Effect of Xiaoji Zhike oral liquid and ambroxol oral liquid in the treatment of mycoplasma pneumonia in children

YANG Ling

Shanghai Medical & Pharmaceutical Journal ›› 2023, Vol. 44 ›› Issue (24) : 15-18.

PDF(1430 KB)
PDF(1430 KB)
Shanghai Medical & Pharmaceutical Journal ›› 2023, Vol. 44 ›› Issue (24) : 15-18.
General practice and community nursing

Effect of Xiaoji Zhike oral liquid and ambroxol oral liquid in the treatment of mycoplasma pneumonia in children

Author information +
History +

Abstract

Objective: To investigate the application effect of Xiaoji Zhike oral liquid and ambroxol oral liquid in the treatment of mycoplasma pneumonia in children. Methods: Fifty children with mycoplasma pneumonia who were treated at the People’s Hospital of Nanfeng County, Jiangxi Province from June 2020 to September 2022 were collected, and a random number table method was used to divide them into an observation group and a control group with 25 cases each. Both groups were given basic treatment such as cough relieving and phlegm resolving. On this basis, the control group was treated with ambroxol oral solution: 6 months to 2 years old, 1.5 mL/dose; 2-6 years old, 2.5 mL/time; 6-12 years old, 5 mL/time; 3 times/d. The observation group was treated with Xiaoji Zhike oral liquid on the basis of the control group: under 1 year old, 5 mL/dose; 1-2 years old, 10 mL/time; 3-4 years old, 15 mL/time; over 5 years old, 20 mL/time; 3 times/d. Both groups were treated for 2 weeks. The time for body temperature recovering normal, hospitalization time, symptom disappearance time, humoral immune level, serum inflammatory indicators, and therapeutic effect were observed. Results: The time for body temperature recovering normal and hospitalization time in the observation group were lower than those in the control group(P<0.05). The disappearance times of cough, lung lesions, and lung rales in the observation group were earlier than those in the control group(P<0.05). After intervention, the levels of CD3+and CD4+ in both groups were significantly increased compared to before treatment, and the observation group was higher than the control group(P<0.05); the levels of IgM and IgA significantly decreased, and the observation group was lower than the control group(P<0.05). After intervention, the levels of hs-CRP and IL-6 in both groups were lower than those in the same group before intervention, and the observation group was lower than those in the control group(P<0.05); the IL-10 level was higher than those before the intervention in the same group, and the observation group was higher than the control group(P<0.05). The total effective rate in the observation group was 96.00%(24/25), which was higher than 72.00%(18/25) in the control group(P<0.05). Conclusion: The application effect of Xiaoji Zhike oral liquid combined with ambroxol oral liquid in the treatment of mycoplasma pneumonia in children is effective, which can shorten the time for children’s body temperature recovering normal, hospitalization time, symptom disappearance time, and improve humoral immunity level, and enhance the treatment effect.

Key words

mycoplasma pneumonia in children / Xiaoji Zhike oral liquid / ambroxol oral liquid / application effect

Cite this article

Download Citations
YANG Ling. Effect of Xiaoji Zhike oral liquid and ambroxol oral liquid in the treatment of mycoplasma pneumonia in children[J]. Shanghai Medical & Pharmaceutical Journal, 2023, 44(24): 15-18
小儿支原体肺炎一般是由外界感染所致,多通过呼吸道传播,肺炎支原体感染是其主要发病原因[1-3]。近年来,小儿支原体肺炎表现出一定程度的上升趋势。该病症发病后会造成患儿肺部严重感染,病情进展快,临床表现缺乏典型性,严重威胁患儿身体健康,临床上需引起足够的重视,积极改善患儿症状,提高患儿生存质量[4-5]。小儿支原体肺炎发病机制主要是支原体对肺组织的直接侵袭,以及免疫性炎症反应[6-7]。重症患儿还会发生肺不张、肺坏死等情况[8]。本院通过消积止咳口服液辅助氨溴索口服液对患儿进行治疗,效果较好。汇报如下:

