罐药综合治疗儿童MPP的临床疗效及对凝血功能的影响

Clinical study on a comprehensive cupping treatment in improving hypercoagulability of mycoplasma pneumoniae pneumonia in children

关键词:  罐药综合治疗  儿童肺炎支原体肺炎  临床疗效  凝血功能

Key words:  comprehensive therapy of cupping and medicine  mycoplasma pneumoniae pneumonia in children  curative effect  coagulation function

摘要:

[目的]评价罐药综合治疗儿童肺炎支原体肺炎（MPP）的临床疗效及其对患儿凝血功能影响。[方法]选取2014年7月-2017年6月北京中医药大学东方医院儿科门诊及病房收治的140例MPP患儿，将其随机分为对照组（70例）与治疗组（70例）。前者采用单纯西医即阿奇霉素静脉滴注治疗，后者在前者基础上实施罐药综合治疗，对比两组在治疗前后临床症状（主要及次要症状积分）凝血功能指标（凝血酶原时间、凝血酶原活动度及D-二聚体）的变化。[结果]治疗组的总有效率高于对照组。治疗组、对照组总分治疗前后组内比较均有统计学差异（P<0.05）。观察终点时在主要症状（咳嗽、痰壅、气喘、发热、听诊）方面，治疗组愈显率更高，症状总分更低（P<0.05），提示治疗组的治疗优于对照组。两组治疗前后凝血酶原时间、凝血酶原活动度及D-二聚体均有不同程度改善，治疗组优于对照组（P<0.05）。[结论]小儿MPP早期应尽早介入中医药内、外治法，有助于改善MPP患儿的临床症状及凝血功能，从而达到更满意的临床效果，并为有效预防严重并发症及降低单用大环内酯类抗生素普遍耐药性提供了临床思路。

Abstract:

[Objective] To evaluate the advantages and effect on blood coagulation function using a comprehensive cupping treatment of mycoplasma pneumoniae pneumonia (MPP) in children.[Methods] The 140 cases of MPP from July 2014 to June 2017 in the inpatient and outpatient pediatrics department of Beijing University of Chinese Medicine's Affiliated Dongfang Hospital were selected and randomly divided into a control group (70 cases) and a treatment group (70 cases). The former group received only Azithromycin treatment, while the other group received additional comprehensive cupping therapy,and the treatment effects for both groups were compared. Each group received treatment for 1 week,and they were followed up for 2 weeks. Both groups were evaluated based on the changes in coagulation function indexes (including pro-thrombin time (PT),pro-thrombin activity (PTA) and D-dimer (DD)) before and after treatment.[Results] The total effective rate of the treatment group was higher than that of the control group. The total scores of the treatment group and the control group were significantly different before and after the treatment (P<0.05). At the end of the clinical course,there were no significant differences in the main symptoms (cough,sputum,asthma,fever,auscultation) between the two groups (P>0.05). In terms of treatment of the main symptoms (cough,phlegm,wheezing,fever,auscultation),the treatment group revealed a higher recovery rate and a lower total symptom score,which was a statistically significant difference (P<0.05). This might suggest that the comprehensive cupping therapy treatment group is superior to the control group. Both groups displayed different levels of improvement in terms of PT,PTA and DD. The treatment group was superior to the control group,with a statistically significant difference.[Conclusion] Early intervention in the treatment of pediatric MPP with Traditional Chinese Medicine can help to reduce the clinical course of this disease,as well as improve the child's coagulation function. This in turn would yield more satisfactory clinical results,effectively prevent any serious complications,and reduce universal resistance arising from the single use of macrolide antibiotics.