探究消啰散穴位贴敷对肺炎支原体肺炎（MPP）患儿细胞因子及T淋巴细胞亚群的影响。

收集2023年10月至2024年10月安徽中医药大学附属太和中医院儿科就诊的102例MPP患儿的临床资料，依次读取102个随机数字并按大小排序或设定奇偶规则，随机数为奇数入试验组，偶数入对照组，分为试验组（51例）与对照组（51例）。对照组患儿接受阿奇霉素治疗，试验组患儿在对照组治疗基础上加用消啰散贴敷治疗。采用Mann-Whitney U检验或Pearson χ²检验比较两组患儿的临床疗效、体征、症状改善、肺功能指标、血清细胞因子水平、T淋巴细胞亚群分布以及不良反应发生率等。

较治疗前，两组患儿用力肺活量（FVC）、峰流速（PEF）、第1秒用力呼气量与用力肺活量比值（FEV1/FVC）均显著提高；白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）和C-反应蛋白（CRP）水平均显著降低，差异均有统计学意义（P均＜0.05）。试验组MPP患儿临床总有效率（98.04%、50/51）、FVC（2.70±0.43）、PEF（6.54±0.82）和FEV1/FVC（76.59±6.88）均显著高于对照组[临床总有效率：76.47%、39/51、FVC（2.18±0.31）L、PEF：（5.27±0.70）L/s和FEV1/FVC：（70.92±6.14）]（χ²=10.667，t=7.005、8.412、4.391；P均＜0.001），血常规指标复常时间（t=7.223、P＜0.001）、咳嗽消失时间（t=6.631、P＜0.001）、喘憋症状消失时间（t=4.856、P＜0.001）、肺部啰音消失时间（t=8.788、P＜0.001）和退热时间（t=12.097、P＜0.001）均显著缩短，血清IL-6[（6.44±0.78）pg/ml vs.（9.55±1.21）：t=15.428、P＜0.001]、TNF-α[（8.24±0.93）vs.（10.93±1.32）：t=11.897、P＜0.001]和CRP[（1.21±0.21）vs.（2.09±0.34）t=15.726、P＜0.001]水平均较对照组显著降低，差异均有统计学意义。治疗后，两组MPP患者CD3⁺ T、CD4⁺ T淋巴细胞水平均较本组治疗前水平显著降低，而CD8⁺ T淋巴细胞水平则显著下降（P均＜0.05）；治疗后试验组MPP患儿CD3⁺ T淋巴细胞[（71.02±7.83）%]和CD4⁺ T淋巴细胞[（43.28±5.24）%]显著高于对照组患儿[（67.55±6.42）%和（38.99±4.65）%]，而CD8⁺ T淋巴细胞水平[（18.24±1.34）% vs.（21.11±1.99）%]显著低于对照组患儿[（21.11±1.99）%]（t=2.447、4.373、8.543，P均＜0.001），差异均有统计学意义。对照组和试验组患儿不良反应发生率分别为7.84%和1.96%，但差异无统计学意义（χ²=1.950、P=0.161）。

将消啰散穴位贴敷应用于MPP患儿，可有效降低患儿血清IL-6、TNF-α和CRP水平，抑制炎症反应，调节T淋巴细胞亚群，提升临床疗效。

To investigate the effect of acupoint application of Xiaoluosan on cytokines and T lymphocyte subsets in children with Mycoplasma pneumoniae pneumonia (MPP).

Clinical data of 102 children with MPP in the Department of Pediatrics, Taihe Traditional Chinese Medicine Hospital affiliated to Anhui University of Traditional Chinese Medicine from October 2023 to October 2024 were collected. Total of 102 random numbers were generated and sorted either in ascending order or according to an odd-even criterion; odd-numbered numbers were assigned to the experimental group (51 cases) and even-numbered numbers to control group (51 cases). Children in control group received treatment with azithromycin, while those in experimental group additionally received Xialuosan patch application. Clinical efficacy, improvement of signs and symptoms, lung function indicators, serum cytokine levels, distribution of T lymphocyte subsets and incidence of adverse reactions of MPP cases between experimental group and control group were compared by Mann-Whitney U test or Pearson χ² test.

Compared with baseline levels before treatment, the forced vital capacity (FVC), peak flow velocity (PEF) and the ratio of forced expiratory volume to forced vital capacity in one second (FEV1/FVC) increased significantly in both groups; but the levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) reduced significantly, all with significant differences (all P<0.05). The clinical total effective rate (98.04%, 50/51), FVC (2.70±0.43) L, PEF (6.54±0.82) L/s and FEV1/FVC (76.59±6.88) of cases in experimental group were significantly higher than those of control group [clinical total effective rate: 76.47%, 39/51, FVC: (2.18±0.31) L, PEF: (5.27±0.70), FEV1/FVC: (70.92±6.14)] (χ²=10.667, t=7.005, t=8.412, t=4.391; all P<0.001). The recovery time of routine blood test indices (t=7.223, P<0.001), disappearance time of cough (t=6.631, P<0.001), disappearance time of wheezing and dyspnea (t=4.856, P<0.001), disappearance time of pulmonary rales (t=8.788, P<0.001) and defervescence time (t=12.097, P<0.001) were all significantly shortened in the experimental group. Serum levels of IL-6 [(6.44±0.78) pg/ml vs. (9.55±1.21) pg/ml: t=15.428, P<0.001], TNF-α [(8.24±0.93) pg/ml vs. (10.93±1.32) pg/ml: t=11.897, P<0.001] and CRP [(1.21±0.21) mg/L vs. (2.09±0.34) mg/L: t=15.726, P<0.001] of cases in experimental group were significantly lower than those of control group, all with significant differences. After treatment, the levels of CD3⁺ T and CD4⁺ T lymphocytes of children in both groups were significantly higher than those of pre-treatment levels, while the level of CD8⁺ T lymphocytes was significantly decreased (all P<0.05). After treatment, the levels of CD3⁺ T lymphocytes [(71.02±7.83)%] and CD4⁺ T lymphocytes [(43.28±5.24)%] of cases in experimental group were significantly higher than those of control group [(67.55±6.42)% and (38.99±4.65)%], whereas the CD8⁺ T lymphocyte level [(18.24±1.34)% vs. (21.11±1.99)%] was significantly lower than that of control group (t=2.447, 4.373, 8.543; all P<0.001), with significant differences. The incidence of adverse reactions was 7.84% of cases in control group and 1.96% in experimental group, but without significant difference (χ²=1.950, P=0.161).

Xiaoluosan acupoint application to MPP children can effectively reduce the levels of IL-6, TNF-α and CRP, inhibit inflammatory response, regulate T lymphocyte subsets and enhance the clinical efficacy.