Abstract:

Objective　To observe the efficacy and safety of Huotan Tongluo Decoction combined with beclomethasone propionate in the treatment of mycoplasma pneumonia (MP) in children. Methods　A total of 103 children with MP admitted to Xuchang Maternity and Child Health Hospital from February 2022 to January 2024 were retrospectively selected as the study objects. The 51 patients treated with beclomethasone propionate (aerosol inhalation) were set as the single group, and the 52 patients treated with Huotan Tongluo Decoction (oral) combined with beclomethasone propionate were set as the combined group. There were 32 boys and 20 girls in the combined group, aged 4-11 (7.46±1.31) years, and the course of disease was 3-18 (10.42±3.49) days. There were 28 boys and 23 girls in the single group, aged 4-10 (7.16±1.20) years, and the course of disease was 3-17 (10.13±3.26) days. Both groups were treated continuously for 14 days. The clinical efficacy, scores of traditional Chinese medicine (TCM) syndromes (cough, fever, asthma, and sputum), levels of inflammatory factors [interleukin-2 (IL-2), white blood cell count (WBC), tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and C-reactive protein (CRP)], immune capacity [immunoglobulin A (IgA), IgG, and IgM], and adverse reactions (rash, diarrhea, nausea/vomiting, etc.) were compared between the two groups. Independent sample t test, paired t test, and χ² test were used. Results　The total effective rate of the combined group [98.08% (51/52)] was higher than that of the single group [86.27% (44/51)] (P<0.05). After treatment, the scores of cough [(1.63±0.40) points], fever [(1.31±0.46) points], asthma [(0.56±0.19) points], and sputum [(1.22±0.39) points] in the combined group were lower than those in the single group [(2.38±0.65) points, (1.95±0.53) points, (0.94±0.26) points, and (1.59±0.67) points] (all P<0.05). The levels of IL-2 [(42.48±3.97) ng/L], WBC [(7.29±0.89)x10⁹/L], TNF-α [(18.33±2.03) ng/L], IFN-γ [(35.66±6.08) ng/L], and CRP [(5.86±1.29) mg/L] in the combined group were lower than those in the single group [(53.89±3.42) ng/L, (8.92±1.37)×10⁹/L, (23.08±2.94) ng/L, (69.34±17.39) ng/L, and (6.91±1.40) mg/L] (all P<0.05). The levels of IgA, IgG, and IgM in the combined group were higher than those in the single group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion　Huotan Tongluo Decoction combined with beclomethasone propionate can relieve the clinical symptoms of MP children, inhibit the inflammatory response, enhance the immune capacity, and have good safety.

Key words:

Mycoplasma pneumonia, Huotan Tongluo Decoction, Beclomethasone propionate, Security, Children

摘要：

目的　观察豁痰通络汤联合丙酸倍氯米松治疗支原体肺炎（MP）患儿的效果及安全性。方法　回顾性选取2022年2月至2024年1月许昌市妇幼保健院收治的103例MP患儿作为研究对象，采用丙酸倍氯米松治疗（雾化吸入给药）的设为单一组（51例），在单一组的基础上，采用豁痰通络汤治疗（口服）的设为联合组（52例）。联合组男32例，女20例；年龄4～11（7.46±1.31）岁；病程3～18（10.42±3.49）d。单一组男28例，女23例；年龄4～10（7.16±1.20）岁；病程3～17（10.13±3.26）d。两组均连续治疗14 d。比较两组临床疗效、中医证候积分（咳嗽、发热、气喘、咳痰）、炎症因子水平［白细胞介素-2（IL-2）、白细胞计数（WBC）、肿瘤坏死因子-α（TNF-α）、干扰素-γ（IFN-γ）、C反应蛋白（CRP）］、免疫能力［免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）］、不良反应（皮疹、腹泻、恶心/呕吐等）。采用独立样本t检验、配对t检验和χ²检验。结果　联合组治疗总有效率［98.08%（51/52）］高于单一组［86.27%（44/51）］（P<0.05）。治疗后，联合组咳嗽［（1.63±0.40）分］、发热［（1.31±0.46）分］、气喘［（0.56±0.19）分］、咳痰［（1.22±0.39）分］积分均低于单一组［（2.38±0.65）分、（1.95±0.53）分、（0.94±0.26）分、（1.59±0.67）分］（均P<0.05）；联合组IL-2［（42.48±3.97）ng/L］、WBC［（7.29±0.89）×10⁹/L］、TNF-α［（18.33±2.03）ng/L］、IFN-γ［（35.66±6.08）ng/L］、CRP［（5.86±1.29）mg/L］水平均低于单一组［（53.89±3.42）ng/L、（8.92±1.37）×10⁹/L、（23.08±2.94）ng/L、（69.34±17.39）ng/L、（6.91±1.40）mg/L］（均P<0.05）；联合组IgA、IgG、IgM水平均高于单一组（均P<0.05）。治疗期间，两组不良反应总发生率比较，差异无统计学意义（P>0.05）。结论　豁痰通络汤联合丙酸倍氯米松治疗能缓解MP患儿的临床症状，减轻炎症反应，增强免疫能力，安全性良好。

关键词:

支原体肺炎, 豁痰通络汤, 丙酸倍氯米松, 安全性, 儿童