| 于欣田,孙冬冬,胡红蕾,李宇哲,刁娟娟.阿奇霉素序贯治疗联合麻杏石甘汤加味对痰热闭肺型肺炎支原体肺炎患儿Th17/Treg细胞因子和NLRP3炎症小体通路的影响[J].,2022,(12):2328-2332 |
| 阿奇霉素序贯治疗联合麻杏石甘汤加味对痰热闭肺型肺炎支原体肺炎患儿Th17/Treg细胞因子和NLRP3炎症小体通路的影响 |
| Effects of Azithromycin Sequential Therapy Combined with Modified Maxing Shigan Decoction on Th17/Treg Cytokines and NLRP3 Inflammatory Body Pathway in Children with Phlegm Heat Closed Lung Mycoplasma Pneumoniae Pneumonia |
| 投稿时间：2021-10-24 修订日期：2021-11-20 |
| DOI：10.13241/j.cnki.pmb.2022.12.026 |
| 中文关键词: 阿奇霉素 麻杏石甘汤加味 痰热闭肺型 肺炎支原体肺炎 Th17/Treg细胞因子 NLRP3炎症小体通路 |
| 英文关键词: Azithromycin sequential therapy Modified Maxing Shigan decoction Phlegm heat closing lung type Mycoplasma pneumoniae pneumonia Th17/Treg cytokines NLRP3 inflammasome body pathway |
| 基金项目:国家中医药管理局中医药循证能力建设项目（2019XZZX-EK004） |
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| 中文摘要: |
| 摘要 目的：观察阿奇霉素序贯治疗联合麻杏石甘汤加味对痰热闭肺型肺炎支原体肺炎（MPP）患儿辅助性T细胞17（Th17）/调节性T细胞（Treg）细胞因子和NOD样受体蛋白3（NLRP3）炎症小体通路的影响。方法：选择山东省中医院2019年4月~2021年5月期间收治的痰热闭肺型MPP患儿106例，根据随机数字表法分为对照组和研究组，各为53例，对照组患儿接受阿奇霉素序贯治疗，研究组患儿接受阿奇霉素序贯治疗联合麻杏石甘汤加味治疗，对比两组疗效、中医证候积分、Th17/Treg细胞因子和NLRP3炎症小体通路相关指标，记录两组不良反应发生情况。结果：与对照组相比，研究组的临床总有效率明显更高（P<0.05）。两组治疗后次证积分、主证积分、总积分均较治疗前下降，且研究组低于对照组（P<0.05）。两组治疗后白介素-17A（IL-17A）、白介素-25（IL-25）水平均较治疗前下降，白介素-10（IL-10）、白介素-35（IL-35）水平均较治疗前升高，且研究组的变化程度大于对照组（P<0.05）。两组治疗后NLRP3 mRNA、接头蛋白凋亡相关斑点样蛋白（ASC）mRNA、半胱天冬酶1（caspase-1） mRNA均较治疗前下降，且研究组的下降程度大于对照组（P<0.05）。两组在治疗期间均未曾出现明显不良反应。结论：阿奇霉素序贯治疗联合麻杏石甘汤加味治疗痰热闭肺型MPP患儿疗效显著，可促进症状改善，作用机制可能与调节Th17/Treg细胞因子和NLRP3炎症小体通路有关。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effect of Azithromycin sequential therapy combined with Modified Maxing Shigan decoction on helper T cell 17 (Th17) / regulatory T cell (Treg) cytokines and NOD like receptor protein 3 (NLRP3) inflammatory body pathway in children with phlegm heat closed lung Mycoplasma pneumoniae pneumonia (MPP). Methods: 106 children with phlegm heat closed lung MPP who were treated in Shandong hospital of traditional Chinese medicine from April 2019 to May 2021 were selected. According to the random number table method, they were divided into control group and study group, with 53 cases in each group. The children in the control group received Azithromycin sequential therapy, and the children in the study group received Azithromycin sequential therapy combined with Modified Maxing Shigan decoction. The curative effects, TCM syndrome scores, Th17/Treg cytokines and NLRP3 inflammatory body pathway related indicators were compared between the two groups, and the occurrence of adverse reactions in the two groups were recorded. Results: Compared with the control group, the total clinical response rate of the study group was significantly higher (P<0.05). After treatment, the secondary symptom score, main symptom score and total score of the two groups decreased compared with those before treatment, and the study group was lower than the control group (P<0.05). After treatment, interleukin-17A (IL-17A) and interleukin-25 (IL-25) levels in the two groups decreased compared with before treatment, and the interleukin-10 (IL-10) and interleukin-35 (IL-35) levels increased compared with before treatment, and the degree of change in study group was greater than that in control group (P<0.05). NLRP3 mRNA, adaptor protein apoptosis related spot like protein (ASC) mRNA and caspase-1 (caspase-1) mRNA in the two groups after treatment decreased compared with before treatment, and the decrease degree in the study group was greater than that in the control group (P<0.05). There were no obvious adverse reactions in both groups during treatment. Conclusion: Azithromycin sequential therapy combined with Modified Maxing Shigan decoction has significant efficacy in the treatment of children with phlegm heat closed lung MPP, which can promote symptom improvement, the mechanism may be related to the regulation of Th17/Treg cytokines and NLRP3 inflammasome body pathway related indicators. |
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