小儿反复呼吸道感染与肺炎支原体关系的探讨及中西医结合治疗的临床研究

发布时间：2018-05-29 22:20

本文选题：反复呼吸道感染 + 小儿　；参考：《成都中医药大学》2010年硕士论文

【摘要】：目的：通过对小儿反复呼吸道感染(RRTI)中肺炎支原体(MP)因素进行调查,探讨小儿RRTI与MP之间的关系,提高对小儿RRTI中MP发病率的认识。方法：采用调查表,100例符合小儿RRTI诊断标准的患儿为实验组,同期100例以咳嗽为主诉,但不符合RRTI诊断标准的急性呼吸道感染患儿为对照组,实验室检查方法采用固相酶联免疫吸附(ELISA)法,定性检测血清中的肺炎支原体抗体IgM(MP-IgM),统计两组MP-IgM发病率。结果：①实验组MP发病率为38%(38/100例),对照组MP发病率为22%(22/100例),P0.05,有显著性差异；②男女OR值的95%可信区间均不包含1,不同性别的OR值无显著差异(P0.05)；③两组各年龄段比较,在1-2岁,经x2检验,x2=6.711,P=0.010,P0.05,具有显著统计学意义,-5岁,χ2=0.487,P=0.485,P0.05,无统计学意义,～14岁,x2=0.848,P=0.357,P0.05,无统计学意义。结论：①实验组的MP发病率要显著高于对照组；②MP是小儿RRTI的重要发病因素之一；两组男女MP发病率大致一致；③实验组在1-2岁发病率要高于对照组,而在～5岁、～14岁,两组MP发病率无明显差异。目的：通过观察中西医结合治疗小儿反复呼吸道感染(RRTI)中肺炎支原体(MP)因素的近期和远期疗效,期望探索中西医治疗该病的优势,提高对小儿反复呼吸道MP感染的认识和临床诊治水平。方法：本研究将符合中西医诊断标准的患儿最终纳入共120例,纳入病例随机分为实验组和对照组,随机方法采取查随机数字表产生,实验组65人,对照组55人。实验组进行分期辨证论治,在急性感染期辨为邪实风热犯肺,给予桑菊饮合银翘散加减并联合阿奇霉素干混悬剂口服；迁延期辩为营卫失和、邪毒留恋,予黄芪桂枝五物汤加减联合阿奇霉素干混悬剂口服；辨为久咳伤肺阴虚咳嗽,则予沙参麦冬汤加减联合阿奇霉素干混悬剂；对照组单纯给予阿奇霉素干混悬剂口服。两组患者如在出现紧急病情时均采用一般基础治疗措施,治疗期为三周,近期疗效为完成治疗后观察两组患儿的在主要症状、体征的变化；远期疗效为三周治疗期满后观察半年,最后描述观察两组主要症状、体征的变化及其对免疫功能的影响。结果：①两组近期疗效比较,秩和检验结果Z=-0.393,P=0.695,(P0.05),无显著性差异；②治疗后半年两组疗效比较Z=-2.370,P=0.018,(P0.05),两组间结果有显著的统计学意义；③实验组总有效率为98.5%,对照组为78.2%；④实验组治疗前后对IgG、IgA、IgM进行t检验,P0.05,均有显著的统计学差异；⑤两组治疗后各年龄段免疫球蛋白比较,IgG、IgA、IgM差值,P0.05,统计学有显著性差异。结论：中西医结合治疗小儿反复呼吸道感染肺炎支原体因素的远期疗效肯定,值得近一步研究。
[Abstract]:Objective: to investigate the factors of mycoplasma pneumoniae (MP) in children with recurrent respiratory tract infection (RRTI), to explore the relationship between MP and RRTI in children, and to improve the understanding of MP incidence in children with RRTI. Methods: a total of 100 children with acute respiratory tract infection (ARI), who met the diagnostic criteria of RRTI in children, were used as experimental group, and 100 children with acute respiratory infection who complained mainly of cough but did not meet the diagnostic criteria of RRTI were used as control group. Methods solid phase enzyme-linked immunosorbent assay (Elisa) was used to qualitatively detect mycoplasma pneumoniae antibody IgMP-IgMN in serum, and the incidence of MP-IgM in two groups was counted. Results the incidence of MP in the experimental group was 38 / 100 and that in the control group was 22 / 22 / 100 (P 0.05). The 95% confidence interval (CI) of OR value of male and female was significantly different. There was no significant difference in OR between two groups (P 0.05). After x2 test, there was significant statistical significance (蠂 2 / 0.487 / P = 0.485 / P = 0.05) and no statistical significance (P = 14) (P = 0.357p = 0.357p = 0.357p = 0.357P 0.05, P 0.05, P = 0.05, P = 0.05, P = 0.05, P = 0.357p = 0.357p, P 0.05, P = 0.05, P = 0.05, P = 0.05). There was no significant difference between the two groups. Conclusion the incidence of MP in the experimental group was significantly higher than that in the control group, which was one of the most important factors of RRTI in children, and the incidence rate of MP in the experimental group was higher than that in the control group at 1-2 years old, while in the control group, it was 14 years old at the age of 5 years. There was no significant difference in the incidence of MP between the two groups. Objective: to observe the short-term and long-term curative effect of combined traditional Chinese and western medicine in the treatment of children with recurrent respiratory tract infection (RRTI) of Mycoplasma pneumoniae (MPN), in order to explore the advantages of traditional Chinese medicine and western medicine in the treatment of the disease. To improve the understanding and clinical diagnosis and treatment of recurrent respiratory tract MP infection in children. Methods: 120 children who met the diagnostic criteria of traditional Chinese and western medicine were randomly divided into two groups: experimental group and control group. 65 patients in the experimental group and 55 in the control group were randomly divided into two groups: the experimental group (n = 65) and the control group (n = 55). The experimental group was treated with differentiation of symptoms and signs by stages. In the acute infection period, the patients were diagnosed as "evil excess wind heat invading the lung", given Sangju Yin and Yinqiao Powder plus or minus and combined with Azithromycin dry suspension oral administration. Huangqi Guizhi Wuwu decoction combined with azithromycin dry suspension was given orally; for long cough injury lung yin deficiency cough Shashen mai Dong decoction combined with azithromycin dry suspension; the control group was only given azithromycin dry suspension oral. The patients in both groups were treated with general basic treatment measures for three weeks, the short-term curative effect was to observe the changes of the main symptoms and signs of the two groups after the completion of the treatment. The long-term curative effect was observed for half a year after the expiration of three weeks treatment. The changes of main symptoms and signs and their effects on immune function in the two groups were described at last. Results there was no significant difference in the recent curative effect between the two groups. The results of rank sum test were ZHU -0.393P 0.695U P0.05, and there was no significant difference between the two groups half a year after treatment. There was significant statistical significance between the two groups. 3The total effective rate of the experimental group was 98.5 and that of the control group was 78.2%. There was significant statistical difference between the two groups before and after treatment. There were significant statistical differences between the two groups (P 0.05). Conclusion: the long-term curative effect of integrated traditional Chinese and western medicine in the treatment of mycoplasma pneumoniae in children with recurrent respiratory tract infection is definite and worthy of further study.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R725.6

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