本文選題：反復(fù)呼吸道感染 + 小兒��； 參考：《成都中醫(yī)藥大學(xué)》2010年碩士論文

【摘要】：目的：通過對小兒反復(fù)呼吸道感染(RRTI)中肺炎支原體(MP)因素進(jìn)行調(diào)查,探討小兒RRTI與MP之間的關(guān)系,提高對小兒RRTI中MP發(fā)病率的認(rèn)識。 方法：采用調(diào)查表,100例符合小兒RRTI診斷標(biāo)準(zhǔn)的患兒為實驗組,同期100例以咳嗽為主訴,但不符合RRTI診斷標(biāo)準(zhǔn)的急性呼吸道感染患兒為對照組,實驗室檢查方法采用固相酶聯(lián)免疫吸附(ELISA)法,定性檢測血清中的肺炎支原體抗體IgM(MP-IgM),統(tǒng)計兩組MP-IgM發(fā)病率。 結(jié)果：①實驗組MP發(fā)病率為38%(38/100例),對照組MP發(fā)病率為22%(22/100例),P0.05,有顯著性差異；②男女OR值的95%可信區(qū)間均不包含1,不同性別的OR值無顯著差異(P0.05)；③兩組各年齡段比較,在1-2歲,經(jīng)x2檢驗,x2=6.711,P=0.010,P0.05,具有顯著統(tǒng)計學(xué)意義,-5歲,χ2=0.487,P=0.485,P0.05,無統(tǒng)計學(xué)意義,～14歲,x2=0.848,P=0.357,P0.05,無統(tǒng)計學(xué)意義。 結(jié)論：①實驗組的MP發(fā)病率要顯著高于對照組；②MP是小兒RRTI的重要發(fā)病因素之一；兩組男女MP發(fā)病率大致一致；③實驗組在1-2歲發(fā)病率要高于對照組,而在～5歲、～14歲,兩組MP發(fā)病率無明顯差異。 目的：通過觀察中西醫(yī)結(jié)合治療小兒反復(fù)呼吸道感染(RRTI)中肺炎支原體(MP)因素的近期和遠(yuǎn)期療效,期望探索中西醫(yī)治療該病的優(yōu)勢,提高對小兒反復(fù)呼吸道MP感染的認(rèn)識和臨床診治水平。 方法：本研究將符合中西醫(yī)診斷標(biāo)準(zhǔn)的患兒最終納入共120例,納入病例隨機(jī)分為實驗組和對照組,隨機(jī)方法采取查隨機(jī)數(shù)字表產(chǎn)生,實驗組65人,對照組55人。實驗組進(jìn)行分期辨證論治,在急性感染期辨為邪實風(fēng)熱犯肺,給予桑菊飲合銀翹散加減并聯(lián)合阿奇霉素干混懸劑口服；遷延期辯為營衛(wèi)失和、邪毒留戀,予黃芪桂枝五物湯加減聯(lián)合阿奇霉素干混懸劑口服；辨為久咳傷肺陰虛咳嗽,則予沙參麥冬湯加減聯(lián)合阿奇霉素干混懸劑；對照組單純給予阿奇霉素干混懸劑口服。兩組患者如在出現(xiàn)緊急病情時均采用一般基礎(chǔ)治療措施,治療期為三周,近期療效為完成治療后觀察兩組患兒的在主要癥狀、體征的變化；遠(yuǎn)期療效為三周治療期滿后觀察半年,最后描述觀察兩組主要癥狀、體征的變化及其對免疫功能的影響。 結(jié)果：①兩組近期療效比較,秩和檢驗結(jié)果Z=-0.393,P=0.695,(P0.05),無顯著性差異；②治療后半年兩組療效比較Z=-2.370,P=0.018,(P0.05),兩組間結(jié)果有顯著的統(tǒng)計學(xué)意義；③實驗組總有效率為98.5%,對照組為78.2%；④實驗組治療前后對IgG、IgA、IgM進(jìn)行t檢驗,P0.05,均有顯著的統(tǒng)計學(xué)差異；⑤兩組治療后各年齡段免疫球蛋白比較,IgG、IgA、IgM差值,P0.05,統(tǒng)計學(xué)有顯著性差異。 結(jié)論：中西醫(yī)結(jié)合治療小兒反復(fù)呼吸道感染肺炎支原體因素的遠(yuǎn)期療效肯定,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.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R725.6

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