世界中医药

目的：观察麻杏石甘汤加减辨治小儿支原体肺炎较单纯西药治疗的疗效优势，探讨其治疗肺炎支原体患儿的作用机制，为临床小儿支原体肺炎治疗方案的选择提供参考。方法：选取2017年1月至2018年5月广西中医药大学附属瑞康医院收治的小儿支原体肺炎患者86例作为研究对象，按就诊先后顺序的单、双号分为观察组和对照组，每组43例。2组患儿均按照常规治疗方案，包括一般治疗、对症处理、抗生素及肾上腺皮质激素治疗，观察组在此基础上加用麻杏石甘汤加减治疗，2组均以连续治疗2周为1个疗程。观察2组治疗前后炎性反应指标白细胞（WBC）、C反应蛋白（CRP）、红细胞沉降率（ESR）、白细胞介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）的变化，观察2组治疗前后免疫功能指标CD3+、CD4+、CD8+的变化；比较2组治疗期间的退热时间、止咳时间、X线阴影消失时间、罗音消失时间、住院时间；比较2组患儿治疗过程中出现的不良反应；比较结束治疗后2组患儿的临床疗效。结果：1）2组患儿治疗前WBC、CRP、ESR、IL-10、TNF-α比较，差异无统计学意义（P>0.05），2组患儿治疗后上述指标均较治疗前明显下降，且观察组患儿上述指标均低于对照组（均P<0.05）。2）2组患儿治疗前CD3+、CD4+、CD8+比较，差异无统计学意义（P>0.05），治疗后2组患儿CD3+、CD4+均较治疗前显著升高，且观察组患儿高于对照组（P<0.05），而CD8+值显著下降，观察组患儿低于对照组（P<0.05）。3）观察组患儿退热时间、止咳时间、X线阴影消失时间、罗音消失时间、住院时间均明显低于对照组（均P<0.05）。4）完成治疗后观察组患儿治愈率、总有效率明显高于对照组（P<0.05）。5）2组患儿治疗期间不良反应发生率比较，差异无统计学意义（P>0.05）。结论：麻杏石甘汤能提高小儿支原体肺炎疗效，抑制炎性反应，缩短病程，提高免疫力。

English Summary:

To compare the curative effects of Maxing Shigan Decoction on mycoplasma pneumonia in children and western medicine alone，and to explore the therapeutic mechanism of Maxing Shigan Decoction on mycoplasma pneumonia in children，so as to provide a reference for the selection of therapeutic schemes for children with mycoplasma pneumonia in clinic.Methods:A total of 86 children with mycoplasma pneumonia admitted to Ruikang Hospital，Affiliated to Guangxi University of Traditional Chinese Medicine from January 2017 to May 2018 were selected as the study subjects.The patients were numbered according to the order of treatment.The single number was 43 cases in the control group and the double number was 43 cases in the study group.Two groups of children were treated according to the routine treatment：general treatment，symptomatic treatment，antibiotics and adrenocortical hormone treatment.The study groups were treated with Maxing Shigan Decoction.The 2 groups of children were treated for 2 weeks as a course of treatment.The changes of inflammatory markers such as white blood cell (WBC)，C-reactive protein (CRP)，erythrocyte sedimentation rate (ESR)，interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) were observed before and after treatment.The changes of immune function indexes such as cluster of differentiation3+ (CD3+)，CD4+，CD8+ were observed and compared between the two groups.The antipyretic time，cough time，X-ray shadow disappearance time，lung rales disappearance time，hospitalization time were observed and compared between the two groups.After the end of treatment，the clinical efficacy of the children was evaluated and compared.Results:1) There was no significant difference in WBC，CRP，ESR，IL-10 and TNF-alpha between the two groups before treatment (P>0.05).The above indexes of the two groups were significantly lower than those before treatment，and the above indexes of the study group were lower than those of the control group (P<0.05).2) There was no significant difference in CD3+，CD4+，CD8+ between the two groups before treatment (P>0.05).After treatment，CD3+，CD4+ in the two groups were significantly higher than before treatment，and the study was higher than that in the control group (P<0.05).CD8+ decreased significantly.The study was lower than that in the control group (P<0.05).3) The fever abatement time，cough relief time，X-ray shadow disappearance time，lung rales disappearance time and hospitalization time in the study group were significantly lower than those in the control group (P<0.05).4) After treatment，the cure rate and total effective rate of the study group were significantly higher than those of the control group (P<0.05).5) There was no significant difference in the rate of adverse reactions between the two groups during treatment (P>0.05).Conclusion:Maxing Shigan decoction can improve the curative effect of mycoplasma pneumonia in children，inhibit inflammatory reaction，and shorten the course of disease and improve immunity.

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