沙参麦冬汤加减联合阿奇霉素序贯疗法治疗小儿支原体肺炎临床研究

目的：观察沙参麦冬汤加减联合阿奇霉素序贯疗法治疗小儿支原体肺炎（MPP） 的临床疗效。方法：将80 例MPP 患儿按随机数字表法分为常规组和试验组各40 例。常规组给予阿奇霉素序贯治疗，试验组给予沙参麦冬汤加减联合阿奇霉素序贯治疗。治疗10 d 后，比较2 组临床疗效、症状体征缓解时间及不良反应发生率，比较2 组治疗前后中医证候积分、炎症因子［白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、降钙素原（PCT）］ 水平。结果：试验组总有效率为97.50%，常规组为80.00%，2 组比较，差异有统计学意义（P＜0.05）。治疗后，试验组退热时间及气喘、咳嗽、啰音消失时间均短于常规组，差异有统计学意义（P＜0.05）。治疗后，2 组中医证候主、次症积分及总积分均较治疗前均降低（P＜0.05），且试验组上述各项积分均低于常规组（P＜0.05）。治疗后，2 组IL-6、TNF-α、PCT 水平均较治疗前降低（P＜0.05），且试验组上述各项指标均低于常规组（P＜0.05）。治疗期间， 试验组不良反应发生率为15.00%， 常规组为17.50%，2 组比较，差异无统计学意义（P＞0.05）。结论：沙参麦冬汤加减联合阿奇霉素序贯疗法治疗小儿MPP 能提高临床疗效，下调炎症因子水平，有效缓解患儿症状体征。

Clinical Study on Modified Shashen Maidong Decoction Combined with SequentialThrapy of Azithromycin for Mycoplasma Pneumonia in Children

Abstract： Objective： To observe the clinical effect of modified Shashen Maidong Decoctioncombined with sequential therapy of Azithromycin on mycoplasma pneumonia (MMP) in children.Methods： A total of 80 children with MPP were divided into the conventional group and the trial groupby random number table method， with 40 cases in each group. The conventional group was givensequential therapy of Azithromycin，and the trial group was given modified Shashen Maidong Decoctioncombined with sequential therapy of azithromycin. Ten days after treatment， the clinical effects， theremission time of symptoms and signs and the incidence of adverse reactions were compared betweenthe two groups. The traditional Chinese medicine (TCM) syndrome scores and levels of inflammatoryfactors， including interleukin- 6 (IL- 6)， tumor necrosis factor- α (TNF- α) and procalcitonin (PCT) werecompared before and after treatment between the two groups. Results： The total effective rate was97.50% in the trial group and 80.00% in the conventional group， the difference being significant (P＜0.05). After treatment，the disappearing time of fever，asthma，cough and rales in the trial group was respectively shorter than that in the conventional group，the difference being significant (P＜0.05). Aftertreatment，the main and secondary syndrome scores and total scores in the two groups were decreasedwhen compared with those before treatment (P＜0.05)， and the above scores in the trial group werelower than those in the conventional group (P＜0.05). After treatment，the levels of IL- 6，TNF- α andPCT in the two groups were decreased when compared with those before treatment (P＜0.05)，and theabove levels in the trial group were lower than those in the conventional group (P＜0.05). Duringtreatment， the incidence of adverse reactions was 15.00% in the trial group and 17.50% in theconventional group， there being no significant difference between the two groups (P＞0.05).Conclusion： Modified Shashen Maidong Decoction combined with sequential therapy of Azithromycincan improve the clinical effect， reduce the levels of inflammatory factors， and effectively relieve thesymptoms and signs of children with MPP.