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清肺合剂治疗小儿支原体肺炎痰热壅肺证的疗效观察

Effect of Qingfei Mixture () on pediatric mycoplasma pneumoniae pneumonia with phlegm heat obstructing Fei (Lung) syndrome.

作者信息

Yang Ai-Jun, Xi Kun, Yao Yan-Qing, Ding Ying-Xue, Yang Li-Jun, Cui Hong

机构信息

Department of Pediatrics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.

出版信息

Chin J Integr Med. 2017 Sep;23(9):681-688. doi: 10.1007/s11655-017-2409-9. Epub 2017 Sep 2.

Abstract

OBJECTIVE

To explore the effect and mechanism of Qingfei Mixture (), a Chinese medicine, in treating mycoplasma pneumonia (MP) in MP patients and rat model METHODS: A total of 46 MP children with phlegm heat obstructing Fei (Lung) syndrome were randomly assigned to two groups by the method of random number table, with 23 children in each group. The control group was treated with intravenous infusion of azithromycin; the treatment group received intravenous infusion of azithromycin and oral administration of Qingfei Mixture. The treatment course was 7 days. Major symptoms and minor symptoms were observed and scored before and after treatments. A rat model of MP was also established. A total of 120 wistar rats were randomly divided into 5 groups: a normal group, infection group, Qingfei Mixture treatment group, azithromycin treatment group, and Qingfei Mixture + azithromycin treatment group. Each group contained 24 rats, from which every 6 were euthanatized 1, 3, 7 and 14 days after infection. MP DNA in pulmonary tissue homogenates was detected using real-time fluorescence quantitative polymerase chain reaction. Pathology was assessed after hematoxylin (HE) staining and lung tissue pathology scores were determined in pulmonary tissue. Transmission electron microscopic detection and electronic image analysis were performed on lung tissue 3 days after infection. Interleukin (IL)-17 was detected in serum using enzymelinked immunosorbent assay (ELISA) 7 days after infection.

RESULTS

In the clinical study, both control and the treatment group showed improved results on removing symptoms of phlegm heat syndrome compared to the control group (P<0.05). In animal experiments, On the 7th day after MP infection, as detected by electron microscopy, the pulmonary capillary basement membranes of the azithromycin + Qingfei Mixture treatment group were much thinner than those of the azithromycin or Qingfei mixture treatment groups (P<0.05). The level of serum IL-17 in the azithromycin + Qingfei Mixture treatment group was lower than that in the azithromycin or Qingfei Mixture groups (P<0.01).

CONCLUSION

Both Qingfei Mixture and azithromycin have therapeutic effects on mycoplasma pneumoniae pneumonia, but the combination of both agents had the greatest effect.

摘要

目的

探讨中药清肺合剂治疗支原体肺炎(MP)患者及大鼠模型的效果及作用机制。方法:将46例痰热壅肺证MP患儿采用随机数字表法随机分为两组,每组23例。对照组采用静脉滴注阿奇霉素治疗;治疗组采用静脉滴注阿奇霉素并口服清肺合剂治疗。疗程为7天。观察并记录治疗前后主要症状和次要症状并评分。同时建立MP大鼠模型。将120只Wistar大鼠随机分为5组:正常组、感染组、清肺合剂治疗组、阿奇霉素治疗组、清肺合剂+阿奇霉素治疗组。每组24只,感染后1、3、7和14天每组分别处死6只大鼠。采用实时荧光定量聚合酶链反应检测肺组织匀浆中的MP DNA。苏木精(HE)染色后进行病理学评估并确定肺组织病理评分。感染后3天对肺组织进行透射电镜检测及电子图像分析。感染后7天采用酶联免疫吸附测定(ELISA)法检测血清白细胞介素(IL)-17。结果:临床研究中,与对照组相比,治疗组在改善痰热证症状方面效果更佳(P<0.05)。动物实验中,MP感染后第7天,电镜检测显示阿奇霉素+清肺合剂治疗组肺毛细血管基底膜比阿奇霉素或清肺合剂治疗组薄得多(P<0.05)。阿奇霉素+清肺合剂治疗组血清IL-17水平低于阿奇霉素或清肺合剂组(P<0.01)。结论:清肺合剂和阿奇霉素对支原体肺炎均有治疗作用,但两者联合效果最佳。

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