清热宣肺解毒汤联合孟鲁司特治疗小儿支原体肺炎后慢性咳嗽的疗效观察

Efficacy observation of Qingre Xuanfei Jiedu Decoction combined with montelukast in the treatment of chronic cough after mycoplasmal pneumonia in children

关键词:  清热宣肺解毒汤  孟鲁司特  小儿支原体肺炎  慢性咳嗽  免疫功能  肺功能

Key words:  Qingre Xuanfei Jiedu Decoction  montelukast  mycoplasma pneumonia in children  chronic cough  immune function  pulmonary function

摘要:

[目的] 观察清热宣肺解毒汤联合孟鲁司特治疗小儿支原体肺炎（MPP）后慢性咳嗽的疗效。[方法] 选取2021年1月—2022年1月在驻马店市中医院接受治疗的MPP后慢性咳嗽患儿90例，以随机抽签法分为3组，各30例。西医组予以孟鲁司特，中医组予以清热宣肺解毒汤，联合组予以清热宣肺解毒汤联合孟鲁司特。比较3组总有效率、不良反应发生情况、复发率及治疗前、治疗2周后肺功能[用力肺活量（FVC）、最大呼气流速（PEF）、第一秒用力呼气容积（FEV1）]、趋化因子水平[半胱氨酰白三烯（CysLTs）、单核细胞趋化蛋白-4（MCP-4）]、免疫功能指标（CD8⁺、CD3⁺、CD4⁺）。[结果] 联合组总有效率（93.33%）明显较中医组（66.67%）、西医组（73.33%）高，复发率（6.67%）明显较中医组（33.33%）、西医组（26.67%）低（P＜0.05），中医组、西医组间无明显差异（P＞0.05）；3组治疗2周后FVC、PEF、FEV1、CysLTs、MCP-4、CD8⁺、CD3⁺、CD4⁺水平均改善，联合组优于中医组、西医组（P＜0.05），中医组、西医组间无明显差异（P＞0.05）；3组无严重不良反应出现。[结论] 清热宣肺解毒汤联合孟鲁司特治疗小儿MPP后慢性咳嗽疗效显著，能改善患儿肺功能，下调趋化因子表达量，增强免疫功能，减少复发风险，且安全性较高。

Abstract:

[Objective] To observe the efficacy of Qingre Xuanfei Jiedu Decoction combined with montelukast in treating chronic cough after mycoplasmal pneumonia（MPP） in children. [Methods] A total of 90 children with chronic cough after MPP who received treatment in our hospital from January 2021 to January 2022 were selected and divided into three groups with 30 cases in each group by random drawing method. The Western medicine group was given montelukast，the Chinese medicine group was given Qingre Xuanfei Jiedu Decoction，and the combined group was given Qingre Xuanfei Jiedu Decoction combined with montelukast. The total effective rate，the incidence of adverse reactions，recurrence rate，and pulmonary function [forced vital capacity（FVC），maximum expiratory flow rate（PEF），forced expiratory volume in 1 second（FEV1）]，levels of chemokine [cysteinyl leukotrienes（CysLTs），monocyte chemoattractant protein-4（MCP-4）]，immune function indicators（CD8⁺，CD3⁺，CD4⁺） were compared between the three groups before and after two weeks of treatment. [Results] The total effective rate（93.33%） of the combined group was significantly higher than that of the Chinese medicine group（66.67%） and Western medicine group（73.33%），and the recurrence rate（6.67%） was significantly lower than that of the Chinese medicine group（33.33%） and Western medicine group（26.67%，P＜0.05），there was no significant difference between the Chinese medicine group and Western medicine group（P＞0.05）. After two weeks of treatment，the levels of FVC，PEF，FEV1，CysLTs，MCP-4，CD8⁺，CD3⁺ and CD4⁺ in the three groups were improved，and the combination group was better than the Chinese medicine group and Western medicine group（P＜0.05），but there was no significant difference between the Chinese medicine group and Western medicine group（P＞0.05）. No serious adverse reactions occurred in the three groups. [Conclusion] Qingre Xuanfei Jiedu Decoction combined with montelukast has significant curative effect in the treatment of chronic cough in children with MPP，it can improve pulmonary function，and down-regulate chemokine expression，enhance immune function，reduce the risk of recurrence，and has high safety.