加味麻杏石甘汤治疗小儿支原体肺炎疗效及X线评价研究
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摘要
目的:分析价加味麻杏石甘汤治疗小儿支原体肺炎效果的应用价值。方法:选取(2016年2月—2018年2月)小儿支原体肺炎患儿84例,根据治疗方法不同分为对照组和观察组。对照组患儿采用阿奇霉素序贯治疗,观察组患儿采用阿奇霉素序贯治疗+加味麻杏石甘汤治疗,采用X线及实验室检验评价患儿治疗后疗效。结果:治疗前,两组患儿中医症候主症、次症及总积分比较,差异无统计学意义(P>0.05)。治疗后,观察组患儿中医症候主症、次症及总积分低于对照组,差异有统计学意义(P<0.05)。观察组患者治愈率+显效率为76.19%,对照组为54.76%,观察组患者治愈率+显效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患儿炎症因子、G-CSF、D-D、CysLTs、MPO、GSH-Px水平比较,差异无统计学意义(P>0.05)。治疗后,观察组患儿炎症因子、G-CSF、D-D、CysLTs水平低于对照组,MPO、GSH-Px水平高于对照组,差异有统计学意义(P<0.05)。结论:加味麻杏石甘汤治疗小儿支原体肺炎疗效显著,可减轻炎症反应,抑制氧化应激反应,改善患儿临床症状。
Objective:To analyze the value of X light in evaluating the effect of JModified Maxing Shigan Decoction in the treatment of mycoplasma pneumonia in children. Methods:From February 2016 to February 2018, 84 children with mycoplasma pneumonia were divided into two groups: control group and observation group. The control group was treated with azithromycin sequential treatment and the observation group with azithromycin sequential treatment and Modified Maxing Shigan Decoction, and the therapeutic effect was evaluated by X ray. Results:Before treatment, there was no significant difference in main symptoms, secondary symptoms or total scores between the two groups(P>0.05). After treatment, the main symptoms, secondary symptoms and total scores of TCM symptoms in the observation group were lower than those in the control group(P<0.05). The cured effective rate was 76.19% in the observation group and 54.76% in the control group. The marked cure rate in the observation group was higher than that in the control group(P<0.05). Before treatment, there was no significant difference in the level of GSH-Px between the two groups(P>0.05). After treatment, the level of inflammatory factor G-CSFN D-Dy CysLTs in the observation group was lower than that in the control group. The level of GSH-Px was higher than that in the control group. In the control group, the difference was statistically significant(P<0.05). Conclusion:Modified Maxing Shigan Decoction is effective in treating mycoplasma pneumonia in children under X-ray. It can reduce inflammatory reaction, inhibit oxidative stress reaction and improve clinical symptoms of children with mycoplasma pneumoniae.
Objective:To analyze the value of X light in evaluating the effect of JModified Maxing Shigan Decoction in the treatment of mycoplasma pneumonia in children. Methods:From February 2016 to February 2018, 84 children with mycoplasma pneumonia were divided into two groups: control group and observation group. The control group was treated with azithromycin sequential treatment and the observation group with azithromycin sequential treatment and Modified Maxing Shigan Decoction, and the therapeutic effect was evaluated by X ray. Results:Before treatment, there was no significant difference in main symptoms, secondary symptoms or total scores between the two groups(P>0.05). After treatment, the main symptoms, secondary symptoms and total scores of TCM symptoms in the observation group were lower than those in the control group(P<0.05). The cured effective rate was 76.19% in the observation group and 54.76% in the control group. The marked cure rate in the observation group was higher than that in the control group(P<0.05). Before treatment, there was no significant difference in the level of GSH-Px between the two groups(P>0.05). After treatment, the level of inflammatory factor G-CSFN D-Dy CysLTs in the observation group was lower than that in the control group. The level of GSH-Px was higher than that in the control group. In the control group, the difference was statistically significant(P<0.05). Conclusion:Modified Maxing Shigan Decoction is effective in treating mycoplasma pneumonia in children under X-ray. It can reduce inflammatory reaction, inhibit oxidative stress reaction and improve clinical symptoms of children with mycoplasma pneumoniae.
引文
[1] 谢辉.阿奇霉素联合脂溶性维生素治疗小儿肺炎支原体肺炎的临床观察[J].重庆医学,2016,45(8):1151-1154.
[2] Chaudhry R,Ghosh A,Chandolia A.Pathogenesis of mycoplasma pneumoniae:An update[J].Indian J Med Microbiol,2016,34(1):7-16.
[3] 耿淑霞,陈艳.蒿芩麻杏石甘汤联合夜咳宁贴敷治疗儿童支原体肺炎临床研究[J].哈尔滨医药,2017,37(5):476-477.
[4] 付新,刘阳,王雪梅,等.麻杏石甘汤的研究进展[J].中医药信息,2017,34(2):126-128.
[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,2003:1204-1205.
[6] 汪受传.中医儿科学[M].北京:中国中医药出版社,2004:100-106.
