硝黄细辛贴治疗小儿肺炎喘嗽(痰热闭肺证)的随机对照研究
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摘要
目的观察硝黄细辛贴治疗小儿肺炎喘嗽(痰热闭肺证)的临床疗效。方法患儿65例随机分为两组,均采用常规抗感染及对症治疗,治疗组给予硝黄细辛贴治疗,对照组予安慰剂贴,疗程17 d。结果与对照组比较,治疗组主要症状体征积分明显下降(P <0.05)。治疗组的住院时间,咳嗽、发热、肺部啰音持续时间等明显低于对照组(P <0.05),随访6个月内的发热和咳嗽次数也明显较少(P <0.05)。炎症指标方面,治疗组的白细胞介素-10(IL-10)、白细胞介素-17(IL-17)、转化生长因子-β1(TGF-β1)水平低于对照组(P <0.01或P <0.001)。结论硝黄细辛贴治疗小儿(痰热闭肺证)肺炎喘嗽疗效显著,可明显改善患儿的主要症状、体征及降低相关的炎症指标。
Objective: To observe the clinical efficacy of Xiaohuang Xixin Application on phlegm-heat obstructing lungs pneumonia in children. Methods: 65 cases were randomly divided into the treatment group and the control group. The two groups were treated with conventional anti-infection and symptomatic treatment.The treatment group received Xiaohuang Xixin Application,the control group to placebo. Results: Compared with the control group,the scores of main symptoms and signs in the treatment group decreased significantly(P < 0.05).There was significant difference in hospitalization time,cough,fever,lung rale duration and so on between two groups(P < 0.05). Fever and cough in the followed up for 6 months were also significantly fewer(P < 0.05). As for inflammatory indicators,IL-10,IL-17,TGF-β1 levels of IL-10,IL-17 and TGF-β1 of the treatment group were lower than those of the control group(P < 0.01 or P < 0.001). Conclusion: The efficacy of Xiaohuang Xixin Application is obvious on phlegm-heat obstructing lungs pneumonia in children. It can significantly improve the main symptoms and signs of children and reduce the related inflammatory markers,worthy of clinical promotion.
Objective: To observe the clinical efficacy of Xiaohuang Xixin Application on phlegm-heat obstructing lungs pneumonia in children. Methods: 65 cases were randomly divided into the treatment group and the control group. The two groups were treated with conventional anti-infection and symptomatic treatment.The treatment group received Xiaohuang Xixin Application,the control group to placebo. Results: Compared with the control group,the scores of main symptoms and signs in the treatment group decreased significantly(P < 0.05).There was significant difference in hospitalization time,cough,fever,lung rale duration and so on between two groups(P < 0.05). Fever and cough in the followed up for 6 months were also significantly fewer(P < 0.05). As for inflammatory indicators,IL-10,IL-17,TGF-β1 levels of IL-10,IL-17 and TGF-β1 of the treatment group were lower than those of the control group(P < 0.01 or P < 0.001). Conclusion: The efficacy of Xiaohuang Xixin Application is obvious on phlegm-heat obstructing lungs pneumonia in children. It can significantly improve the main symptoms and signs of children and reduce the related inflammatory markers,worthy of clinical promotion.
引文
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[2]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,2002:1204-1205.
[3]陆权,陈慧中,沈叙庄.儿童社区获得性肺炎管理指南(试行)(下)[J].中华儿科杂志,2007,58(3):223-230.
[4]沈玉鹏,杨志华.韩芳林教授运用麻杏化瘀汤治疗小儿肺炎喘嗽痰热闭肺证的体会[J].中医儿科杂志,2016,12(3):10-11.
[5]孙雪文,韩凤芹,张志涛,等.麻杏石甘汤煎煮方式对哮喘模型小鼠气道黏液分泌和急性低氧环境的影响[J].中国实验方剂学杂志,2013,19(6):30-32.
[6]李姗姗,朱英.中药活性成分抗炎作用的研究进展[J].中华中医药学刊,2012,31(1):143-146.
[7]宋磊,徐明,侯静红,等.肺炎支原体感染患儿外周血CD4~+CD25~+调节性T细胞的变化及其临床意义[J].标记免疫分析与临床,2011,8(6):356-359.
[8]JH Lee,HN Yu,LC Wang,et al.The levels of CD4+CD25+regulatory T cells in paediatric patients with allergic rhinitis and bronchialasthma[J].Clinical and Experimental Immunology,2007,148(3):53-63.
[9]Hong Wei Chu,John G.Rino,Rachel B.Wexler,et al.Mycoplasma pneumoniae infection increases airway collagen deposition in amurine model of allergic airway inflammation[J].Am J Physiol Lung Cell Mol Physiol,2005,289(128):L125-L133.
[10]Daisuke Kurai,Kazuhide Nakagaki,Hiroo Wada,et al.Mycoplasma pneumoniae extract induces an IL-17-associated inflammatory reaction in murine lung:impli cation for mycoplasmal pneumonia[J].Inflammation,2013,36(2):285-292.
[11]董秀兰.加味五虎汤治疗痰热闭肺型小儿支原体肺炎临床及细胞免疫研究[D].广州:广州中医药大学,2014.
[12]康妍萌,丁明杰,韩玉玲.细胞因子与肺炎支原体感染的相关研究进展[J].山东医药,2011,51(21):113-114.
[13]修婵,白晓红.大黄、芒硝外敷佐治小儿肺炎50例疗效观察[J].中医儿科杂志,2009,5(4):13-15.
[14]郑丽新,李强.大黄单味外敷治疗小儿肺炎的临床观察[J].中医儿科杂志,2009,5(2):46-47.
[15]李明.浅谈大黄的采收炮制和作用[J].陕西中医,2010,31(3):356-357.
[16]应帮智,张卫华,张振凌.中药芒硝药理作用的研究[J].现代中西医结合杂志,2003,12(20):2155-2156.
[17]曲淑岩,毋英杰.细辛油的抗炎作用[J].药学学报,1982,30(1):12-16.