The Effect Of Added Wuhu Decoction On The Children With Mycoplasma Pneumoniae Pneumonia Of Phlegm-heat Obstructing Lungs By Regulation Of Cell Immunity

ObjectivesTo investigate the effect of added Wuhu Decoction on children with mycoplasma pneumonia of phlegm-heat obstructing lungs and their cellular immune function, comprehensively evaluate the effect of added Wuhu decoction combined with azithromycin in the treatment of phlegm-heat obstructing lungs of mycoplasma pneumonia in children. to provide clinical and related parameters and cell immunity level application basis for the popularization and application of added Wuhu Decoction on children with mycoplasma pneumonia of phlegm-heat obstructing lungs and further research.MethodsThis study was designed as a prospective randomized clinical control study,60cases of children with mycoplasma pneumonia of phlegm-heat obstructing lungs were randomly divided into2groups, named as test group A and test group B with30cases in each group. The test group B were treated with azithromycin (Zithromax) combined with basic treatment and external compress of Rhubarb Glauber’s salt; The test group A were treated with added Wuhu Decoction associated with the treatment used in the test group B. Symptom Integral score (the main symptom, minor symptoms) before and after treatment were calculated; The level of T-lymphocyte subsets(CD3+、CD4+、CD8+、CD4+/CD8+) and levels of cytokines IL-17, IL-10, TGF-β1in peripheral blood sample were analyzed before and after treatment and compared with the corresponding level from30age-matched healthy children during the same period. Then statistical software SPSS11.0was used to analyze all of the data. Results1.60children with mycoplasma pneumonia of phlegm-heat obstructing lungs were included in this study, there wasn’t significant difference between the baseline character of two test groups, including gender, age distribution, cough and fever duration (P>0.05); there wasn’t significant difference in the scores of main symptom, secondary symptom and general symptom,(P>0.05).2. There wasn’t significant difference in T lymphocyte subsets of CD3+CD4-、CD8-、CD4+/CD8+between two test groups before treatment (P>0.05). There wasn’t significant difference in the level of IL-10, IL-17, TGF-β1between two groups (P>0.05).3. Before treatment, the test group A and the test group B were compared with30healthy age-control subject respectively in T lymphocyte subsets and level of IL-10, IL-17, TGF-β1. There was no significant difference in T lymphocyte subsets:CD3+、CD4+、CD8+、CD4+/CD8+, among three groups (P>0.05); Compared with the age-control group, the level of IL-10, IL-17, TGF-β1in the test group A and the test group B were significantly increased (P<0.01).4. There wasn’t significant difference in clinical cure rate, the control rate and total efficiency between the test group A and the test group B after treatment, however, according to the comparison of symptom integral, integral reduce, hospitalization time, fever duration, cough duration, pulmonary rales duration between two groups, the clinical effect of treatment used in group A was significantly better than group B(P<0.01).5. After treatment, the test group A and the test group B were compared with healthy age-control group respectively, there were no significant difference in T lymphocyte subsets:CD3+、CD4+、CD8+、CD4+/CD8+among these three groups (P>0.05).6. After treatment, there wasn’t the significant difference in the level of CD3and CD4of the two groups compared with the status before treatment (P>0.05); CD8+and CD4+/CD8+of two groups were significantly different from the corresponding status before treatment (P<0.01), which implied the test group A is better than test group B in the regulation of T lymphocyte subsets.7. After treatment, the test group A and the test group B were compared with healthy group respectively in IL-10, IL-17, TGF-β1levels. there were significant difference (P<0.01) 8. After treatment, the difference of two group of IL-10, IL-17TGF-β1levels compare to before:IL-10(-35.17±29.67) pg/ml,(-13.73±29.87) pg/ml; TGF-β1(-473.05±6462.15) pg/ml,(2801.31±2806.61) pg/ml. the comparison of their difference wre significantly (P<0.01). IL-17(-10.88±9.24) pg/ml,(-7.15±8.71) pg/ml, there was no significant difference (P>0.05).Conclusions1. Increased levels of cytokines IL-10, IL-17, TGF-β1levels in children with mycoplasma pneumonia suggest that there was imbalance between anti-inflammatory cytokines and the proinflammatory cytokines, which lead to imbalance of Treg/Thl7, leading to cellular immunological disorder, then inducing lung injury and fibrosis in patients with immune inflammatory response, and ultimately appearing a series of clinical manifestation.2. During convalescence of MPP, levels of T lymphocyte subsets in both test group A and the test group B were similar to the level of healthy children; IL-10, IL-17level was decreased compared with that before treatment, but was significantly different from with the level of healthy children, and the TGF-β1levels maintained at a high level, which indicate that there might be a chronic inflammatory reaction of lung, pulmonary fibrosis, the immune imbalance of Treg/Th17has not completely recovered, it may be potential factor of airway hyperresponsiveness of children which is easy to recur and even develope to asthma.3.The clinical outcome in test group A was better than the the test group B, owning a stronger regulation to the level of T lymphocyte subsets compared with test group B, regulating the level of cytokines of IL-10, TGF-β1levels more strongly than the test group B. But there was no significant difference in regulation of the cytokines IL-17between2test groups. Therefore, added Wuhu Decoction function might be beneficial to reduce inflammation, and lung fibrosis by its function of opening the obstructed qi, clearing heat and resolving phlegm, removing blood stasis in children with MPP of phlegm-heat obstructing lungs, by the regulation of the level of cytokines IL-10, IL-17, TGF-β1and enhancement of Treg/Th17balance, ultimately improving the clinical efficacy.