[7] 中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南[S].中华儿科杂志,2013,51(11):856-862.
[8] Afshar M,Foster CL,Layden JE,et al.Azithromycin use and outcomes in severe sepsis patients with and without pneumonia[J].J Crit Care,2016,17(32):120-125.
[9] 陈映辉.阿奇霉素序贯疗法合痰热清治疗支原体肺炎临床疗效及安全性研究[J].现代中西医结合杂志,2016,25(14):1570-1571,1585.
[10] Muro S,Tabara Y,Matsumoto H,et al.Relationship among chlamydia and mycoplasma pneumoniae seropositivity,IKZFI genotype and chronic obstructive pulmonary disease in a ceneral Japanese population:The nagahama study[J].Medicine Baltimore,2016,95(15):e3371.
[11] 杨明光,德勤.阿奇霉素配伍脂溶性维生素对支原体肺炎患儿血清炎症因子、趋化因子及肺功能的影响[J].海南医学院学报,2017,23(7):969-972.
[12] 杨淑芝.加味麻杏石甘汤对小儿支原体肺炎痰热证的疗效研究[J].检验医学与临床,2017,14(6):881-882.
[13] 王东升,霍婧伟,傅瑶,等.阿奇霉素联合中药拔罐治疗儿童支原体肺炎疗效观察[J].北京中医药,2017,4(8):739-741.
[14] 王志江,楼献奎.麻杏石甘汤加味联合阿奇霉素治疗小儿肺炎支原体肺炎的疗效观察[J].现代实用医学,2018,30(3):373-375.
[15] 王云霞,刘文光,谷强.合并支原体感染的大叶性肺炎患儿肺泡灌洗液中常规细胞学检测及意义[J].中国内镜杂志,2016,22(2):30-34.
[16] 张东海.TNF-a、IL-6、IL-10在肺炎支原体肺炎患儿血清中的表达及意义[J].海南医学院学报,2016,22(12):1283-1286.
[17] Yoneda N,Yoneda S,Niimi H,et al.Polymicrobial Amniotic fluid infection with mycoplasma/ureaplasma and other bacteria induces severe intra-amniotic inflammation associated with poor perinatal prognosis in preterm labor[J].Am J Reprod Immunol,2016,75(2):112-125.
[18] De Brito RC,Iucena-Silva N,Torresl C,et al.The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia[J].BMC Pulm Med,2016,16(1):170.
[19] 邵新环,张彩艳,吕俊,等.小儿肺炎支原体肺炎的临床特点(附226例分析)[J].山东医药,2017,57(31):73-75.
[20] 唐青松.小儿肺炎支原体肺炎临床治疗研究[J].中国社区医师,2017,33(4):54-55.
[21] Rodman JB,Krivec U,Praprotnik M,et al.Clinical characteristics of infections caused by Mycoplasma pneumoniae P1 genotypes in children[J].European Journal of Clinical Microbiology & Infectious Diseases,2018,6(1):1-8.
[22] 陈尚德.小儿肺炎支原体肺炎诊治方法探讨[J].中国卫生标准管理,2017,8(3):56-58.
[23] 侯萍.大环内酯类药物联合自拟清肺通腑泻痰方治疗小儿支原体肺炎的效果分析[J].辽宁中医杂志,2018,45(9):1890-1893.
[24] 韩晓虹,陆晓丹,符青.小儿消积止咳口服液联合阿奇霉素治疗小儿支原体肺炎[J].辽宁中医杂志,2018,45(3):551-553.
[25] 刘方雷,王鹏飞,田春香,等.复方苦参注射液对原发性肺癌放射性肺炎的防治探讨[J].辽宁中医杂志,2018,45(2):317-319.
[26] 何薇,黄文娴,曾伟兰.支原体肺炎患儿应用阿奇霉素联合中医辨证分型治疗临床应用价值研究[J].辽宁中医药大学学报,2017,19(7):195-197.
[27] 张云鹏,牛佳,汪宇.止咳清肺口服液治疗社区获得性肺炎临床研究[J].辽宁中医药大学学报,2017,19(8):208-210.
[28] 胡利军,李胖.痰热清联合阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的效果分析[J].辽宁中医杂志,2017,44(7):1442-1444.
[29] 郭秀伟,张培彤,孙桂芝.孙桂芝治疗放射性肺炎经验浅析[J].辽宁中医杂志,2017,44(10):2045-2047.
[30] 刘方雷,王鹏飞,田春香,等.复方苦参注射液对原发性肺癌放射性肺炎的防治探讨[J].辽宁中医杂志,2018,45(2):317-319.
[2] Chaudhry R,Ghosh A,Chandolia A.Pathogenesis of mycoplasma pneumoniae:An update[J].Indian J Med Microbiol,2016,34(1):7-16.
[3] 耿淑霞,陈艳.蒿芩麻杏石甘汤联合夜咳宁贴敷治疗儿童支原体肺炎临床研究[J].哈尔滨医药,2017,37(5):476-477.
