Efficacy Evaluation Of Yinlai Decoction In Treating Children With Mycoplasma Pneumoniae Pneumonia With Heat Accumulation In Lung And Stomach

Gastrointestinal heat refers to the syndrome that the invisible heat pathogen or the visible heat knot is blocked in the gastrointestinal tract,resulting in the hyperactivity of gastrointestinal Qi.The studys show that there is a correlation between gastrointestinal heat and respiratory tract infection in children.The lung-stomach heat retention syndrome can be caused by gastrointestinal heat steaming or feeling external evil on the basis of gastrointestinal heat,and cause or aggravate the respiratory tract infection in children.In Study 1,16S rRNA amplification sequence technology was used to detect the changes of gut microbiota's structure and function in children with upper respiratory tract infection(URTI)of lung heat syndrome and gastrointestinal heat syndrome,and further explore the influence of gastrointestinal heat syndrome on lung heat syndrome,so as to provide evidence support of Microecology for lung-stomach heat retention syndrome.In Study 2,Yinlai Decoction was used to treat Mycoplasma pneumoniae pneumonia(MPP)in children with lung-stomach heat retention syndrome,to evaluate its effectiveness and safety,and to provide a new treatment for children pneumonia.Study 1Objective To investigate the effect of gastrointestinal heat syndrome on lung heat syndrome of children with upper respiratory tract infection from the perspective of gut microbiota.Methods The self-made URTI scale and the diagnosis scale for gastrointestinal heat syndrome·pediatric section were used to obtain symptom score of 3 to 7 years old children with URTI lung heat syndrome,and general information,clinical symptoms,medication days,and faeces were collected.16S rRNA amplicon sequencing was used to determine GH-positive children(LS group)and negative children(L group)gene sequence of the V3-V4 region of the microbiota in the faeces.Based on the gene sequence,we described the composition of the gut microbiota of the two groups,compared the alpha diversity index and the difference between the groups,the beta diversity and the structural difference,and made the significance analysis between the groups Amplicon Sequence Variants,made function prediction and difference analysis,discussed clinical factors affecting the structure of the gut microbiota using redundant analysis(RDA).Results A total of 23 children were collected from the two groups,12 patients in the LS group and 11 patients in the L group.Between the groups' age,sex,height,weight,body mass index were not statistically difference.The URTI score of LS group was significantly higher than that of L group.There was no significant difference between the two groups' URTI symptoms.The effective sequences shared by the two groups accounted for 85.66%of the total effective sequences.There was no difference in alpha diversity and beta diversity in the two groups of gut microbiota.The difference was that the LS group was significantly higher in the relative abundance of ruminococcus_gnavus_group,prevotella₉,staphylococcus,and actinomyces than in the L group.Groups function was mainly concentrated in the aspects of metabolism,genetic information processing and environmental information processing,and Signaling Molecules and Interaction significantly increased in relative abundance.RDA analysis showed that the URTI score had the greatest effect on the distribution of the gut microbiota,and the URTI score is positively correlated with the GH score and negatively correlated with the age.Ruminococcus_gnavus_group and Staphylococcus were positively correlated with the URTI and GH.Conlusion Gut microbiota's diversity in children with URTI of lung heat syndrome and GH were not significantly different from that of children with lung heat syndrome,but GH can affect relative abundance of gut microbiota of children with URTI lung heat syndrome,increase the interaction between signal molecules,exacerbate the inflammatory response in the children's intestines.GH may aggregate the degree of the URTI lung heat syndrome and the inflammatory response by changing the relative abundance of gut microbiota.Study 2Objective To evaluate the efficacy and safety of Yinlai Decoction combined with azithromycin in the treatment of Mycoplasma pneumoniae pneumonia(MPP)in children with lung-stomach heat retention syndrome.Methods 12 children with MPP were selected from the pediatrics outpatient and inpatient department of Dongzhimen Hospital of Beijing University of Chinese Medicine(BUCM)and Dongfang Hospital of BUCM as the experimental group,and 25 children with MPP were selected from the pediatric inpatient department of China-Japan Friendship Hospital as the control group.The control group was given azithomycin,and the experimental group was given Yinlai Decoction on the basis of the control group for 5-7 days.On the before the treatment,after treatment 3 days and 5-7 days,the markedly effective rate and effective rate of diseases and syndromes,the scores of diseases,syndromes,primary and secondary syndromes,and improvement of clinical manifestations of Lung-stomach heat retention syndrome were compared between the two groups.We observed their combined medication,the occurrence of adverse events,and the impact on the liver and kidney function.Results After 5-7 days of treatment,about the disease,the markedly effective rate of the experimental group(50%)was higher than that in the control group(9.5%)(P<0.05),the effective rate of the experimental group(100%)was higher than that of the control group(81%)(P>0.05).About the syndrome,the markedly effective rate of the experimental group(50%)was higher than that in the control group(14.3%)(P>0.05),the effective rate of the experimental group(100%)was higher than that of the control group(90.5%)(P>0.05).After 3 days of treatment,the scores of diseases,syndromes,primary and secondary syndromes of both groups decreased significantly(P<0.05).The disease score in the experimental group was less than that in the control group(P<0.05).The scores of syndromes,primary and secondary syndromes of both groups were similar,and there was no significant difference(P>0.05).After 5-7 days of treatment,the scores of diseases,syndromes,primary and secondary syndromes of both groups decreased significantly(P<0.05).The scores of diseases,syndromes,primary and secondary syndromes of both groups were similar,and there was no significant difference(P>0.05).In the aspect of breath sound,the symptoms in the experimental group were significantly less than those in the control group(P<0.01).In terms of fever,all the febrile children in the experimental group were relieved after 3 days,and all the febrile in the control group after 7 days,with no statistical difference(P>0.05).About the asthma and moss yellow,the improvement degree of the experimental group was better than that of the control group(P<0.05).About the redness and swelling of pharynx,dry stool,sore throat,swelling of tonsil,halitosis,the improvement degree of the experimental group was lower than that of the control group(P<0.05).About the cough,yellow phlegm,red lips,reduced stool frequency,red tongue,thick moss,thirst,hot hands,feet and heart,irritability,stupor,nausea and vomiting,blush,restless sleep,yellow urine,there were no significant difference between the two groups before and after treatment(P>0.05).During the study period,the proportion of children in the experimental group with w-estern medicine for relieving cough and phlegm and asthma were significantly less than that of the control group(P<0.05),and no adverse reactions occurred in both groups.After treatment,the liver and kidney function of the two groups were not abnormal.Conclusion In the experimental group,the rales in the lung were improved significantly,and all febrile children were antipyretic within 3 days,indicating that Yinlai Decoction has a significant effect in promoting the absorption of rales in the lung and antipyretic.In addition,there wew no significant difference between the two groups in terms of cough and cough phlegm,while the concomitant medication of the experimental group was significantly less than that of the control group,indicating that the effect of Yinlai Decoction on relieving cough,resolving phlegm and asthma was equivalent to that of common western medicine.The results of this study show that Yinlai Decoction combined with azithromycin can improve the clinical efficacy of MPP,Yinlai Decoction is safe,and can reduce the concomitant medication,which is worthy of clinical promotion and application.