摘要
【目的】探讨麻杏石甘汤加减联合阿奇霉素治疗痰热闭肺型肺炎支原体肺炎(MPP)患儿的临床疗效及对γ干扰素(IFN-γ)、白细胞介素4(IL-4)表达的影响。【方法】将60例痰热闭肺型MPP患儿随机分为治疗组和对照组,每组各30例。对照组给予阿奇霉素干混悬剂口服治疗,治疗组在对照组基础上给予麻杏石甘汤加减治疗,疗程为10 d。观察2组患儿治疗前后中医证候积分及IFN-γ、IL-4表达水平的变化情况,并评价2组患儿的临床疗效和安全性。【结果】(1)治疗1个疗程后,治疗组的总有效率为93.3%(28/30),对照组为80.0%(24/30),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患儿的发热、咳嗽、气喘、痰鸣等中医证候积分均较治疗前降低(P<0.05),且治疗组对发热、咳嗽、痰鸣等中医证候积分的降低作用均明显优于对照组(P<0.05)。(3)治疗后,2组患儿血清IL-4水平均较治疗前降低(P<0.05),血清IFN-γ水平均较治疗前升高(P<0.05),且治疗组对血清IL-4水平的降低作用及对血清IFN-γ水平的升高作用均优于对照组(P<0.05)。(4)治疗过程中,2组患儿均未发现严重不良反应,血尿常规和心肝肾功能等安全性指标也均未见明显异常。【结论】麻杏石甘汤加减联合阿奇霉素治疗痰热闭肺型MPP患儿疗效确切,可有效改善患儿的临床症状和体征,这可能与其能够抑制IL-4表达和上调IFN-γ表达,从而更好地调节免疫失衡状态有关。
Objective To investigate the clinical efficacy of modified Ma Xing Shi Gan Decoction combined with azithromycin for the treatment of mycoplasma pneumoniae pneumonia(MPP)in the children with phlegm-heat obstructing lung syndrome, and to observe the influence on the expression of interferon gamma(IFN-γ)and interleukin 4(IL-4). Methods Sixty MPP children with the syndrome of phlegm-heat obstructing lung were randomly divided into the treatment group(n = 30)and the control group(n = 30). The control group was treated with azithromycin dry suspension orally, and the treatment group was treated with modified Ma Xing Shi Gan Decoction combined with azithromycin dry suspension orally. The course of treatment for the two groups lasted 10 days. Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome and the expression levels of IFN-γ and IL-4 in the two groups were compared. After treatment,the clinical efficacy and safety of the two groups were also evaluated. Results(1)After treatment for one course of treatment,the total effective rate of the treatment group was 93.33%(28/30)and that of the control group was 80.0%(24/30). The treatment group had stronger efficacy than the control group, and the difference was statistically significant(P<0.05).(2)After treatment,the scores of TCM syndrome of fever,cough,dyspnea,and wheezing sound in the two groups were decreased in comparison with those before treatment(P<0.05),and the treatment group had stronger effect on decreasing the scores of fever,cough,and wheezing sound than the control group(P<0.05).(3)After treatment,the serum IL-4 level in the two groups was decreased and IFN-γ level was increased in comparison with those before treatment(P<0.05), and the treatment group had stronger effect on decreasing IL-4 level and on increasing IFN-γ level than the control group(P<0.05).(4)During the trial, no obvious adverse reaction occurred in the two groups,neither any abnormalities of blood and urine routine test results or safety examination results for the function of heart,liver and kidney were found. Conclusion Modified Ma Xing Shi Gan Decoction combined with azithromycin is effective for the treatment of mycoplasma pneumoniae pneumonia(MPP)in the children with phlegm-heat obstructing lung syndrome by relieving the clinical symptoms and signs of MPP children.And its mechanism is probably related with the down-regulation of the expression of IL-4 and up-regulation of the expression of IFN-γ,which is beneficial to correcting the immune imbalance of the children.
作者
朱丽臻
石艳红
蔡小其
ZHU Li-Zhen;SHI Yan-Hong;CAI Xiao-Qi(Guangzhou Municipal Hospital of Traditional Chinese Medicine,Guangzhou 510130 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2020年第10期1876-1880,共5页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广州市中医医院青苗科技计划项目(编号:2018A02)。
关键词
麻杏石甘汤
肺炎支原体肺炎
痰热闭肺型
临床疗效
Γ干扰素
白细胞介素4
Ma Xing Shi Gan Decoction
mycoplasma pneumoniae pneumonia
phlegm-heat obstructing lung syndrome
clinical effect
interferon gamma(IFN-γ)
interleukin 4(IL-4)