[4] 付新,刘阳,王雪梅,等.麻杏石甘汤的研究进展[J].中医药信息,2017,34(2):126-128.
[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,2003:1204-1205.
[6] 汪受传.中医儿科学[M].北京:中国中医药出版社,2004:100-106.
[7] 中华医学会儿科学分会呼吸学组.儿童社区获得性肺炎管理指南[S].中华儿科杂志,2013,51(11):856-862.
[8] Afshar M,Foster CL,Layden JE,et al.Azithromycin use and outcomes in severe sepsis patients with and without pneumonia[J].J Crit Care,2016,17(32):120-125.
[9] 陈映辉.阿奇霉素序贯疗法合痰热清治疗支原体肺炎临床疗效及安全性研究[J].现代中西医结合杂志,2016,25(14):1570-1571,1585.
[10] Muro S,Tabara Y,Matsumoto H,et al.Relationship among chlamydia and mycoplasma pneumoniae seropositivity,IKZFI genotype and chronic obstructive pulmonary disease in a ceneral Japanese population:The nagahama study[J].Medicine Baltimore,2016,95(15):e3371.
[11] 杨明光,德勤.阿奇霉素配伍脂溶性维生素对支原体肺炎患儿血清炎症因子、趋化因子及肺功能的影响[J].海南医学院学报,2017,23(7):969-972.
[12] 杨淑芝.加味麻杏石甘汤对小儿支原体肺炎痰热证的疗效研究[J].检验医学与临床,2017,14(6):881-882.
[13] 王东升,霍婧伟,傅瑶,等.阿奇霉素联合中药拔罐治疗儿童支原体肺炎疗效观察[J].北京中医药,2017,4(8):739-741.
[14] 王志江,楼献奎.麻杏石甘汤加味联合阿奇霉素治疗小儿肺炎支原体肺炎的疗效观察[J].现代实用医学,2018,30(3):373-375.
[15] 王云霞,刘文光,谷强.合并支原体感染的大叶性肺炎患儿肺泡灌洗液中常规细胞学检测及意义[J].中国内镜杂志,2016,22(2):30-34.
[16] 张东海.TNF-a、IL-6、IL-10在肺炎支原体肺炎患儿血清中的表达及意义[J].海南医学院学报,2016,22(12):1283-1286.
[17] Yoneda N,Yoneda S,Niimi H,et al.Polymicrobial Amniotic fluid infection with mycoplasma/ureaplasma and other bacteria induces severe intra-amniotic inflammation associated with poor perinatal prognosis in preterm labor[J].Am J Reprod Immunol,2016,75(2):112-125.
[18] De Brito RC,Iucena-Silva N,Torresl C,et al.The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia[J].BMC Pulm Med,2016,16(1):170.
[19] 邵新环,张彩艳,吕俊,等.小儿肺炎支原体肺炎的临床特点(附226例分析)[J].山东医药,2017,57(31):73-75.
[20] 唐青松.小儿肺炎支原体肺炎临床治疗研究[J].中国社区医师,2017,33(4):54-55.
[21] Rodman JB,Krivec U,Praprotnik M,et al.Clinical characteristics of infections caused by Mycoplasma pneumoniae P1 genotypes in children[J].European Journal of Clinical Microbiology & Infectious Diseases,2018,6(1):1-8.
[22] 陈尚德.小儿肺炎支原体肺炎诊治方法探讨[J].中国卫生标准管理,2017,8(3):56-58.
[23] 侯萍.大环内酯类药物联合自拟清肺通腑泻痰方治疗小儿支原体肺炎的效果分析[J].辽宁中医杂志,2018,45(9):1890-1893.
[24] 韩晓虹,陆晓丹,符青.小儿消积止咳口服液联合阿奇霉素治疗小儿支原体肺炎[J].辽宁中医杂志,2018,45(3):551-553.
[25] 刘方雷,王鹏飞,田春香,等.复方苦参注射液对原发性肺癌放射性肺炎的防治探讨[J].辽宁中医杂志,2018,45(2):317-319.
[26] 何薇,黄文娴,曾伟兰.支原体肺炎患儿应用阿奇霉素联合中医辨证分型治疗临床应用价值研究[J].辽宁中医药大学学报,2017,19(7):195-197.
[27] 张云鹏,牛佳,汪宇.止咳清肺口服液治疗社区获得性肺炎临床研究[J].辽宁中医药大学学报,2017,19(8):208-210.
[28] 胡利军,李胖.痰热清联合阿奇霉素序贯疗法治疗小儿肺炎支原体肺炎的效果分析[J].辽宁中医杂志,2017,44(7):1442-1444.
[29] 郭秀伟,张培彤,孙桂芝.孙桂芝治疗放射性肺炎经验浅析[J].辽宁中医杂志,2017,44(10):2045-2047.
[30] 刘方雷,王鹏飞,田春香,等.复方苦参注射液对原发性肺癌放射性肺炎的防治探讨[J].辽宁中医杂志,2018,45(2):317-319.