清肺通络汤对肺炎支原体肺炎患儿中医证候积分及血清炎性因子水平的影响
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摘要
目的:观察清肺通络汤对肺炎支原体肺炎(Mycoplasma Pneumonia,MPP)患儿中医证候积分及血清炎性因子水平的影响,进一步明确通络法治疗MPP的临床疗效及优势。方法:将80例MPP患儿随机分为治疗组与对照组,每组各40例。治疗组采用阿奇霉素单程疗法联合中药清肺通络汤内服,对照组采用阿奇霉素序贯疗法,两组疗程均为20天。分别于治疗第0、7、14、20天应用中医证候评分量表进行疗效评定,同时测定治疗前后血清IL-6、IL-10水平。结果:①中医证候疗效比较:治疗组的愈显率为95%,对照组的愈显率为75.00%;两组在治疗7、14、20天时的中医证候疗效差异均具有统计学意义(P <0.05),治疗组疗效优于对照组;②证候积分比较:治疗第7、14、20天治疗组中医证候总积分明显低于对照组(P <0.05)。两组患儿治疗后的主症及次症评分均较治疗前明显降低,且治疗组患儿第20天咳嗽、痰壅、口渴评分低于对照组(P <0.05);③血清炎性因子水平比较:治疗组治疗后IL-6、IL-10水平均明显下降(P <0.05),且治疗后治疗组IL-6、IL-10水平明显低于对照组(P <0.05)。结论:清肺通络汤可有效改善MPP患儿的中医证候评分,降低血清炎性因子水平,临床疗效确切。
Objective: to observe the effect of Qingfei Tongluo Decoction on TCM syndrome score and serum inflammatory factors in children with mycoplasma pneumonia(MPP), and further to clarify the clinical efficacy and advantages of Tongluo therapy for MPP. Methods:a total of 80 children with MPP were randomly divided into the treatment group and the control group, with 40 cases in each group. The treatment group was treated with azithromycin single course combined with Qingfei Tongluo Decoction and the control group with Azithromycin Sequential therapy. The two groups were treated for 20 days. In the zeroth, seventh, fourteenth and 20 days of treatment, the TCM Syndrome Scale was used to evaluate the curative effect, and the levels of serum IL-6 and IL-10 before and after treatment were measured. Result:① The curative effect of TCM syndrome: the healing rate of the treatment group was 95% and the rate of the control group was75%. The two groups in the treatment of 7, 14, 20 days of TCM syndrome differences were statistically significant(P <0.05) and the treatment group was better than the control group; ② Syndrome score comparison: the total score of TCM syndrome in the treatment group in the seventh, fourteenth, twentieth days was significantly lower than that of the control group(P < 0.05). The scores of main symptoms and secondary symptoms in the two groups were significantly lower than those before treatment, and the cough, sputum and thirst scores on the twentieth day in the treatment group were lower than those in the control group(P < 0.05); ③ The level of serum inflammatory factors: after treatment, the levels of IL-6 and IL-10 in the treatment group were significantly decreased(P < 0.05), and the levels of IL-6 and IL-10 in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion:Qingfei Tongluo Decoction can effectively improve the score of TCM syndrome in MPP children and reduce the level of serum inflammatory factors, with accurate clinical effect.
Objective: to observe the effect of Qingfei Tongluo Decoction on TCM syndrome score and serum inflammatory factors in children with mycoplasma pneumonia(MPP), and further to clarify the clinical efficacy and advantages of Tongluo therapy for MPP. Methods:a total of 80 children with MPP were randomly divided into the treatment group and the control group, with 40 cases in each group. The treatment group was treated with azithromycin single course combined with Qingfei Tongluo Decoction and the control group with Azithromycin Sequential therapy. The two groups were treated for 20 days. In the zeroth, seventh, fourteenth and 20 days of treatment, the TCM Syndrome Scale was used to evaluate the curative effect, and the levels of serum IL-6 and IL-10 before and after treatment were measured. Result:① The curative effect of TCM syndrome: the healing rate of the treatment group was 95% and the rate of the control group was75%. The two groups in the treatment of 7, 14, 20 days of TCM syndrome differences were statistically significant(P <0.05) and the treatment group was better than the control group; ② Syndrome score comparison: the total score of TCM syndrome in the treatment group in the seventh, fourteenth, twentieth days was significantly lower than that of the control group(P < 0.05). The scores of main symptoms and secondary symptoms in the two groups were significantly lower than those before treatment, and the cough, sputum and thirst scores on the twentieth day in the treatment group were lower than those in the control group(P < 0.05); ③ The level of serum inflammatory factors: after treatment, the levels of IL-6 and IL-10 in the treatment group were significantly decreased(P < 0.05), and the levels of IL-6 and IL-10 in the treatment group were significantly lower than those in the control group(P < 0.05). Conclusion:Qingfei Tongluo Decoction can effectively improve the score of TCM syndrome in MPP children and reduce the level of serum inflammatory factors, with accurate clinical effect.
引文
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2 Meyer Sauteur PM,Unger WW,Nadal D,et al.Infection with and Carriage of Mycoplasma pneumoniae in Children.Front Microbiol,2016,5(7):1-12.
