ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2018, Vol. 10 ›› Issue (2): 146-149.doi: 10.3969/j.issn.1674-3865.2018.02.017

• 临床研究 • 上一篇    下一篇

静脉应用穿心莲内酯对急性支气管肺炎患儿体温平稳作用的研究

单敏，黄燕，崔振泽   

  1. 116012 辽宁 大连，大连市儿童医院呼吸内科
  • 出版日期:2018-04-25 发布日期:2018-11-19
  • 通讯作者: 黄燕，E-mail：13304280868@126.com
  • 作者简介:单敏（1982-），女，医学硕士，主治医师。研究方向：儿童呼吸系统疾病的诊治

Study on the effect of intravenous dripping of andrographolide in stabilizing body temperature of children with acute bronchial pneumonia

SHAN Min, HUANG Yan，CUI Zhenze   

  1.  Department of Respiratory Medicine, Dalian Children's Hospital, Dalian 116012, China
  • Online:2018-04-25 Published:2018-11-19

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摘要：
目的
观察支气管肺炎患儿应用穿心莲内酯治疗后体温平稳时间及相关细胞因子水平变化，探讨穿心莲内酯体温平稳作用机制。
方法
选择2011年10月至2012年3月大连市儿童医院呼吸内科收治住院的急性支气管肺炎患儿40例为研究对象，随机分为观察组和对照组各20例。对照组给予常规治疗；观察组在常规治疗的基础上静脉滴注穿心莲内酯注射液；7～10 d为1个疗程。抽取每组患儿治疗前和体温平稳24 h后的血清，采用ELISA法检测血清前列腺素E2（PGE2）、白细胞介素1β（IL-1β）、白细胞介素6（IL-6）、γ干扰素（IFN-γ）和肿瘤坏死因子α（TNF-α）水平。观察两组患儿体温平稳时间和治疗前后血清中PGE2、IL-1β、IL-6、IFN-γ和TNF-α水平变化。
结果
观察组体温平稳时间为（3.10±0.25）d，显著短于对照组（4.16±0.23）d，差异有统计学意义（P<0.01）。观察组治疗前后血清IL-6、IFN-γ水平比较差异有统计学意义（P<0.05）；血清PGE2、IL-1β、TNF-α水平比较差异无统计学意义（P>0.05）。两组治疗后血清PGE2和IFNγ水平比较差异有统计学意义（P<0.05）；两组治疗后血清IL-1β、IL-6、TNF-α水平比较差异无统计学意义（P>0.05）。
结论
穿心莲内酯能够直接作用于调节体温中枢的重要介质——PGE2，减少PGE2的释放，调节体温，使发热患儿体温降至正常，达到体温平稳效果。穿心莲内酯可以通过抑制内源性致热源IFN-γ和IL-6，从而减少下丘脑释放PGE2，达到调节体温作用，使患儿体温平稳恢复正常。穿心莲内酯对血清中的IL-1β和TNF-α的浓度在观察例数内影响不明显。

关键词: 支气管肺炎, 穿心莲内酯, 发热, 细胞因子, 儿童

Abstract:
objective
To study the effect mechanism of andrographolide in stabilizing body temperature by observing the time of stable temperature and the changes in the level of related cytokines after the treatment.
Methods
A total of 40 children with acute bronchial pneumonia were included as the research subjects, who were treated in Dalian Children's Hospital from Oct. 2011 to Mar. 2012, and they were randomly divided into two groups: observation group(n=20) and control group(n=20). Both groups were given conventional treatment, and the observation group was also treated by intravenous dripping of andrographolide injection, 7 to 10 days as a course. The serum was taken before treatment and at 24h after the temperature was stable. ELISA was adopted to determine the level of PGE2，IL-1β，IL-6，IFN-γ and TNF-α. Observe the time of stabilizing temperature, and the changes in the level of PGE2，IL-1β，IL-6，IFN-γ and TNF-α in the serum before and after treatment.
Results
The time of stabilizing temperature in the observation group was (3.10±0.25)d, significantly shorter than that in the control group, which was (4.16±0.23)d, the difference being statistically significant(P<0.01). There was statistical difference in the level of IL-6 and IFN-γ before and after treatment(P<0.05), but there was no statistical difference in serum level of PGE2，IL-1β，IL-6 or TNF-α(P>0.05). There was statistical difference in serum level of PGE2 and IFNγ after treatment in both groups(P<0.05), but there was no statistical difference in the level of IL-1β，IL-6 or TNF-α(P>0.05).
Conclusion
Andrographolide can directly act on act on PGE2——an important medium in regulating temperature center, reducing the release of PGE2 and regulating the body temperature, which results in the decrease of the children's body temperature and the temperature returns to normal and stays stable. Andrographolide can decrease PGE2 released by hypothalamus by inhibiting IFN-γ and IL-6, achieving the effect of regulating and stabilizing the temperature. The effect of andrograpolide on serum concentration of IL-1β and TNF-α is not significant as far as this study is concerned.

Key words: Bronchial pneumonia, Andrographolide, Fever, Cytokines, Children