养阴清肺汤联合孟鲁司特治疗小儿支原体肺炎致慢性咳嗽临床研究
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摘要
目的:观察在常规疗法基础上以养阴清肺汤联合孟鲁司特治疗小儿支原体肺炎(MPP)致慢性咳嗽的疗效。方法:将58例MPP致慢性咳嗽的患儿采用随机数字表法分为2组各29例,2组均在抗炎、降温、镇咳等对症处理基础上加用孟鲁司特钠咀嚼片治疗,研究组联合中药养阴清肺汤治疗,2组均持续治疗2周。观察2组患儿的症状体征缓解时间、治疗效果及不良反应发生情况,检测治疗前后血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6 (IL-6)的水平。结果:治疗后,研究组总有效率96.55%,对照组总有效率79.31%,2组比较,差异有统计学意义(P <0.05)。研究组咳嗽、发热、气喘及肺部湿啰音消失时间均较对照组缩短,差异均有统计学意义(P <0.05)。2组均未见明显不良反应。结论:在常规疗法基础上以孟鲁司特钠咀嚼片联合养阴清肺汤治疗MPP致慢性咳嗽,有助于缓解患儿的症状体征和减轻炎症反应,临床疗效及安全性显著。
Objective:To observe the clinical effect of Yangyin Qingfei tang combined with montelukast based on theroutine treatment for chronic cough caused by mycoplasma pneumonia(MPP) in children. Methods: Divided 58 cases of children with chronic cough caused by MPP into two groups according to random number table method,29 cases in each group. Based on the symptomatic treatment of anti-inflammation,cooling and antitussive,the two groups were treated with montelukast sodium chewable tablets, and the study group additionally received Yangyin Qingfei tang for treatment. The treatment of the two groups lasted for two weeks continuously. Observed the remission time of symptoms and body signs,the therapeutic effect and the adverse reactions, and detected the levels of tumor necrosis factor-α(TNF-α) and interleukins-6(IL-6) before and after treatment in the two groups. Results:After treatment, the total effective rate was96.55% in the study group and was 79.31% in the control group,the difference being significant(P < 0.05). The disappearance time of coughing,fever,asthma and moist rales in the study group was shorter than that in the control group,differences being significant(P < 0.05). No adverse reaction was found in the two groups during the treatment. Conclusion:Based on the routine treatment,the therapy of montelukast sodium chewable tablets combined with Yangyin Qingfei tang for chronic cough caused by MPP can relieve the symptoms and body signs,and reduce the inflammatory reactions of children,with significant clinical effect and safety.
Objective:To observe the clinical effect of Yangyin Qingfei tang combined with montelukast based on theroutine treatment for chronic cough caused by mycoplasma pneumonia(MPP) in children. Methods: Divided 58 cases of children with chronic cough caused by MPP into two groups according to random number table method,29 cases in each group. Based on the symptomatic treatment of anti-inflammation,cooling and antitussive,the two groups were treated with montelukast sodium chewable tablets, and the study group additionally received Yangyin Qingfei tang for treatment. The treatment of the two groups lasted for two weeks continuously. Observed the remission time of symptoms and body signs,the therapeutic effect and the adverse reactions, and detected the levels of tumor necrosis factor-α(TNF-α) and interleukins-6(IL-6) before and after treatment in the two groups. Results:After treatment, the total effective rate was96.55% in the study group and was 79.31% in the control group,the difference being significant(P < 0.05). The disappearance time of coughing,fever,asthma and moist rales in the study group was shorter than that in the control group,differences being significant(P < 0.05). No adverse reaction was found in the two groups during the treatment. Conclusion:Based on the routine treatment,the therapy of montelukast sodium chewable tablets combined with Yangyin Qingfei tang for chronic cough caused by MPP can relieve the symptoms and body signs,and reduce the inflammatory reactions of children,with significant clinical effect and safety.
引文
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[12]赵西斌,李燕宁.桑菊饮合止咳散加减联合阿奇霉素治疗小儿肺炎支原体感染临床观察[J].新中医,2017,49(9):107-109.
[13]窦金明,申文忠,韩辉.清肺养阴汤治疗小儿支原体肺炎[J].山东中医杂志,2006,25(10):688.
[14]王军锋.血清IL-6、IL-8、IL-10、TNF-α检测结果对预防儿童肺炎支原体肺炎的临床意义[J].华南预防医学,2017,17(1):83-85.
[15]唐洁芬,余培煌.养阴清肺汤联合孟鲁司特治疗小儿支原体感染肺炎后慢性咳嗽临床观察[J].四川中医,2016,23(8):72-75.
[16]刘艳飞,刘玥,成龙,等.养阴清肺汤治疗慢性咳嗽和慢性阻塞性肺疾病疗效和安全性的Meta分析[J].中国循证医学杂志,2017,18(6):698-704.
[2]崔玉婕,陶芳,李鹏,等.患儿肺炎支原体感染的临床研究[J].中华医院感染学杂志,2015,25(18):4263-4264,4290.
[3]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,2012.
[4]中华医学会儿科学分会呼吸学组慢性咳嗽协作组.中国儿童慢性咳嗽诊断与治疗指南(2013年修订)[J].中华儿科杂志,2014,52(3):184-188.
[5]国家中医药管理局.ZY/T00.1~001.9-94中医病证诊断疗效标准[S].南京:南京大学出版社,1994.
[6]郭俊珍.阿奇霉素联合痰热清治疗小儿支原体肺炎临床疗效观察[J].山西医药杂志,2016,45(7):810-811.
[7]张晓娟,沈伊娜.小儿肺炎支原体肺炎发病机制的研究进展[J].安徽医学,2016,37(1):111-113.
[8]陈志敏,赵顺英,王颖项,等.肺炎支原体感染的若干问题[J].中华儿科杂志,2016,54(2):84-87.
[9]李晓品,李艳红,许凤勤,等.阿奇霉素对肺炎支原体肺炎感染患儿Th1/Th2指标的影响研究[J].中华医院感染学杂志,2016,26(16):3797-3799.
[10]冯伟伟,阮为勇,王宇军,等.苏黄止咳胶囊与孟鲁司特治疗小儿肺炎支原体感染后咳嗽的疗效观察[J].现代中西医结合杂志,2015,24(29):3239-3241.
[11]赵久龄,王玉水,郭泽洋.儿童肺炎支原体肺炎的中医药治疗进展[J].中国中医急症,2014,23(8):1502-1504.
[12]赵西斌,李燕宁.桑菊饮合止咳散加减联合阿奇霉素治疗小儿肺炎支原体感染临床观察[J].新中医,2017,49(9):107-109.
[13]窦金明,申文忠,韩辉.清肺养阴汤治疗小儿支原体肺炎[J].山东中医杂志,2006,25(10):688.
[14]王军锋.血清IL-6、IL-8、IL-10、TNF-α检测结果对预防儿童肺炎支原体肺炎的临床意义[J].华南预防医学,2017,17(1):83-85.
[15]唐洁芬,余培煌.养阴清肺汤联合孟鲁司特治疗小儿支原体感染肺炎后慢性咳嗽临床观察[J].四川中医,2016,23(8):72-75.
[16]刘艳飞,刘玥,成龙,等.养阴清肺汤治疗慢性咳嗽和慢性阻塞性肺疾病疗效和安全性的Meta分析[J].中国循证医学杂志,2017,18(6):698-704.