1 资料与方法

1.1 一般资料

收集2020年6月—2022年9月在江西省南丰县人民医院接受治疗的支原体肺炎患儿50例,均符合相关诊断标准[9],表现有咳嗽、咳痰、气喘、发热等症状,并经X线检查、实验室检查后确诊。患儿辨证均为饮食积滞、痰热蕴肺型。采用随机数字表法将患儿分成观察组和对照组各25例。观察组男性14例,女性11例,年龄为1~10岁,平均(6.11±1.66)岁;病程为1~6 d,平均(3.48±0.67)d。对照组男性15例,女性10例,年龄为1~10岁,平均(6.07±1.31)岁;病程为1~6 d,平均(3.22±0.58)d。两组患儿的性别、年龄等具有可比性(P>0.05)。患儿监护人知情同意并签署知情同意协议书。排除:合并心脏病、肝肾功能障碍者;不符合本研究干预方案者;难以配合完成本研究者。

1.2 方法

两组均给予镇咳、化痰等基础治疗。在此基础上,对照组给予氨溴索口服液治疗:6个月~2岁,1.5 mL/次;2~6岁,2.5 mL/次;6~12岁,5 mL/次;3次/d。观察组在对照组基础上联合消积止咳口服液治疗:1周岁以内,5 mL/次;1~2岁,10 mL/次;3~4岁,15 mL/次;5岁以上,20 mL/次;3次/d。两组均治疗2周。观察患儿体温恢复正常时间、住院时间、症状消失时间以及体液免疫水平(CD3+、CD4+、IgM、IgA)、血清炎症指标(hs-CRP、IL-6、IL-10),比较两组疗效[10]。治愈:患儿经治疗后,各症状均消失;显效:患儿经治疗后,各症状明显好转,X线胸片阴影消失;有效:患儿经治疗后,各症状好转,肺部啰音减小,X线胸片阴影变小;无效:患儿经治疗后,各症状无好转,肺部啰音无明显改变。总有效率=(治愈例数+显效例数+有效例数)/总例数×100%。

1.3 统计学分析

采用SPSS 22.0进行数据处理,计量数据表示为均数±标准差,行t检验;计数数据表示为百分率,行χ2检验;P<0.05表示差异有统计学意义。

2 结果

2.1 两组体温恢复正常时间、住院时间、症状消失时间对比

观察组体温恢复正常时间早于对照组(P<0.05),住院时间短于对照组(P<0.05);咳嗽、肺部病灶、肺部啰音等症状消失时间都要早于对照组(P<0.05),见表1
表1 两组体温恢复正常时间、住院时间以及症状消失时间对比 (x¯±s,d)
分组 体温恢复正常时间 住院时间 症状消失时间
咳嗽 肺部病灶 肺部啰音
观察组(n=25) 6.23±1.22 7.26±1.22 1.58±0.42 3.11±0.74 4.11±0.98
对照组(n=25) 8.33±1.35 10.58±1.69 3.96±0.87 4.99±0.97 6.02±1.34
t值 10.887 17.211 28.333 12.703 9.745
P值 <0.05 <0.05 <0.05 <0.05 <0.05

2.2 两组体液免疫水平对比

干预前,两组CD3+、CD4+、IgM、IgA水平对比差异无统计学意义(P>0.05)。干预后,两组CD3+、CD4+水平高于同组干预前,IgM、IgA水平低于同组干预前,数据间对比差异有统计学意义(P<0.05),且观察组CD3+、CD4+水平高于对照组,IgM、IgA水平低于对照组,数据间对比差异有统计学意义(P<0.05)。见表2
表2 两组体液免疫水平对比 (x¯±s,g/L)
分组 CD3+ CD4+ IgM IgA
观察组(n=25)
干预前 1.19±0.15 0.72±0.12 2.74±0.24 2.13±0.31
干预后 2.98±0.34 1.56±0.35 1.21±0.15 0.82±0.14
t值 59.667 35.000 31.875 21.129
P值 <0.05 <0.05 <0.05 <0.05
对照组(n=25)
干预前 1.18±0.13 1.74±0.14 2.76±0.21 2.15±0.29
干预后 2.25±0.29 1.63±0.29 2.03±0.19 1.41±0.24
t值 41.154 3.929 17.381 12.759
P值 <0.05 <0.05 <0.05 <0.05
t组间干预后 10.735 1.000 27.333 21.071
P组间干预后 <0.05 <0.05 <0.05 <0.05

