Effect of modified Xuanbai Chengqi Decoction on intestinal microflora and sIgA content in children with mycoplasma pneumonia of phlegm⁃heat blocking lung syndrome

Chunxiu BAO; Yonghong JIANG

doi:10.16305/j.1007-1334.2022.2202020

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Effect of modified Xuanbai Chengqi Decoction on intestinal microflora and sIgA content in children with mycoplasma pneumonia of phlegm⁃heat blocking lung syndrome

更新时间：2022-10-09

- Effect of modified Xuanbai Chengqi Decoction on intestinal microflora and sIgA content in children with mycoplasma pneumonia of phlegm⁃heat blocking lung syndrome
- Shanghai Journal of Traditional Chinese Medicine Vol. 56, Issue 7, Pages: 53-58(2022)
- 作者机构：
  
  1.上海中医药大学附属龙华医院儿科（上海 200032）
- 作者简介：
- 基金信息：
- DOI：10.16305/j.1007-1334.2022.2202020
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包春秀,姜永红.加味宣白承气汤对痰热闭肺型肺炎支原体肺炎患儿肠道菌群及sIgA水平的影响[J].上海中医药杂志,2022,56(7):53-58.

BAO Chunxiu,JIANG Yonghong.Effect of modified Xuanbai Chengqi Decoction on intestinal microflora and sIgA content in children with mycoplasma pneumonia of phlegm⁃heat blocking lung syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(7):53-58.
包春秀,姜永红.加味宣白承气汤对痰热闭肺型肺炎支原体肺炎患儿肠道菌群及sIgA水平的影响[J].上海中医药杂志,2022,56(7):53-58. DOI： 10.16305/j.1007-1334.2022.2202020.

BAO Chunxiu,JIANG Yonghong.Effect of modified Xuanbai Chengqi Decoction on intestinal microflora and sIgA content in children with mycoplasma pneumonia of phlegm⁃heat blocking lung syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(7):53-58. DOI： 10.16305/j.1007-1334.2022.2202020.

摘要

目的,2,观察加味宣白承气汤联合西医常规疗法治疗痰热闭肺型肺炎支原体肺炎（MPP）的临床疗效，以及该方对患儿肠道菌群数量、分泌型免疫球蛋白A（sIgA）水平的影响，从肠-肺轴角度探索中医药治疗MPP的机制。,方法,2,将60例痰热闭肺型MPP患儿随机分为对照组和观察组，每组30例；招募同期健康儿童30例，设为正常组。对照组予阿奇霉素治疗，观察组在对照组治疗措施的基础上联合使用加味宣白承气汤，两组疗程均为5 d。观察临床疗效，采集各组儿童的粪便标本，采用实时定量聚合酶链反应法检测双歧杆菌、乳酸杆菌、黄瘤胃球菌、丁酸梭菌数量，采用酶联免疫吸附测定法检测sIgA含量，采用Person相关系数描述肠道菌群数量与sIgA含量的相关性，同时进行安全性评价。,结果,2,①观察组总有效率为 93.33%，对照组总有效率为70.00%，观察组临床疗效优于对照组（,P,<,0.01）。②与正常组比较，痰热闭肺型MPP患儿粪便双歧杆菌、乳酸杆菌、黄瘤胃球菌、丁酸梭菌数量减少（,P,<,0.001）；治疗后，观察组双歧杆菌、乳酸杆菌、黄瘤胃球菌、丁酸梭菌数量增加（,P,<,0.001），且多于对照组（,P,<,0.001）。③与正常组比较，痰热闭肺型MPP患儿粪便sIgA含量降低（,P,<,0.05）；治疗后，观察组粪便sIgA含量升高（,P,<,0.001），且高于对照组（,P,<,0.001）。④痰热闭肺型MPP患儿粪便中双歧杆菌、乳酸杆菌、黄瘤胃球菌、丁酸梭菌数量与sIgA含量呈正相关（,P,<,0.001）。⑤治疗期间，所有患儿均未出现明显不良反应。,结论,2,加味宣白承气汤联合西医常规疗法治疗痰热闭肺型MPP疗效满意，其机制与增加肠道有益菌数量、调节肠道黏膜免疫有关。

Abstract

Objective,2,To observe the clinical efficacy of modified Xuanbai Chengqi Decoction （XBCQ） in the treatment of mycoplasma pneumoniae pneumonia （MPP） of phlegm-heat blocking lung syndrome， investigate the effect of modified XBCQ on the intestinal microflora and the content of secretory immunoglobulin A （sIgA） in pediatric patients， and explore the mechanism of traditional Chinese medicine （TCM） in the treatment of MPP based on gut-lung axis.,Methods,2,Sixty children with MPP of phlegm-heat blocking lung syndrome were randomly divided into a control group （,n,=30） and an observation group （,n,=30）； and 30 healthy children were recruited at the same time as a normal group. The control group was administered with azithromycin， and the observation group was administered with modified XBCQ together with the treatment of the control group. The treatment of both groups lasted 5d. We observed the clinical efficacy， collected feces samples from children in each group， and used real-time quantitative polymerase chain reaction to detect the number of ,Bifidobacterium,， ,Lactobacillus,， ,Ruminococcus flavefaciens, and ,Clostridium butyricum,， and enzyme-linked immunosorbent assay to detect the sIgA content. We used the Person correlation coefficient to describe the correlation between the number of intestinal microflora and the sIgA content in feces， and we also performed safety evaluation.,Results,2,①The total effective rate of the observation group was 93.33%， and that of the control group was 70.00 %. The clinical efficacy of the observation group was better than that of the control group （,P,<,0.01）. ②The number of ,Bifidobacterium,， ,Lactobacillus,， ,Ruminococcus flavefaciens ,and ,Clostridium butyricum, in feces was lower in children with MPP of phlegm-heat blocking lung syndrome than that in healthy children of the normal group （,P,<,0.001）； after treatment， the number of ,Bifidobacterium,， ,Lactobacillus,， ,Ruminococcus flavefaciens, and ,Clostridium butyricum, increased in the observation group （,P,<,0.001） and was higher than that in the control group （,P,<,0.001）. ③Children with MPP of phlegm-heat blocking lung syndrome had lower fecal sIgA content than healthy children of the normal group （,P,<,0.05）； after treatment， the fecal sIgA content in the observation group increased （,P,<,0.001） and was higher than that of the control group （,P,<,0.001）. ④The number of ,Bifidobacterium,， ,Lactobacillus,， ,Ruminococcus,flavefaciens, and ,Clostridium butyricum, in feces of children with MPP of phlegm-heat blocking lung syndrome was positively correlated with the sIgA content （,P,<,0.001）. ⑤During the course of treatment， no significant adverse reaction was observed in patients under treatment.,Conclusions,2,Satisfactory results have been obtained among patients with MPP of the phlegm-heat blocking lung syndrome treated by modified XBCQ with conventional therapy. The mechanism is related to the increase of beneficial intestinal microflora and intestinal mucosal immunity regulation.

关键词

肺炎支原体肺炎痰热闭肺证儿童加味宣白承气汤肠道菌群分泌型免疫球蛋白A临床试验

Keywords

mycoplasma pneumoniae pneumoniaphlegm-heat blocking lung syndromechildrenmodified Xuanbai Chengqi Decoctionintestinal microflorasIgAclinical trial

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