| Objectives: This research aims to firstly explore into the clinical efficacy of methylprednisolone against RMPP(Refractory Mycoplasma Pneumoniae Pneumonia) in Children; secondly analyze how its curative efficacy differs when a different dosage of methylprednisolone is applied to remedy RMPP, and examine its adverse reaction. This will supply an evidence-based medical reference for more reasonably utilizing glucocorticoids to clinically remedy RMPP in children.Methods: Pick ninety sufferers(1-14 years old) who are admitted to the Pediatrics Ward in Yanan University Affiliated Hospital from September 2013 to August 2015 and who satisfy the RMPP Diagnosis Standard. The method of random number table is used to divide such ninety sufferers into three groups, which are respectively Small-Dosage Treatment Group(A), Large-Dosage Treatment Group(B) and Contrast Group, and each group includes thirty cases. The Contrast Group sufferers are given the conventional treatment such as azithromycin while Group A and Group B sufferers are given a small dosage of methylprednisolone(2mg/kg·d) and a large dosage of methylprednisolone(10mg/kg·d) by intravenous infusion respectively besides the conventional treatment. Compare such indices as how long it takes to abate fever, how long it takes to alleviate cough, the time of their stay in hospital, lung imaging changes, adverse reaction, etc., and judge the curative efficacy.Results: Firstly, the total efficacy rate is 56.7% for the Contrast Group while it is 95% for Group A and Group B, showing the statistical significance(P<0.05). The total efficacy rate for Group A and Group B is 93.3% and 96.7% respectively, not showing the statistical significance(P>0.05). Secondly, it takes shorter time for both Group A and Group B than the Contrast Group in terms of fever abatement, cough alleviation and stay in hospital among some other aspects, showing statistical significance(P<0.05). And it takes shorter time for Group B than Group A when comparing the time for fever abatement, cough alleviation and stay in hospital, also showing statistical significance(P<0.05).Thirdly, after the treatment for two weeks, the chest X-Ray(CT) shows that most of phlogosis is absorbed for sixteen sufferers(53.3%) in Group A, for twenty sufferers(66.7%) in Group B, and for 5 sufferers(16.7%) in Contrast Group. The comparison between the treatment group(Group A and Group B) and Contrast Group indicates that the treatment group has a higher rate of lung shadow absorption than Contrast Group, showing statistical significance(P<0.05). The comparison between Group A and Group B indicates that Group B has a higher rate of lung shadow absorption than Group A, also showing statistical significance(P<0.05). Fourthly, no severe adverse reaction occurs such as peptic ulcer when the treatment group(Group A and Group B) sufferers are treated with methylprednisolone. Only slight adverse reaction has occurred such as episodic high blood pressure, hyperglycosemia, tachycardia, electrolyte disturbance and mental symptom. The comparison of the adverse reaction occurrence rate between Group A and Group B does not show any statistical significance(P>0.05). No special treatment is given to such two groups for adverse reactions, and the symptoms fade away when they are not given methylprednisolone.Conclusions: Firstly, the intravenous infusion of methylprednisolone can be combined to increase the total efficacy rate while the conventional anti-infective treatment is given to remedy RMPP, and the clinical efficacy apparently improves. Secondly, the intravenous infusion of a small and large dosage of methylprednisolone for remedying RMPP does not show significant differences in terms of the total efficacy rate, and no severe adverse reactions occur. Thirdly, a large dosage of methylprednisolone can abate fever and alleviate cough in a shorter time, shorten the stay in hospital, improve the lung shadow absorption rate, and more efficiently relieve clinical symptoms for RMPP sufferers. |
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