摘要
目的观察银翘散合麻杏石甘汤加减联合三联雾化吸入治疗急性期肺炎支原体肺炎(MPP)(风热闭肺证)的临床疗效及对炎症因子的影响。方法选择200例MPP(风热闭肺证)患儿作为观察对象,随机分为对照组与观察组各100例。对照组给予退热、止咳、化痰、平喘等对症处理措施,注射用乳糖酸红霉素及三联雾化吸入;观察组在对照组治疗的基础上口服银翘散合麻杏石甘汤加减方,每天1剂,疗程7 d。记录临床痊愈天数和比例、完全退热天数和比例、肺部阴影完全吸收比例;进行治疗前后风热闭肺证评分,检测治疗前后C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和降钙素原(PCT)水平、乳酸脱氢酶(LDH)、D-二聚体(D-D)和中性粒细胞/淋巴细胞比值(NLR);记录转为难治性MPP或重症MPP、大环内酯类药物无反应性MPP比例。结果治疗后,观察组患儿临床痊愈时间、咳嗽缓解时间和完全退热时间均短于对照组(P<0.05);观察组临床痊愈、完全退热和肺部阴影完全吸收比例均高于对照组(P<0.05);治疗后,两组患儿风热闭肺证主证(咳嗽、发热、咽痛)及总分降低(P<0.05),且观察组低于对照组(P<0.05);治疗后,两组患儿CRP、IL-6、TNF-α、PCT、LDH、D-D和NLR下降(P<0.05),且治疗后观察组低于对照组(P<0.05);治疗后,观察组难治性MPP、重症MPP和大环内酯类药物无反应性MPP发生率低于对照组(P<0.05);观察组临床疗效总有效率高于对照组(P<0.05)。结论银翘散合麻杏石甘汤加减内服联合三联雾化吸入治疗急性期MPP(风热闭肺证)患儿,能缩短病程,抑制促炎因子表达,降低难治性MPP、重症MPP和大环内酯类药物无反应性MPP发生,改善预后。
Objective:To observe the clinical efficacy of oral administration of Modified Yinqiao Powder combined with Maxing Shigan Decoction and triple nebulization in treating children with acute mycoplasma pneumonia(MPP)presenting with the syndrome of wind-heat obstructing lung.Methods:A total of 200 eligible pediatric patients were randomly divided into a control group and an observation group,each with 100 cases.The control group received symptomatic treatment including antipyretics,cough suppressants,expectorants,bronchodilators,intravenous erythromycin lactobionate and triple nebulization.On this basis,the observation group received oral administration of Modified Yinqiao Powder combined with Maxing Shigan Decoction,one dose per day,for 7 days.The time and proportion of clinical recovery,complete defervescence,and complete absorption of pulmonary shadows were recorded.Syndrome scores for wind-heat obstructing lung were assessed before and after treatment.Levels of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),procalcitonin(PCT),lactate dehydrogenase(LDH),D-dimer(D-D),and neutrophil-to-lymphocyte ratio(NLR)were measured preand post-treatment.Incidence rates of refractory MPP(RMPP),severe MPP(SMPP),and macrolide-unresponsive MPP(MUMPP)were also recorded.Results:After treatment,the observation group showed shorter durations of clinical recovery,cough relief,and defervescence compared with the control group(P<0.05).The proportions of clinical recovery,complete defervescence,and complete absorption of pulmonary shadows were higher in the observation group than in the control group(P<0.05).Both groups showed significant decreases in symptom scores for cough,fever,sore throat,and total scores after treatment(P<0.05),with greater improvements in the observation group(P<0.05).Levels of CRP,IL-6,TNF-α,PCT,LDH,D-D,and NLR after treatment decreased significantly in both groups(P<0.05),and the observation group showed lower levels than the control group(P<0.05).The incidence of RMPP,SMPP,and MUMPP was significantly lower in the observation group(P<0.05).The total effective rate was also higher in the observation group than in the control group(P<0.05).Conclusion:Oral administration of Modified Yinqiao Powder combined with Maxing Shigan Decoction and triple nebulization in children with acute MPP and syndrome of wind-heat obstructing lung can shorten the disease course,accelerate symptom and sign resolution,inhibit pro-inflammatory cytokine expression,reduce the risk of RMPP,SMPP,and MUMPP,and improve prognosis.
作者
秦东
田春馨
朱晓丽
刘小磊
Qin Dong;Tian Chunxin;Zhu Xiaoli;Liu Xiaolei(Pukou Hospital of Traditional Chinese Medicine Affiliated to China Pharmaceutical University,Jiangsu,Nanjing 211800,China)
出处
《中国中医急症》
2025年第7期1216-1220,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
江苏省中医药学会科研项目(ZXFZ2024031)。
关键词
肺炎支原体肺炎
儿童
银翘散
麻杏石甘汤
风热闭肺证
炎症因子
预后
Mycoplasma pneumoniae pneumonia
Children
Yinqiao Powder
Maxing Shigan Decoction
Syndrome of wind-heat obstructing lung
Inflammatory factors
Prognosis
