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.