3 Song Q,Xu B P,Shen K L.Bacterial Co-infection in Hospitalized Children with Mycoplasma pneumoniae Pneumonia.Research Paper,2016,53(15):879-882.
4 Gretchen L,Parrott,Takeshi Kinjo,et al.A Compendium for Mycoplasma pneumoniae.Front Microbiol,2016,7(4):1-16.
5诸福堂,胡亚美,江载芳.实用儿科学(第7版).北京:人民卫生出版社,2002:1185-1204.
6国家中医药管理局.中医病证诊断疗效标准.中华人民共和国中医药行业标准.南京:南京大学出版社,1994:287-288.
7马融,胡思源.儿科疾病中医药临床研究技术要点.北京:中国医药科技出版社,2011:51.
8陈金亮,杨晓黎.略论络病理论的形成与发展.中国中医药信息杂志.2003,10(10):1-2.
9张英英,徐萌,刘金艳,等.试论“脏络”.中医杂志,2013,54(21):1801-1804.
10陈云.脉络实质探析.山东中医药大学学报,2011,35(4):313-314.
11姜之炎,肖臻,姜永红,等.清肺通络法治疗小儿支原体肺炎的临床疗效评价.上海中医药大学学报,2016,5(30):17-21.
12林燕,姜之炎.清肺通络法治疗小儿支原体肺炎.山东中医杂志,2016,35(9):784-787.
13刘秀秀,姜之炎.从“肺络痹阻”探讨儿童肺炎支原体肺炎肺功能变化.吉林中医药,2016,36(4):376-378.
14 Kimura A,Kishimoto T.IL-6:Regulator of Treg/Th17 balance.Eur JImmunol,2010,40(7):1830-1835.
15 Barczyk A,Pierzhchala W,Kon OM,et al.Cytokine production by bronchoalveolar lavage T lymphcytes in chronic obstructive pulmonary disease.J Allergy Clin Immunol,2006,117(6):1484-1492.
16 Ouyang W,Rutz S,Crellin N K,et al.Regulation and functions of the IL-10 family of cytokines in inflammation and disease.Annu Rev Immunol,2011,29:71-109.
17梁粤.肺炎支原体肺炎患儿外周血IL-10/IL-17表达与肺功能变化的相关性研究.临床儿科杂志,2015,33(88):686-688.
18乔红梅,庞焕香,张云峰,等.肺炎支原体肺炎患儿IL-6、IL-10、TNF-α的变化.临床儿科杂志,2012,30(1):59-61.
2 Meyer Sauteur PM,Unger WW,Nadal D,et al.Infection with and Carriage of Mycoplasma pneumoniae in Children.Front Microbiol,2016,5(7):1-12.
3 Song Q,Xu B P,Shen K L.Bacterial Co-infection in Hospitalized Children with Mycoplasma pneumoniae Pneumonia.Research Paper,2016,53(15):879-882.
4 Gretchen L,Parrott,Takeshi Kinjo,et al.A Compendium for Mycoplasma pneumoniae.Front Microbiol,2016,7(4):1-16.
5诸福堂,胡亚美,江载芳.实用儿科学(第7版).北京:人民卫生出版社,2002:1185-1204.
6国家中医药管理局.中医病证诊断疗效标准.中华人民共和国中医药行业标准.南京:南京大学出版社,1994:287-288.
7马融,胡思源.儿科疾病中医药临床研究技术要点.北京:中国医药科技出版社,2011:51.
8陈金亮,杨晓黎.略论络病理论的形成与发展.中国中医药信息杂志.2003,10(10):1-2.
9张英英,徐萌,刘金艳,等.试论“脏络”.中医杂志,2013,54(21):1801-1804.
10陈云.脉络实质探析.山东中医药大学学报,2011,35(4):313-314.
11姜之炎,肖臻,姜永红,等.清肺通络法治疗小儿支原体肺炎的临床疗效评价.上海中医药大学学报,2016,5(30):17-21.
12林燕,姜之炎.清肺通络法治疗小儿支原体肺炎.山东中医杂志,2016,35(9):784-787.
13刘秀秀,姜之炎.从“肺络痹阻”探讨儿童肺炎支原体肺炎肺功能变化.吉林中医药,2016,36(4):376-378.
14 Kimura A,Kishimoto T.IL-6:Regulator of Treg/Th17 balance.Eur JImmunol,2010,40(7):1830-1835.
15 Barczyk A,Pierzhchala W,Kon OM,et al.Cytokine production by bronchoalveolar lavage T lymphcytes in chronic obstructive pulmonary disease.J Allergy Clin Immunol,2006,117(6):1484-1492.
16 Ouyang W,Rutz S,Crellin N K,et al.Regulation and functions of the IL-10 family of cytokines in inflammation and disease.Annu Rev Immunol,2011,29:71-109.
17梁粤.肺炎支原体肺炎患儿外周血IL-10/IL-17表达与肺功能变化的相关性研究.临床儿科杂志,2015,33(88):686-688.
18乔红梅,庞焕香,张云峰,等.肺炎支原体肺炎患儿IL-6、IL-10、TNF-α的变化.临床儿科杂志,2012,30(1):59-61.
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