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郑州大学 附属儿童医院,河南省儿童医院,郑州儿童医院,郑州450018
李前前,硕士,主治医师,从事中医药治疗小儿呼吸系统疾病研究,E-mail:liqianqian2306@163.com
韩雪,硕士,主任医师,从事中医药治疗小儿呼吸及神经系统疾病研究,E-mail:hxue1016@163.com
收稿日期:2023-06-05,
网络出版日期:2023-08-08,
纸质出版日期:2023-10-05
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李前前,韩雪,四霄雪等.肺宁排毒汤治疗儿童难治性肺炎支原体肺炎的临床疗效[J].中国实验方剂学杂志,2023,29(19):145-150.
LI Qianqian,HAN Xue,SI Xiaoxue,et al.Clinical Effect of Feining Paidu Decoction on Refractory Mycoplasma Pneumoniae Pneumonia in Child Patients[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(19):145-150.
李前前,韩雪,四霄雪等.肺宁排毒汤治疗儿童难治性肺炎支原体肺炎的临床疗效[J].中国实验方剂学杂志,2023,29(19):145-150. DOI: 10.13422/j.cnki.syfjx.20240591.
LI Qianqian,HAN Xue,SI Xiaoxue,et al.Clinical Effect of Feining Paidu Decoction on Refractory Mycoplasma Pneumoniae Pneumonia in Child Patients[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(19):145-150. DOI: 10.13422/j.cnki.syfjx.20240591.
目的
2
观察肺宁排毒汤治疗儿童难治性肺炎支原体肺炎的临床疗效及机制。
方法
2
采用随机、对照的研究方法,将96例患儿随机分为对照组和观察组,每组48例。对照组给予阿奇霉素(10 mg·kg
-1
·d
-1
)静滴,疗程7 d,甲泼尼龙(1 mg·kg
-1
·d
-1
)静滴,疗程3 d,并予补液、退热等对症治疗,观察组口服肺宁排毒汤,每日1剂,疗程7 d。观察两组患儿中医证候积分、临床疗效、血清可溶性B7-H3(sB7-H3)、血清炎性因子、凝血功能及肺部影像学[计算机断层扫描(CT)]评分变化,记录不良反应事件的发生情况。
结果
2
观察组临床疗效总有效率为95.74%(45/47),对照组为80.43%(37/46),观察组总有效率显著高于对照组(
Z
=-3.702,
P
<
0.01)。与本组治疗前比较,两组患儿中医证候积分、肺部影像学评分、sB7-H3、肿瘤坏死因子-
α
(TNF-
α
)、白细胞介素-1
β
(IL-1
β
)、白细胞介素-6(IL-6)、
D
-二聚体(
D
-D)、纤维蛋白原(FIB)均明显下降(
P
<
0.05,
P
<
0.01)。与对照组治疗后比较,观察组上述指标均明显优于对照组(
P
<
0.05,
P
<
0.01)。与本组治疗前比较,对照组凝血酶时间(TT)差异无统计学意义,而观察组较前明显延长(
P
<
0.05);与本组治疗前比较,两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)指标差异均无统计学意义;两组均未发生严重不良反应。
结论
2
肺宁排毒汤可通过减轻炎症反应,改善高凝状态,促进肺部炎症吸收,提高儿童难治性肺炎支原体肺炎的临床疗效。
Objective
2
To observe the clinical efficacy of Feining Paidu decoction on refractory Mycoplasma pneumoniae pneumonia in child patients.
Method
2
A randomized controlled trial (RCT) was conducted, with 96 child patients randomly divided into a control group and an observation group, each containing 48 cases. The control group received intravenous azithromycin (10 mg·kg
-1
·d
-1
) for 7 days, intravenous methylprednisolone (1 mg·kg
-1
·d
-1
) for 3 days, along with supportive treatments such as fluid infusion and antipyretics. The observation group received oral administration of Feining Paidu decoction once a day for 7 days. Changes in traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, serum soluble B7-H3 (sB7-H3), serum inflammatory factors, coagulation function, and lung imaging [computer tomography(CT)] scores were observed in both groups. Adverse reaction events were also recorded.
Result
2
The total effective rate in the observation group was 95.74% (45/47), significantly higher than 80.43% (37/46) in the control group (
Z
=-3.702,
P
<
0.01). Compared with the results before treatment, TCM syndrome scores, lung imaging scores, sB7-H3, tumor necrosis factor-
α
(TNF-
α
), interleukin-1
β
(IL-1
β
), interleukin-6 (IL-6),
D
-dimer (
D
-D), and fibrinogen (FIB) levels in both groups all significantly decreased after treatment (
P
<
0.05,
P
<
0.01). After treatment, the observation group showed significantly better results in these indicators than the control group (
P
<
0.05,
P
<
0.01). There was no statistically significant difference in thrombin time (TT) in the control group before and after treatment, while the observation group showed a significant prolongation after treatment (
P
<
0.05). There were no statistically significant differences in activated partial thromboplastin time (APTT) and prothrombin time (PT) between the two groups before treatment, and no serious adverse reactions occurred in either group.
Conclusion
2
Feining Paidu decoction combined with conventional treatment can alleviate inflammatory responses, improve hypercoagulable states, promote the absorption of pulmonary inflammation, and enhance the clinical efficacy of refractory Mycoplasma pneumoniae pneumonia in children.
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