2.3 两组血清炎症指标对比

干预前,两组血清炎症因子hs-CRP、IL-6、IL-10水平对比差异无统计学意义(P>0.05)。干预后,两组hs-CRP、IL-6水平低于同组干预前,IL-10水平高于同组干预前,数据间对比差异有统计学意义(P<0.05);且观察组hs-CRP、IL-6水平低于对照组,IL-10水平高于对照组(P<0.05)。见表3
表3 两组血清炎症指标对比 (x¯±s
分组 hs-CRP/(g/L) IL-6/(ng/L) IL-10/(ng/L)
观察组(n=25)
干预前 35.77±4.98 95.38±5.22 96.33±10.22
干预后 8.99±0.46 52.04±4.69 175.98±12.14
t值 26.888 41.513 38.968
P值 <0.05 <0.05 <0.05
对照组(n=25)
干预前 35.79±5.21 95.44±5.09 96.28±8.76
干预后 15.64±2.11 79.64±8.15 126.48±11.12
t值 19.338 15.521 17.237
P值 <0.05 <0.05 <0.05
t组间干预后 72.283 29.424 20.387
P组间干预后 <0.05 <0.05 <0.05

2.4 两组疗效对比

观察组总有效率为96.00%(24/25),高于对照组的72.00%(18/25,P<0.05),见表4
表4 两组疗效对比 [n(%)]
分组 治愈 显效 有效 无效 总有效
观察组
(n=25)
15(60.00) 7(28.00) 2(8.00) 1(4.00) 24(96.00)
对照组
(n=25)
7(28.00) 8(32.00) 3(12.00) 7(28.00) 18(72.00)
χ2 6.247
P值 <0.05

3 讨论

儿童因生理结构特殊,支气管管腔较细,而且黏膜血运丰富,容易感染病原体而发病[11-13]。小儿支原体肺炎患儿的发病机制,一方面是支原体对肺组织的直接侵袭;另外一方面,则是免疫机制的重要作用[14-15]。研究有效的措施,对于减轻患儿的临床症状十分必要。本研究结果显示,观察组体温恢复正常时间、住院时间均短于对照组(P<0.05),说明患儿恢复比较快,较早可以出院。观察组咳嗽、肺部病灶、肺部啰音消失时间均早于对照组(P<0.05),说明患儿的治疗效果较好。观察组和对照组干预后CD3+、CD4+水平高于同组干预前,IgM、IgA水平低于同组干预前,数据间对比差异有统计学意义(P<0.05),且观察组CD3+、CD4+水平高于对照组(P<0.05),IgM、IgA水平低于对照组(P<0.05);说明患儿的体液免疫功能得到有效的改善。观察组和对照组干预后hs-CRP、IL-6水平低于同组干预前,IL-10水平高于同组干预前,数据间对比差异有统计学意义(P<0.05);且观察组hs-CRP、IL-6水平低于对照组,IL-10水平高于对照组,数据间对比差异有统计学意义(P<0.05);说明患儿的炎症因子水平有变化,患儿的病情有控制。CRP通过加强吞噬细胞吞噬作用,从而提高机体免疫功能,人体免疫增强初期,会表现为血液浓度的明显上升。IL-6是一种作用于免疫细胞间的细胞因子。从本研究结果可以看出,患儿的这些指标改善较好。小儿消积止咳口服液具有清热肃肺、消积止咳的功效,能够抑制咳嗽,改善患儿临床症状。其主要成分还能够改善机体的体液免疫应答状况,减轻机体炎症反应[16-17]
总之,消积止咳口服液辅助氨溴索口服液在小儿支原体肺炎治疗中的应用效果较好,可以改善患儿的体温恢复正常时间、住院时间、症状消失时间、体液免疫水平,提高治疗效果。

