| 摘要: |
| 目的:探讨点刺与麻蒌方贴敷联合西医治疗风热犯肺型儿童肺炎的疗效及其对呼吸道黏膜免疫的影响。方法:采用前
瞻性研究方法收集2022 年1 月至2023 年7 月河北秦皇岛市中医医院收治的肺炎患儿86 例,按随机数表法分为常规西医组和
点刺联合贴敷组。其中,常规西医组43 例患儿中,因服用其他药物脱落1 例,最终纳入42 例,给予西医常规治疗;点刺联合贴
敷组43 例患儿中,因难以配合脱落2 例,最终纳入41 例,在西医常规治疗的基础上联合点刺联合麻蒌方贴敷治疗。比较两组
患儿临床疗效及治疗前后中医证候评分,记录肺部啰音消失时间、咳痰缓解时间、咳嗽缓解时间、发热消失时间、喘息缓解时间
等,检测甲壳质酶40(YKL-40)、烟酰胺磷酸核糖基转移酶(NAMPT)、表面活性蛋白D(SP-D)、T 淋巴细胞亚群CD4+ 、CD8+ 及唾
液分泌型免疫球蛋白水平(sIgA)水平,并比较两组患儿不良反应发生情况。结果:点刺联合贴敷组患儿总有效率为97. 56%,高
于常规西医组的78. 57%(P<0. 05)。点刺联合贴敷组患儿发热恶风、痰稠色黄、微有汗出、呼吸急促、口渴欲饮、咽红、咳嗽评分
低于常规西医组(P<0. 05),肺部啰音消失时间、咳痰缓解时间、咳嗽缓解时间、发热消失时间、喘息缓解时间短于常规西医组(P<
0. 05)。点刺联合贴敷组患儿YKL-40、NAMPT、SP-D 水平低于常规西医组,差异均有统计学意义(P<0. 05)。点刺联合贴敷组
患儿CD8+水平低于常规西医组(P<0. 05),CD4+ 、sIgA 水平高于常规西医组(P<0. 05)。两组患儿不良反应发生率比较差异无
统计学意义(P>0. 05)。结论:点刺与麻蒌方贴敷联合西医治疗风热犯肺型肺炎患儿的临床疗效显著,可改善呼吸道黏膜免疫,
抑制机体炎症,提高患儿肺功能。 |
| 关键词: 点刺 麻蒌方贴敷 儿童 肺炎 呼吸道黏膜免疫 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2024.12.006 |
|
| 基金项目:河北省中医药管理局科研计划项目,编号2021383。 |
|
| Efficacy of Acupuncture and Maloufang Application Combined with Western Medicine in the Treatment of Children with Pneumonia of Wind-Heat Invading the Lung Type and Its Effects on Respiratory MucosalImmunity |
| Liu Xiaoxi, Li Shanshan, Zhang Yunpei |
| (Qinhuangdao Hospital of Traditional Chinese Medicine, Hebei Qinhuangdao 066000, China) |
| Abstract: |
| Objective: To explore efficacy of acupuncture and Maloufang application combined with Western medicine in the treatment
of children with pneumonia of wind-heat invading the lung type and its effects on respiratory mucosal immunity. Methods: A total of 86
children with pneumonia admitted into Qinhuangdao Hospital of Traditional Chinese Medicine from Jan. 2022 to Jul. 2023 were
prospectively extracted to be divided into the conventional Western medicine group and acupuncture and Maloufang application group
according to the random number table method. Among the 43 cases in the conventional Western medicine group, 1 case fell off due to
taking other drugs, and 42 cases were eventually enrolled and given conventional Western medicine treatment. Of the 43 children in the
acupuncture and Maloufang application group, 2 cases fell off due to difficulty in cooperation, and 41 cases were finally enrolled and
received acupuncture and Maloufang application on the basis of the conventional Western medicine treatment. The clinical efficacy and
traditional Chinese medicine syndrome scores before and after treatment were compared between two groups. The disappearance time of
lung rale, relief time of sputum, relief time of cough, disappearance time of fever, and relief time of gasp were recorded. The levels of
chitinase 40 ( YKL-40), nicotinamide phosphoribosyl transferase ( NAMPT), surface active protein D ( SP-D), T lymphocyte
subpopulation CD4+ , CD8+ and salivary secretory immunoglobulin A (sIgA) were detected. The incidence of adverse drug reactions was
compared between two groups. Results: The total effective rate was 97. 56% in the acupuncture and Maloufang application group, higher
than 78. 57% in the conventional Western medicine group (P < 0. 05). The scores of fever, thick yellow sputum, slight sweating,
shortness of breath, thirst, sore throat, and cough in the acupuncture and Maloufang application group were lower than those in the
conventional Western medicine group (P<0. 05). The disappearance time of lung rale, relief time of sputum, relief time of cough,
disappearance time of fever, and relief time of gasp in the acupuncture and Maloufang application group were shorten than those in the
conventional Western medicine group (P<0. 05). YKL-40, NAMPT and SP-D in acupuncture and Maloufang application group were
lower than those in conventional Western medicine group (P<0. 05). The level of CD8+ in acupuncture and Maloufang application group
was significantly lower than that in conventional Western medicine group (P<0. 05), and the levels of CD4+ and sIgA in acupuncture
and Maloufang application group were higher than those in conventional Western medicine group (P<0. 05). There was no statistically
significant difference in the incidence of adverse drug reactions between two groups (P >0. 05). Conclusion:The clinical efficacy of
acupuncture and Maloufang application combined with Western medicine in the treatment of children with pneumonia of wind-heat
invading the lung type is significant, which can improve respiratory mucosal immunity, inhibit body inflammation and enhance lung
function in children with pneumonia of wind-heat invading the lung type. |
| Key words: acupuncture Maloufang application children pneumonia respiratory mucosal immunity |
