中西医结合治疗小儿肺炎支原体肺炎效果观察

目的观察中西医结合治疗小儿肺炎支原体肺炎(mycoplasma pneumoniae pneumonia,MPP)的效果。方法选取2011年1月—2013年10月收治的MPP的患儿480例,随机分为对照组和治疗组各240例。对照组单纯采用阿奇霉素治疗,10 mg/kg溶于生理盐水(浓度为1 mg/ml)中静脉滴注,1次/d,连续用药3 d后停药3 d,改为口服阿奇霉素10 mg/kg,1次/d,连续用药3 d停药2 d,再连续用药3 d。治疗组在对照组的基础上联合麻杏石甘汤加减进行治疗,水煎服,日1剂,连续服用14d。对比两组疗效、症状体征消失时间、治疗时间及治疗前后血清CRP、IgE浓度,观察两组不良反应。结果总有效率对照组60.0%,治疗组93.3%,比较差异有统计学意义(P0.05)。治疗组症状体征消失时间及治疗时间[(7.5±2.1)、(9.6±1.5)d]均明显短于对照组[(11.2±2.6)、(13.4±2.8)d],比较差异均有统计学意义(均P0.05)。治疗后治疗组血清CRP、IgE浓度[(7.2±4.6)mg/L、(134.3±8.5)U/L]明显低于对照组[(18.4±5.1)mg/L、(167.3±15.4)U/L],比较差异均有统计学意义(均P0.05)。不良反应发生率治疗组5.0%,对照组10.0%,比较差异有统计学意义(P0.05)。结论中西医结合治疗小儿MPP可有效清肺热、止咳平喘,明显提高治疗效果,减小不良反应,有效缩短治疗时间,值得在临床推广使用。

Clinical observation on integrated Chinese and western medicine for children with mycoplasma pneumonia

Objective To observe the clinical efficacy of integrated Chinese and western medicine for mycoplasma pneumonia （MPP） in children.Methods 480 children with MPP treated from January 2011 to October 2013 were randomly divided into control group and treatment group,240 children for each group.Control group were treated with azithromycin,10 mg/kg dissolved in 20-40 ml of normal saline （concentration of 1 mg/ml） for intravenous administration,once daily,for three days.And then azithromycin was discontinued,3d later,oral azithromycin was given,10 mg/kg,once daily,for 3 days,followed by withdrawal of 2d,then continuous administration of 3d.Treatment group received Maxing Shigan decoction in addition,one dose daily for 14d.Both groups were com- pared for clinical efficacy,the time to symptom disappearance,treatment course and serum levels of CRP and IgE,and adverse reactions.T-test was used for measurement data,χ^2 test for count data,the result of P〈0.05 indicated the difference was statistically significant.Results The total effective rate was 60% in the control group and 93.3% in treatment group,the difference was statistically significant（P〈0.05）.The time to symptom disappearance and treatment course were （7.5 ± 2.1）d and （9.6± 1.5） respectively in treatment group,which were significantly shorter than those in control group [（11.2 ±2.6）,（13.4 ± 2.8）d],the difference was statistically significant（P〈0.05）.The serum levels of CRP and IgE were （7.2 ± 4.6）mg/L and （134.3 ± 8.5）U/L] in treatment group, which were significantly lower than those in control group [（18.4 ± 5.1）mg/L,（167.3 ± 15.4）U/L],the difference was statistically significant（P〈0.05）.The incidence of adverse reactions was 5% in treatment group and10% in control group,the difference was statistically significant（P〈0.05）.Conclusion Integrated Chinese and western medicine for mycoplasma pneumonia（MPP） in children has the action of clearing lung heat, arresting cough and asthma,and can obviously improve clinical efficacy,reduce adverse reactions,which is worthy of clinical use.