher than that in the control group. The levels of IL-10 IL-25 and MDA of thrombin regulatory protein were lower than those of the control group(P<0.05). Conclusion:Maxing Shigan Decoction combined with fiberbronchoscope was effective in the treatment of mycoplasma pneumonia in children. It could improve the immune function of the patients and decrease the level of MDA expression of thrombin regulatory protein in the serum of the patients.
Objective:To analyze the effect of Maxing Shigan Decoction combined with bronchoalveolar lavage(bronchoalveolar lavage) on the levels of immunoglobulin and thrombin regulatory protein in children with mycoplasma pneumonia. Methods:122 cases of mycoplasma pneumonia were divided into two groups: control group and observation group. Antipyretic, expectorant, fluid filling, body position drainage and other routine treatment were used in both two groups. The control group combined fiberoptic bronchoscope treatment and the observation group on the basis combined Mashing Shigan Decoction. We analyzed the clinical effect of two groups of children after treatment. Results:Before treatment, two groups' cough wheezing, fever, yellow phlegm, red tongue with yellow fur and pharynx red swelling score had no statistical difference(P>0.05). After treatment, the observation group's were lower than those of the control group. Before treatment, there was no significant difference in the levels of immunoglobulin between the two groups(P>0.05). After treatment, the IgM in the observation group was lower than that in the control group(P<0.05). The level of IgG was lower than that of the control group, but there was no significant difference of the IgA level(P>0.05). There was no significant difference in the levels of IL-35 and MDA-SOD between the two groups(P>0.05). After treatment, the level of IL-35 SOD in the observation group was higher than that in the control group. The levels of IL-10 IL-25 and MDA of thrombin regulatory protein were lower than those of the control group(P<0.05). Conclusion:Maxing Shigan Decoction combined with fiberbronchoscope was effective in the treatment of mycoplasma pneumonia in children. It could improve the immune function of the patients and decrease the level of MDA expression of thrombin regulatory protein in the serum of the patients.
引文
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[15] 朱海艳.清热解毒方对小儿难治性支原体肺炎患者IFN-γ IL-4 IL-6水平的影响[J].河北医学,2017,23(7):1132-1135.
[16] 张喆,杜青,施红波,等.阿奇霉素联合甘草锌治疗支原体肺炎患儿疗效的研究[J].中华医院感染学杂志,2016,26(12):2848-2850.
[17] 赵德育,陈慧中,杨倩媛,等.临床征象对识别儿童社区获得性肺炎支原体肺炎价值的系统综述[J].中华儿科杂志,2016,54(2):104-110.
[18] 高翔.阿奇霉素序贯疗法对小儿支原体肺炎患者炎性因子及体液免疫功能调节的影响研究[J].抗感染药学,2016,13(4):850-853.
[19] Guo H,He Z,Li M,et al.Imbalance of peripheral blood Th17 and Treg responses in children with refractory Mycoplasma pneumoniae pneumonia[J].J Infect Chemother, 2016,22(3):162-166.
[20] 边红恩,陈团营,单海军.麻杏石甘汤联合阿奇霉素对小儿支原体肺炎患者抗炎、促炎因子及免疫功能的影响[J].中国实验方剂学杂志,2017,23(22):177-181.
[2] 别心坦.麻杏石甘汤联合抗生素治疗伴心肌损害肺炎支原体肺炎疗效观察[J].现代中西医结合杂志,2016,25(17):1876-1879.
[3] 何剑养,邓学灵,李党坚,等.纤维支气管镜肺泡灌洗治疗儿童肺炎重症支原体肺炎的临床观察[J].慢性病学杂志,2016,17(5):505-507.
[4] 王良军.中西医结合治疗小儿支原体肺炎风热郁肺型64例临床观察[J].中医儿科杂志,2016,12(1):34-37.
[5] 胡亚美,江载芳.诸福棠实用儿科学[M].7版.北京:人民卫生出版社,2002:1204-1205.
[6] 江育仁,俞景茂.实用中医儿科学[M].2版.上海:上海科学技术出版社,2005:198-203.
[7] 郑筱萸.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:112.
[8] Ding S,Wang X,Chen W,et al.Decreased interleukin-10 responses in children with severe mycoplasma pneumoniae pneumonia[J].PLoS One,2016,11(1):146-157.
[9] 朱湘芸,王洵,赵弘卿.支气管哮喘患儿血清TNF-α、IgE水平变化及其与肺炎支原体感染的关系[J].山东医药,2017,57(1):79-80.
[10] 唐敏锋.加减麻杏石甘汤联合止咳穴位贴治疗儿童支原体肺炎疗效观察[J].陕西中医,2017,38(3):299-301.
[11] 胡雯.麻杏石甘汤对儿童支原体肺炎外周静脉血免疫球蛋白IgE水平的影响[J].内蒙古中医药,2017,8(15):32-33.
[12] 谭中富,杨明.炎琥宁注射液辅助治疗难治性肺炎支原体肺炎患儿的临床疗效及其对免疫功能、细胞因子的影响研究[J].实用心脑肺血管病杂志,2017,25(7):48-52.
[13] 连会娟.清热化痰祛瘀方联合常规西药治疗小儿难治性支原体肺炎36例[J].中医研究,2017,30(6):36-38.
[14] 谢晓飞,孙丽平.哮咳饮加黄芩治疗小儿支原体肺炎后慢性咳嗽[J].中国中西医结合儿科学,2016,8(4):460-462.
[15] 朱海艳.清热解毒方对小儿难治性支原体肺炎患者IFN-γ IL-4 IL-6水平的影响[J].河北医学,2017,23(7):1132-1135.
[16] 张喆,杜青,施红波,等.阿奇霉素联合甘草锌治疗支原体肺炎患儿疗效的研究[J].中华医院感染学杂志,2016,26(12):2848-2850.
[17] 赵德育,陈慧中,杨倩媛,等.临床征象对识别儿童社区获得性肺炎支原体肺炎价值的系统综述[J].中华儿科杂志,2016,54(2):104-110.
[18] 高翔.阿奇霉素序贯疗法对小儿支原体肺炎患者炎性因子及体液免疫功能调节的影响研究[J].抗感染药学,2016,13(4):850-853.
[19] Guo H,He Z,Li M,et al.Imbalance of peripheral blood Th17 and Treg responses in children with refractory Mycoplasma pneumoniae pneumonia[J].J Infect Chemother, 2016,22(3):162-166.
[20] 边红恩,陈团营,单海军.麻杏石甘汤联合阿奇霉素对小儿支原体肺炎患者抗炎、促炎因子及免疫功能的影响[J].中国实验方剂学杂志,2017,23(22):177-181.