ABSTRACT
Objective:To investigate the clinical efficacy of Loulu Shengma Tang combined with azithromycin in the treatment of pediatric mycoplasma pneumoniae pneumonia（MPP） with obstruction of lung by pathogenic heat， and its effect on inflammatory factors， treg and Foxp3 mRNA. Method:Totally 274 children with MPP were divided into observation group （137 cases） and control group （137 cases）. Observation group was treated with Loulu Shengma Tang combined with azithromycin dry suspension， while control group was treated with azithromycin dry suspension alone. The changes of traditional Chinese medicine（TCM） syndrome score of pathogenic-heat obstruction in the lung， serum inflammatory cytokines ［interleukin-6 （IL-6），interleukin-10 （IL-10），tumor necrosis factor-α （TNF-α），C-reactive protein （CRP）］， CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were observed after treatment. The clinical efficacy and the incidence of adverse reactions were compared between two groups. Result:The total effective rate of observation group was 94.16%（129/137） after treatment， which was significantly higher than 77.37% （106/137）of observation group （P<0.05）. The disappearance times of cough， lung rale， fever and lung shadow in observation group were shorter than that in control group （P<0.05）. After treatment， TCM syndrome score of pathogenic-heat obstruction in lung was significantly higher than those in control group （P<0.05）， serum IL-6， IL-10， TNF-α and CRP levels in observation group were significantly lower than those in control group （P<0.05， P<0.01）， while CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were significantly higher than those in control group （P<0.05）. The incidence of adverse reactions in observation group was 7/137 （5.11%）， which was significantly lower than 16/137 （11.68%） in control group. Conclusion:The clinical efficacy of Loulu Shengma Tang combined with azithromycin dry suspension in the treatment of pediatric MPP and its effect on serum inflammatory factors （IL-6， IL-10， TNF-α， CRP）， regulatory T cells and Foxp3 mRNA expressions were better than those of azithromycin dry suspension alone. The incidence of adverse reactions of Loulu Shengma Tang was lower than that of azithromycin dry suspension alone.
ABSTRACT
Objective:To observe the clinical efficacy of addition and subtraction therapy of Shashen Maidongtang for syndrome of Yin deficiency and lung heat at convalescent period in patients with mycoplasma pneumoniae pneumonia， and to investigate its regulatory effect on immune inflammatory response. Method:One hundred and forty-eight patients were randomly divided into control group （74 cases） and observation group （74 cases） by random number table. During the treatment， 70 patients completed the study in control group （loss to follow-up in 2 cases， elimination in 3 cases）， and 71 patients completed the study in observation group （loss to follow-up in 4 cases）. Patients in both groups got Azithromycin tablets for 3 days， 10 mg·kg-1·d-1， pidotimod granules， 0.4-0.8 g/time， 2 times/day， and Ambroxol oral solution， 2.5-15 mL/time， 2 times/day. The patients in control group additionally received Yangyin Qingfei oral liquid， 5-10 mL/time， 2-3 times/day， while the patients in observation group additionally received addition and subtraction therapy of Shashen Maidongtang， 1 dose/day， with a treatment course of 7 days in both groups. Before and after treatment， scores of cough symptom and cough visual analogue score （VAS） were graded， and the time to disappearance of cough， lung rales and expectoration as well as the time to recovery of chest radiograph were recorded. Scores of syndrome of yin deficiency and lung heat and Leicester Cough Questionnaire （LCQ） were also graded. Levels of T lymphocyte subsets （CD3+， CD4+， CD8+ and CD4+/CD8+）， interleukin-6 （IL-6）， IL-10， tumor necrosis factor-α （TNF-α）， substance P （Substance P） and procalcitonin gene related peptide （CGRP） were detected， and the safety was also evaluated. Result:Total effective rate for the disease was 95.77% （68/71） in observation group， higher than 82.86% （58/70） in control group （χ2=6.186， P<0.05）. Scores of cough symptoms and VAS were higher than those in control group （P<0.01）， and scores of various items in LCQ scale and the total score of LCQ were all higher than those in control group （P<0.01）. The time to disappearance of cough， lung rales and expectoration as well as the time to recovery of chest radiograph in observation group were shorter than those in control group （P<0.01）. Levels of CD3+， CD4+ and CD4+/CD8+ were higher than those in control group （P<0.01）， and levels of CD8+， IL-6， IL-10， TNF-α， SP in serum and CGRP in sputum were all lower than those in control group （P<0.01）. Conclusion:On the basis of conventional western medicine treatment， addition and subtraction therapy of Shashen Maidongtang can reduce the degree of cough， shorten the course of disease， improve the quality of life， improve the cellular immune function， reduce the inflammatory injury， and reduce the sensitivity of cough， with better clinical efficacy and safety as compared with Western medicine alone.
ABSTRACT
Objective To observe the outcomes of intranasal endoscopic holmium laser-assisted dacryocystorhinostomy in the treatment of chronic dacryocystitis. Methods Forty-seven patients(47 eyes) with chronic dacryocystitis underwent intranasal endoscopic holmium laser-assisted dacryocystorhinostomy.The postoperative follow-up included lacrimal irrigation and intranasal endoscopic examination. Results The patients were followed up for 3 to 6 months.The cure rate was 87.2%,the improvement rate was 6.4%,and the total effective rate(cure rate+improvement rate) was 93.6%.Conclusion Intranasal endoscopic holmium laser-assisted dacryocystorhinostomy causes no scar in the face,less nasal tissue damage,shorter operation time and less hemorrhage,and does not affect the lacrimal irrigation system,which allows correction of intranasal causes of failure in traditional dacryocystorhinostomy.