References

[1]
郑地松. 小儿消积止咳口服液联合氨溴索注射液治疗小儿痰热壅肺型支原体肺炎的临床疗效[J]. 临床合理用药杂志, 2022, 15(3): 133-135.
[2]
刘军燕. 阿奇霉素联合小儿消积止咳口服液治疗小儿支原体肺炎的临床疗效和安全性[J]. 心理医生, 2018, 24(3): 102-103.
[3]
Kutty PK, Jain S, Taylor TH, et al. Mycoplasma pneumoniae among children hospitalized with community-acquired pneumonia[J]. Clin Infect Dis, 2019, 68(1): 5-12.
The epidemiology of Mycoplasma pneumoniae (Mp) among US children (<18 years) hospitalized with community-acquired pneumonia (CAP) is poorly understood.In the Etiology of Pneumonia in the Community study, we prospectively enrolled 2254 children hospitalized with radiographically confirmed pneumonia from January 2010-June 2012 and tested nasopharyngeal/oropharyngeal swabs for Mp using real-time polymerase chain reaction (PCR). Clinical and epidemiological features of Mp PCR-positive and -negative children were compared using logistic regression. Macrolide susceptibility was assessed by genotyping isolates.One hundred and eighty two (8%) children were Mp PCR-positive (median age, 7 years); 12% required intensive care and 26% had pleural effusion. No in-hospital deaths occurred. Macrolide resistance was found in 4% (6/169) isolates. Of 178 (98%) Mp PCR-positive children tested for copathogens, 50 (28%) had ≥1 copathogen detected. Variables significantly associated with higher odds of Mp detection included age (10-17 years: adjusted odds ratio [aOR], 10.7 [95% confidence interval {CI}, 5.4-21.1] and 5-9 years: aOR, 6.4 [95% CI, 3.4-12.1] vs 2-4 years), outpatient antibiotics ≤5 days preadmission (aOR, 2.3 [95% CI, 1.5-3.5]), and copathogen detection (aOR, 2.1 [95% CI, 1.3-3.3]). Clinical characteristics were non-specific.Usually considered as a mild respiratory infection, Mp was the most commonly detected bacteria among children aged ≥5 years hospitalized with CAP, one-quarter of whom had codetections. Although associated with clinically nonspecific symptoms, there was a need for intensive care in some cases. Mycoplasma pneumoniae should be included in the differential diagnosis for school-aged children hospitalized with CAP.
[4]
朱翠华. 阿奇霉素联合小儿消积止咳口服液治疗小儿支原体肺炎的疗效观察[J]. 饮食保健, 2019, 6(37): 67-68.
[5]
Lee YC, Chang CH, Lee WJ, et al. Altered chemokine profile in Refractory Mycoplasma pneumoniae pneumonia infected children[J]. J Microbiol Immunol Infect, 2021, 54(4): 673-679.
[6]
罗林坚, 李兰芳, 蔡光华, 等. 阿奇霉素联合小儿消积止咳口服液治疗小儿支原体肺炎的临床疗效和安全性观察[J]. 中国处方药, 2020, 18(9): 130-132.
[7]
李勤英. 小儿消积止咳口服液辅助治疗肺炎支原体感染后慢性咳嗽患儿的疗效观察[J]. 实用中西医结合临床, 2020, 20(13): 81-82.
[8]
Meyer Sauteur PM, Berger C. Proadrenomedullin in mycoplasma pneumoniae community-acquired pneumonia in children[J]. Clin Infect Dis, 2021, 73(7): e1769-e1771.
[9]
胡亚美, 江载芳. 诸福棠实用儿科学[M]. 7版. 北京: 人民卫生出版社, 2002: 1204-1206.
[10]
中华医学会儿科学分会呼吸学组, 《中华实用儿科临床杂志》编辑委员会. 儿童肺炎支原体肺炎诊治专家共识(2015年版)[J]. 中华实用儿科临床杂志, 2015, 30(17): 1304-1308.
[11]
胡跃华. 阿奇霉素联合小儿消积止咳口服液治疗小儿支原体肺炎的疗效观察[J]. 中国社区医师, 2018, 34(13): 105-106.
[12]
Zhu Z, Zhang T, Guo W, et al. Clinical characteristics of refractory mycoplasma pneumoniae pneumonia in children treated with glucocorticoid pulse therapy[J]. BMC Infect Dis, 2021, 21(1): 126.
[13]
齐占华. 阿奇霉素联合小儿消积止咳口服液治疗小儿支原体肺炎的效果观察[J]. 中国实用医药, 2018, 13(32): 128-129.
[14]
黄锦娟, 洛阳巨. 小儿消积止咳口服液联合阿奇霉素治疗小儿支原体肺炎的疗效[J]. 中国合理用药探索, 2018, 15(12): 60-62.
[15]
李彦甫, 靳燕霞. 阿奇霉素联合小儿消积止咳口服液治疗支原体肺炎疗效观察[J]. 北方药学, 2018, 15(2): 38-39.
[16]
李晓红. 阿奇霉素联合小儿消积止咳口服液治疗小儿支原体肺炎的效果观察[J]. 中国农村卫生, 2018, 11(13): 44; 43.
[17]
裴哲. 小儿消积止咳口服液联合注射用炎琥宁治疗儿童支原体肺炎的临床效果[J]. 河南医学研究, 2018, 27(23): 4351-4352.
PDF(1430 KB)

168

Accesses

0

Citation

Detail

Sections
Recommended

/