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 ›› 2016, Vol. 8 ›› Issue (2): 139-143.doi: 10.3969/j.issn.1674-3865.2016.02.005

• 临床论著 • 上一篇    下一篇

中西医结合分期治疗儿童肺炎支原体感染

喻闽凤，陈贤君   

  1. 330006 南昌，江西中医药大学附属医院儿科（喻闽凤）；341400 江西 赣州，南康市中医院儿科（陈贤君）
  • 出版日期:2016-04-25 发布日期:2018-11-19
  • 通讯作者: 陈贤君，E-mail：642829431@qq.com
  • 作者简介:喻闽凤（1969-），女，医学博士，主任医师。研究方向：小儿呼吸系统、泌尿系统疾病的诊治

Clinical study of children with Mycoplasma pneumoniae infection cough treated by integrated medicine staging therapies

YU Minfeng，CHEN Xianjun   

  1. Department of Pediatrics,the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang 330006,China.
  • Online:2016-04-25 Published:2018-11-19

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摘要：
目的：观察中西医结合分期治疗儿童肺炎支原体感染咳嗽的临床疗效。
方法：江西中医药大学附属医院儿科门诊2013年3月至2014年12月收治肺炎支原体感染咳嗽患儿120例，随机分为中医治疗组、西医治疗组及中西医治疗组各40例。中医治疗组给予中医分期治疗。初期以解表驱邪、清热化痰，或和解少阳为法，治疗1个疗程；中期以理气化痰、活血化瘀，佐以清热解毒为法，治疗1个疗程；恢复期以补益气阴，调和营卫，清除余邪为法，治疗2个疗程。西医治疗组给予口服阿奇霉素干混悬剂治疗，服用3 d，停4 d。中西医治疗组在西医治疗基础上加用中医分期治疗。3组患儿均以7 d为1个疗程，共治疗4个疗程，治疗后随访2个月。观察3组治疗7、14、28 d后咳嗽、咳痰症状积分，主症、次症积分的改善情况；观察治疗后及随访2个月后MP-IgM转阴率；观察3组临床疗效。
结果：（1）治疗前后疗效比较：治疗7 d后，中西医治疗组总有效率高于中医治疗组、西医治疗组，差异有统计学意义（
P<0017），中医治疗组与西医治疗组总有效率比较差异无统计学意义（P>0017）。治疗14 d后，中西医治疗组总有效率高于西医治疗组，差异有统计学意义（P<0017）；中医治疗组总有效率与西医治疗组、中西医治疗组比较差异无统计学意义（P>0017）。治疗28 d后，3组疗效比较差异无统计学意义（P>005）。（2）MP-IgM转阴率比较：治疗后3组MP-IgM转阴率比较差异无统计学意义（P>005）。随访2个月后3组MP-IgM转阴率比较差异有统计学意义（P<005），中西医治疗组MP-IgM转阴率明显高于中医治疗组及西医治疗组，差异有统计学意义（P<0017），而中医治疗组与西医治疗组MP-IgM转阴率比较差异无统计学意义（P>0017）。
结论：在西医阿奇霉素治疗的基础上加用中医分期疗法治疗儿童肺炎支原体感染咳嗽在改善临床症状和体征方面，治疗有效，且明显优于单纯中医分期治疗及单纯阿奇霉素治疗。中医分期治疗本病的中期疗效优于阿奇霉素治疗，而早晚期疗效比较，两组治疗方法无明显差异。

关键词: 肺炎支原体感染, 咳嗽, 中西医结合治疗, 儿童

Abstract:
Objective:To observe the clinical effect of the treatment for pediatric Mycoplasma pneumoniae infection cough by integrated medicine staging therapies.
Methods:Select 120 cases of children with Mycoplasma pneumoniae infection and they were divided into Chinese medicine treatment group(group A),Western medicine treatment group(group B),and the combination therapy group(group C),40 patients in each group.Group A received Chinese medicine for the staging treatment;group B was given azithromycin therapy;group C was given azithromycin combined with Chinese medicine staging therapy.Three groups of children had a treatment course of 7 days,totally four courses of treatment,and then were followed up for two months after treatment.After 7 days,14 days and 28 days of treatment,respectively,observe the cough and expectoration scores,the improvement in major and minor symptom scores;observe the negative-conversion rate of MP-IgM after treatment and at 2 months of follow-up;observe the clinical effect in the 3 groups.
Results:(1)Comparison of the effect before and after treatment:after 7 d of treatment,the total effective rate of Group C was higher than that of Group A and B,the difference being statistical(P<0017),but there was no statistical difference between Group B and C(P<0017);after 14 d of treatment,the total effective rate of Group C was higher than that of Group C(P<0017),but there was no statistical difference between Group A and Group B and C(P>0017).After 28 d of treatment,there was no statistical difference in the effect among the 3 groups(P>005).(2)Comparison of negative-conversion rate of MP-IgM:there was no statistical difference among the 3 groups after treatment(P>005);at 2 months of follow-up,the difference in the rate was statistical among the 3 groups(P<005),which was higher in Group C(P<0017),but no statistical difference was shown between Group A and B(P>0017).
Conclusion:In terms of improving clinical symptoms and signs,the treatment with azithromycin combined with Chinese staging treatment is effective for children with Mycoplasma pneumoniae infection cough,and is better than the use of either of them alone.The mid-term effect of Chinese staging treatment is better than that of azithromycine,but no difference is observed in the early and late period of the treatment.

Key words: Mycoplasma pneumoniae infection, Coug, Integrative Chinese and western medicine treatment, Children