摘要
目的:探讨化痰通络汤治疗儿童支原体肺炎(MPP)合并心肌损伤的临床疗效。方法:选取上海中医药大学附属龙华医院儿科MPP合并心肌损伤,证型属于痰热闭肺,损伤心络证的住院患儿106例,并随机分为对照组和治疗组,每组53例。两组均给予阿奇霉素抗感染及对症支持治疗,对照组给予辅酶Q_(10),治疗组给予化痰通络汤口服,均治疗5 d。评价两组临床疗效,比较两组治疗前后的超敏C反应蛋白(hs-CRP)、心肌酶谱,丙二醛(MDA)、总超氧化物歧化酶(T-SOD),心电图(ECG)以及主症、次症积分。结果:治疗组总有效率为98.08%(51/52),显著优于对照组[84.31%(43/51)](P<0.05)。治疗组AST、LDH、CK、CK-MB、MDA、cTnⅠ、hs-CRP以及ECG异常率显著低于对照组(P<0.01,P<0.05),T-SOD显著高于对照组(P<0.01)。治疗组主症(除发热外)、次症各项评分均显著低于对照组(P<0.01,P<0.05)。结论:化痰通络汤联合阿奇霉素治疗支原体肺炎合并心肌损伤的临床疗效肯定,可有效改善咳嗽、咯痰、喘促、心悸等临床症状,下调炎症反应,改善心肌酶谱,调节氧化应激指标。
Objective:To investigate the clinical effect of Huatan Tongluo Decoction in the treatment of children with mycoplasma pneumoniae pneumonia(MPP)complicated with myocardial injury.Methods:A total of 106 children who were hospitalized in the Department of Pediatrics,Longhua Hospital,Shanghai University of Traditional Chinese Medicine due to MPP combined with myocardial injury,and the syndrome which was phlegm-heat closing the lung and damage to the collaterals of heart were included in the study.The children were randomly divided into control group and treatment group with 53 in each group.Both groups were given azithromycin for anti-infection and symptomatic and supportive treatment.The control group was given coenzyme Q_(10) orally,and the treatment group was given Huatan Tongluo Decoction orally.The course of treatment was 5 days.The clinical efficacy of the two groups was evaluated.The hs-CRP,myocardial enzyme spectrum,MDA,T-SOD,electrocardiogram,and scores of main and secondary symptoms before and after treatment were compared.Results:The total effective rate in the treatment group was 98.08%(51/52),which was significantly higher than that in the control group,84.31%(43/51)(P<0.05).The levels of AST,LDH,CK,CK-MB,MDA,cTnl,hs-CRP and the abnormal rate of ECG in the treatment group were significantly lower than those in the control group(P<0.01,P<0.05).T-SOD in the treatment group was significantly higher than that in the control group(P<0.01).The levels of cTnI and hs-CRP in the treatment group were lower than those in the control group(P<0.05).The main symptoms(except fever),and the secondary symptoms scores in the treatment group were significantly lower than those in the control group(P<0.01,P<0.05).The main symptoms of asthma,and the secondary symptoms of fatigue scores in the treatment group were lower than those in the control group(P<0.05).Conclusion:Huatan Tongluo Decoction combined with azithromycin has a positive clinical effect in the treatment of mycoplasma pneumonia complicated with myocardial injury
作者
马金叶
姜永红
周冬雪
刘旭华
李赛
樊秋月
MA Jinye;JIANG Yonghong;ZHOU Dongxue;LIU Xuhua;LI Sai;FAN Qiuyue(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)
出处
《中华中医药杂志》
CSCD
北大核心
2023年第12期6107-6112,共6页
China Journal of Traditional Chinese Medicine and Pharmacy
基金
上海市科委医学引导类(中、西医)科技支撑项目(No.19401933600)
上海市十三五临床重点专科中医儿科项目(No.shslczdzk04102)
上海市进一步加快中医药传承创新发展三年行动计划[No.ZY(2021-2023)-0206-01]。
关键词
儿童
支原体肺炎
心肌损伤
化痰通络汤
疗效
症状评分
氧化应激
超敏C反应蛋白
Children
Mycoplasma pneumoniae pneumonia(MPP)
Myocardial injury
Huatan Tongluo Decoction
Clinical effect
Symptom score
Oxidative stress
Hypersensitive C-reactive protein(hs-CRP)
