加味二陈汤联合西医常规治疗小儿肺炎支原体感染后慢性咳嗽临床研究

Clinical Study on Modified Erchen Decoction Combined with Conventional Western Medicine for Chronic Cough in Children After Mycoplasma pneumoniae Infection

摘要:

目的：观察加味二陈汤联合西医常规治疗小儿肺炎支原体感染后慢性咳嗽（CCAMP） 的临床疗效。方法：采取前瞻性随机对照研究设计法。按随机数字表法将焦作市妇幼保健院收治的196例CCAMP患儿分为对照组与治疗组（每组98 例）。最终对照组完成研究92 例（脱落2 例，剔除4 例），治疗组完成研究94 例（脱落1例，剔除3例）。对照组给予西医常规治疗，治疗组在西医常规治疗的基础上给予加味二陈汤治疗，连续治疗14天后评估2组中医证候评分、咳嗽症状评分、临床疗效，检测比较血清炎性因子、细胞免疫功能指标，并统计比较不良反应发生率。结果：治疗14天后，2组中医证候评分、咳嗽症状评分均低于治疗前，且治疗组中医症候积分、咳嗽症状评分均低于对照组（P＜0.05）。2组血清白细胞介素-4（IL-4）、白细胞介素-6 （IL-6）、肿瘤坏死因子-α （TNF-α） 水平均低于治疗前，且治疗组以上各项指标水平均低于对照组（P＜0.05）。2组血清免疫球蛋白［免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）］ 水平均高于治疗前，且治疗组各项血清免疫球蛋白水平均高于对照组（P＜0.05）。中医证候疗效总有效率治疗组94.68% （89/94）， 对照组83.70% （77/92）， 差异有统计学意义（P＜0.05）。治疗组不良反应发生率6.38%（6/94），对照组16.30%（15/92），2组比较，差异有统计学意义（P＜0.05）。结论：加味二陈汤联合西医常规治疗小儿CCAMP，可有效改善患儿中医症状及咳嗽症状，减轻机体炎症反应，提高机体免疫力，减少药物不良反应，优于单纯西医常规治疗。

Abstract:

Abstract：Objective：To observe the clinical efficacy of modified Erchen Decoction combined with conventional western medicine in the treatment of chronic cough after mycoplasma pneumoniae infection （CCAMP） in children. Methods：A prospective randomized controlled trial design was adopted. A total of 196 children with CCAMP admitted to Jiaozuo Maternal and Child Health Hospital were randomly divided into the control group and the treatment group using the random number table method， with 98 cases in each group. Finally， 92 cases completed the study in the control group （2 dropped out，4 excluded），and 94 cases completed the study in the treatment group （1 dropped out， 3 excluded）. The control group received conventional western medicine treatment，while the treatment group received modified Erchen Decoction on the basis of conventional western medicine. After 14 consecutive days of treatment，the traditional Chinese medicine syndrome scores， cough symptom scores， and clinical efficacy were evaluated in both groups. Serum inflammatory factors and cellular immune function indicators were compared. The incidence of adverse reactions was also compared between the two groups. Results： After 14 days of treatment， the traditional Chinese medicine syndrome scores and cough symptom scores in both groups decreased compared with those before treatment， and the scores in the treatment group were lower than those in the control group （P＜0.05）. The serum levels of interleukin-4 （IL-4）， interleukin-6 （IL-6）， and tumor necrosis factor-alpha （TNF-α） in both groups decreased compared with those before treatment，and the serum levels of IL-4，IL-6，and TNF-α in the treatment group were lower than those in the control group （P＜0.05）. The levels of serum immunoglobulin [immunoglobulin A （IgA）， immunoglobulin M （IgM），immunoglobulin G （IgG）] in both groups increased compared with those before treatment， and the levels of IgA，IgM，and IgG in the treatment group were higher than those in the control group （P＜0.05）. The total effective rate of overall traditional Chinese medicine syndrome efficacy was 94.68% （89/94） in the treatment group and 83.70%（ 77/92） in the control group，with a statistically significant difference（ P＜0.05）. The incidence of adverse reactions was 6.38% （6/94） in the treatment group and 16.30% （15/92） in the control group， and the difference between the two groups was statistically significant （P＜0.05）. Conclusion：Modified Erchen Decoction combined with conventional western medicine in the treatment of CCAMP in children can effectively improve traditional Chinese medicine symptoms manifestations and cough symptoms， reduce inflammatory responses， enhance immunity， and have fewer adverse drug reactions. It is superior to conventional western medicine alone.