从微观水平观察银黛汤对重症支原体肺炎患儿气道黏膜的改善情况

Observation on the improvement of Yindai Decoction on the airway mucosa of children with severe mycoplasma pneumoniae pneumonia from the microscopic level

关键词:  儿童重症肺炎支原体肺炎  毒热闭肺证  银黛汤  纤维支气管镜检查

Key words:  severe mycoplasma pneumoniae pneumonia in children  toxic heat blocking lung syndrome  Yindai Decoction  fiberoptic bronchoscopy

摘要:

[目的] 评价银黛汤加减对于儿童重症肺炎支原体肺炎（毒热闭肺证）患儿气道黏膜的改善情况。[方法] 收集重症肺炎支原体肺炎毒热闭肺证患儿90例，采用随机数字表法随机分为试验组和对照组，其中3例患儿因病情加重、未规律服用中药，予以剔除，最终纳入87例患儿，其中试验组44例，对照组43例。两组均给予西医常规治疗，试验组加用银黛汤加减口服10 d。分别在治疗前、治疗后10 d，比较两组症状评分，进行总疗效评估。治疗后3 d，观察两组患儿纤维支气管镜的镜下表现，治疗后10 d，45例患儿再次行纤维支气管镜治疗，对比两次纤维支气管镜下气道黏膜的变化。[结果] 治疗后10 d，试验组症状总分低于对照组，差异具有统计学意义（P<0.05）。两组纤维支气管镜镜下表现比较中，治疗后10 d，试验组炎性狭窄、分泌物增多的发生率低于对照组，差异具有统计学意义（P<0.05）。[结论] 银黛汤加减辅助西医治疗重症肺炎支原体肺炎毒热闭肺证患儿，可明显改善支气管气道黏膜情况，有利于疾病恢复，提高临床疗效。

Abstract:

[Objective] To evaluate the effect of Yindai Decoction on the improvement of airway mucosa in children with severe mycoplasma pneumonia （toxin heat closing lung syndrome）. [Methods] Total 90 children with severe pneumonia caused by Mycoplasma pneumoniae diagnosed toxin heat closed lung syndrome be randomly divided into an experimental group and a control group. Among them, 3 children were excluded due to worsening of the condition and irregular use of traditional Chinese medicine. Finaｌｌｙ，87 children were included, and 44 in the experimental group and 43 in the control group.. Both groups were treated with routine Western medicine，and the test group was treated with Yindai Decoction for 10 days. The symptom scores of the two groups were compared before treatment and 10 days after treatment，and the total efficacy was evaluated. On the 3rd day after treatment，the bronchoscopic manifestations of the two groups of children were observed. On the 10th day after treatment，45 children were treated with bronchofibroscope again，and the changes of airway mucosa under bronchofibroscope were compared. [Results] The 10 days after treatment，the symptom score of the test group was lower than that of the control group，the difference was statistically significant. In the comparison of fibrobronchoscopic manifestations between the two groups，the incidence of inflammatory stenosis and increased secretion in the test group was lower than that in the control group 10 days after treatment，with a statistically significant difference. [Conclusion] Yindai Decoction can significantly improve the condition of bronchial and airway mucosa in children with severe mycoplasma pneumoniae pneumonia，which is helpful for disease recovery and clinical efficacy.