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目的:观察中西医结合治疗小儿重症肺炎的临床疗效,及其对患儿肺功能、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的影响。方法:选取本院收治的76例小儿重症肺炎患儿为研究对象,按照随机数字表法分为对照组和观察组各38例。对照组给予常规西药治疗,观察组在对照组用药基础上加以中药汤剂治疗。比较2组临床疗效及治疗前后肺功能指标[最大呼气中段流量(MMF)、峰流速(PEF)、最大吸气压(MIP)、最大呼气压(MEP)]和血清TNF-α、IL-6水平的变化。结果:对照组治疗总有效率为81.6%,低于观察组的97.4%,差异有统计学意义(P<0.05)。观察组高热、咳嗽、肺部啰音、心率异常、呼吸异常以及腹胀的消失时间均短于对照组(P<0.05)。治疗前,2组MMF、PEF、MIP和MEP比较,差异均无统计学意义(P>0.05)。治疗后,2组MMF、PEF、MIP和MEP均优于同组治疗前(P<0.05);观察组的4项肺功能指标均优于对照组(P<0.05)。治疗前,2组血清TNF-α和IL-6水平比较,差异均无统计学意义(P>0.05)。治疗后,2组血清TNF-α和IL-6水平均较治疗前下降(P<0.05);观察组的血清TNF-α和IL-6水平均低于对照组(P<0.05)。结论:中西医结合治疗小儿重症肺炎可提高临床疗效,改善肺炎症状、肺功能指标及降低血清TNF-α、IL-6水平,且不良反应少。
Objective: To observe the clinical efficacy of integrated traditional Chinese and western medicine in the treatment of pediatric severe pneumonia and its effect on the lung function, serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) Methods: Totally 76 infants with severe pneumonia admitted to our hospital were selected as study subjects and divided into control group and observation group according to random number table method. The control group was given conventional western medicine, while the observation group was treated with Chinese medicine decoction on the basis of the control group. The clinical efficacy and the changes of pulmonary function indexes (MMF, PEF, MIP, MEP) and serum TNF-α, IL -6 level of change. Results: The total effective rate of the control group was 81.6%, which was lower than that of the observation group (97.4%), the difference was statistically significant (P <0.05). The observation group had shorter fever, cough, pulmonary rales, abnormal heart rate, abnormal breathing and disappearance of bloating than the control group (P <0.05). Before treatment, there were no significant differences in MMF, PEF, MIP and MEP between the two groups (P> 0.05). After treatment, the two groups of MMF, PEF, MIP and MEP were better than the same group before treatment (P <0.05); the observation group of four pulmonary function indicators were better than the control group (P <0.05). Before treatment, there was no significant difference in serum TNF-α and IL-6 levels between the two groups (P> 0.05). After treatment, the serum levels of TNF-α and IL-6 in both groups were significantly lower than those before treatment (P <0.05). The levels of TNF-α and IL-6 in the observation group were lower than those in the control group (P <0.05). Conclusion: Integrative treatment of pediatric severe pneumonia can improve clinical efficacy, improve symptoms of pneumonia, pulmonary function and serum TNF-α, IL-6 levels, and less adverse reactions.