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目的:探讨加味五虎汤联合阿奇霉素治疗痰热闭肺型小儿支原体肺炎的临床疗效,及对T淋巴细胞亚群的影响。方法:研究对象为2015年1月—2017年2月河南中医药大学第二附属医院收治的150例痰热闭肺型小儿支原体肺炎患儿,采取随机数字表将其分成两组,每组75例。两组患儿均给予阿奇霉素治疗,观察组联合给予加味五虎汤治疗,比较两组临床疗效以及治疗前后T淋巴细胞亚群、炎性细胞因子变化情况。结果:经14 d治疗后,观察组总有效率达98.67%,对照组总有效率为88.00%,观察组优于对照组(P<0.01)。观察组患儿干湿啰音、咳嗽消失时间以及退热时间较对照组患儿均有缩短(P<0.01)。经14 d治疗后,两组CD4+水平,CD4+/CD8+均有明显上升(P<0.01),与对照组治疗后比较,观察组CD4+水平,CD4+/CD8+升高更显著(P<0.01);观察组CD8+水平有显著下降(P<0.01),对照组无明显变化。两组患儿在治疗14 d后血清白细胞介素-6(IL-6),白细胞介素-8(IL-8),肿瘤坏死因子(TNF)-α水平相对于治疗前有明显降低,但与对照组治疗后比较,观察组上述血清炎性因子水平降低更显著(P<0.01)。两组治疗过程中均未发生明显的药物不良反应,且观察组不良反应发生率显著低于对照组(P<0.01)。结论:加味五虎汤联合阿奇霉素治疗痰热闭肺型小儿支原体肺炎能有效减轻患儿机体内炎症反应,提高免疫功能,疗效确切。
Objective: To investigate the clinical efficacy of Jiaweiduhu Decoction combined with azithromycin in the treatment of Mycoplasmal pneumonia in children with sputum heat and lung disease, and its effect on T lymphocyte subsets. Methods: From January 2015 to February 2017, 150 children with sputum pneumoconiosis Mycoplasma pneumonia who were admitted to the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine were divided into two groups with random number table example. Two groups of children were given azithromycin treatment, the observation group combined Jiaweiliuhu Decoction treatment, the clinical efficacy and treatment of both groups before and after T lymphocyte subsets, inflammatory cytokines changes. Results: After 14 days of treatment, the total effective rate was 98.67% in the observation group and 88.00% in the control group. The observation group was superior to the control group (P <0.01). The wet and dry rales of children in the observation group, the disappearance of cough and the time of fever were shorter than those in the control group (P <0.01). The levels of CD4 + and CD4 + / CD8 + in the two groups increased significantly after 14 days of treatment (P <0.01). Compared with the control group, the levels of CD4 + and CD4 + / CD8 + in the two groups increased significantly (P <0.01) Group CD8 + levels were significantly decreased (P <0.01), the control group no significant change. The levels of serum IL-6, IL-8 and TNF-α in both groups after treatment for 14 days were significantly lower than those before treatment Compared with the control group after treatment, the observed serum inflammatory cytokine levels decreased more significantly (P <0.01). No significant adverse drug reactions occurred in the two groups, and the incidence of adverse reactions in the observation group was significantly lower than that in the control group (P <0.01). Conclusion: Jiaweiduhu decoction combined with azithromycin in the treatment of sputum heat and pneumonia in children with Mycoplasma pneumonia can effectively reduce the inflammatory reaction in children, improve immune function, the exact effect.