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目的:观察小儿肺热咳喘口服液配合纤维支气管镜肺泡灌洗术(BAL)辅助治疗儿童难治性肺炎支原体肺炎(RMPP)合并肺部大片病灶的临床效果。方法:选取我院2011年2月至2015年3月收治的82例RMPP合并肺部大片病灶患儿作为研究对象,随机分为对照组和观察组各41例。两组均进行基础抗感染治疗,同时均给予纤维支气管镜BAL治疗,观察组在此基础上加用小儿肺热咳喘口服液,比较两组治疗效果,观察患儿临床症状改善情况,测定两组患儿治疗前后血清白介素-6(IL-6)、白介素-4(IL-4)、γ干扰素(IFN-γ)水平的变化。结果:(1)观察组总有效率为92.7%,高于对照组的75.6%(P<0.05)。(2)治疗后,两组患儿各症状评分均降低,与治疗前比较差异有统计学意义(P<0.05),且观察组各症状评分降低幅度大于对照组(P<0.05)。(3)治疗后,两组患儿各炎症指标水平均降低,与治疗前比较差异有统计学意义(P<0.05),且观察组降低幅度大于对照组(P<0.05)。(4)观察组患儿退热时间、肺部体征消失时间及住院时间均短于对照组(P<0.05)。结论:在常规抗感染的基础上,采用小儿肺热咳喘口服液配合纤支镜BAL辅助治疗RMPP合并肺部大片病灶患儿,可下调血清炎症因子水平,显著改善肺部症状及体征,提高总有效率。
Objective: To observe the clinical effect of Xiaoerfehenkechuan oral solution combined with bronchofibroscopy and alveolar lavage (BAL) in adjuvant treatment of children with refractory mycoplasma pneumoniae pneumonia (RMPP) complicated with large lung lesions. Methods: A total of 82 children with RMPP complicated with large lung lesions admitted to our hospital from February 2011 to March 2015 were selected as study subjects and randomly divided into control group and observation group of 41 cases. Both groups were treated with basal anti-infective therapy, meanwhile bronchoalveolar lavage (BAL) was given to the observation group. On the basis of this observation, the observation group was treated with Hyperactivity Kechuan Oral Liquid. The therapeutic effect was compared between the two groups. The improvement of clinical symptoms was observed. The changes of serum interleukin-6, interleukin-4 and interferon-gamma in the children before and after treatment were observed. Results: (1) The total effective rate in the observation group was 92.7%, higher than that in the control group (75.6%, P <0.05). (2) After treatment, the score of each symptom in both groups was lower than that before treatment (P <0.05), and the score of each symptom in the observation group decreased more than that of the control group (P <0.05). (3) After treatment, the levels of each inflammatory index in both groups decreased, with statistical significance (P <0.05), and the decrease in observation group was greater than that in control group (P <0.05). (4) The observation group patients with antipyretic time, the disappearance of lung signs and hospital stay were shorter than the control group (P <0.05). Conclusion: Based on routine anti-infectives, the therapeutic effect of Xiaoerfehenkechuan oral liquid combined with bronchoscopy BAL in children with RMPP complicated with large lung lesions can reduce the level of serum inflammatory cytokines and significantly improve the symptoms and signs of the lungs The total efficiency.