目的：探讨阿奇霉素联合芩百清肺浓缩丸对儿童肺炎支原体感染的临床疗效。方法2013年1月—2014年6月收治肺炎支原体感染患儿156例，随机分为3组：中药组、西药组、联合组，每组52例。选择同期52例健康体检儿童为健康对照组，西药组口服阿奇霉素，中药组口服芩百清肺浓缩丸，联合组口服阿奇霉素联合芩百清肺浓缩丸。比较4组血清炎性因子（ IL-6、IL-8、TNF-α、）和免疫球蛋白（ IgA 、IgG、IgM）水平。结果治疗2周后，联合组、西药组和中药组有效率分别为98灋．1％（51／52）、84．6％（44／52）、90．4％（47／52），联合组高于西药组、中药组，差异有统计学意义（ P ＜0．05）。与联合组比较，西药组、中药组的咳嗽消失时间、发热消失时间、肺部啰音消失时间、X线胸片浸润影消失时间和住院时间，差异均有统计学意义（ P ＜0．05），而西药组与中药组比较，差异无统计学意义（ P ＞0．05）。治疗前，3个病例组患儿血清炎性因子水平（IL-6、IL-8、TNF-α）明显高于健康对照组（ P ＜0．05）；与治疗前比较，治疗2周后，3组血清炎性因子水平均显著降低（ P ＜0．05）；且治疗后联合组血清炎性因子水平均显著低于西药组和中药组（ P ＜0．05），西药组与中药组比较差异无统计学意义（ P ＞0．05）。治疗前，3个病例组患儿IgA水平显著低于健康对照组，IgG、IgM水平明显高于健康对照组（ P ＜0．05）；与治疗前比较，治疗2周后，3组IgA水平显著增加，IgG、IgM水平明显降低（ P ＜0．05）；且联合组IgA水平明显高于西药组和中药组，IgG、IgM水平显著低于西药组和中药组（ P ＜0．05），西药组与中药组比较差异无统计学意义（ P ＞0．05）。结论芩百清肺浓缩丸联合阿奇霉素治疗儿童肺炎支原体肺炎可降低细胞炎性因子水平、改善免疫功能可较好地改善病情，提高疗效。%Objective To investigate the clinical curative effect of azithromycin combined with Qibaiqingfei pill on mycoplasma pneumonia infection in children.Methods One hundred and fifty-six children with mycoplasma pneumonia infec-tion were enrolled they were randomly assigned to three groups:Traditional Chinese medicine group, western medicine group, joint groups, and each group with 52 cases.Selected the same period 52 cases of healthy children as healthy control group, western medicine group were treated with azithromycin, Chinese medicine group received oral Qibaiqingfei pill, the joint group reveived oral azithromycin combined with Qibaiqingfei pill.Serum inflammatory factors between the 4 groups ( IL-6, IL-8, TNF-α) and immunoglobulin ( IgA, IgG, IgM) level were detected.Results After 2 weeks treatment, joint group, western medicine group and traditional Chinese medicine group’s efficiency were 98.1%(51 /52), 84.6%(44/52), 90.4%(47/52);and compared with joint group, western medicine group and Chinese medicine group were lower, the difference was statistically significant ( P <0.05).Compared with joint group, western medicine group and Chinese medicine group’ s cough disappearance time, fever disappeared time, pulmonary rales disappear time, X-ray infiltration shadow disappearance time and hospitalization time revealed statistically significant differences ( P <0.05), and no statistically significant differ-ences were found between Western medicine group and traditional Chinese medicine group ( P >0.05).Before treatment, disease group’s serum inflammatory factor levels (IL-6, IL-8, TNF-α) were significantly higher than those in healthy control group ( P <0.05);compared with before treatment, 2 weeks after treatment, 3 groups’ serum inflammatory factor levels sig-nificantly reduced ( P <0.05);and after treatment, joint group’s serum inflammatory factor levels were significantly lower than those in the Western group and traditional Chinese medicine group ( P <0.05) , western medicine group and traditional Chinese medicine group showed no statistical significance ( P >0.05).Before treatment, the disease group’s IgA level was significantly lower than that in healthy control group, IgG and IgM levels were significantly higher than those in healthy control group ( P <0.05); compared with before treatment, 2 weeks after treatment, 3 groups’ IgA level was significantly in-creased, level of IgG and IgM wer significantly reduced ( P <0.05);and the joint groups’s IgA level was significantly high-er than that of groups of Western medicine and traditional Chinese medicine, level of IgG and IgM were significantly lower than that of Western medicine group and traditional Chinese medicine group ( P <0.05) , western medicine group and traditional Chinese medicine group showed no statistical significance ( P >0.05).Conclusion It demonstrated that the Qibaiqingfei pill combined with azithromycin in treatment of children with Mycoplasma pneumonia pneumonia could reduce inflammatory cell factor level, improve immune function and the condition.
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