儿童重症肺炎支原体肺炎免疫机制研究及中西医结合治疗进展

Study on the immunological mechanisms and advances in integrated Chinese-western medicine treatment of severe Mycoplasma pneumoniae pneumonia in children

摘要

肺炎支原体是儿童社区获得性肺炎的主要病原体之一，多数感染呈自限性，但部分患儿因免疫反应过度，可进展为重症肺炎支原体肺炎，导致临床治疗难度增加。本文综述重症肺炎支原体肺炎的免疫病理机制，重点阐述先天免疫异常、适应性免疫失调、细胞因子风暴等在引起肺组织损伤中的关键作用。同时，结合中医学“正气存内、邪不可干” “热毒炽盛” “肺失宣降”等核心理论，探讨中医药通过清热解毒、宣肺化痰、益气养阴等多途径、多靶点调控免疫失衡的内在机制，并进一步阐述中西医结合干预在缓解炎症、改善预后中的潜在优势。旨在为重症肺炎支原体肺炎的早期识别、免疫调控及中西医结合防治提供新的理论与临床参考。

Abstract

Mycoplasma pneumoniae(MP) is one of the major pathogens causing community-acquired pneumonia in children. While most infections are self-limited, some pediatric patients may develop severe Mycoplasma pneumoniae pneumonia(SMPP) due to an excessive immune response, which significantly increases the difficulty of clinical treatment. This article reviews the immunopathological mechanisms of SMPP, with a focus on the key roles of innate immune dysfunction, adaptive immune imbalance, and cytokine storms in inducing lung tissue damage. Meanwhile, by integrating core theories of traditional Chinese medicine (TCM) such as ＂preservation of healthy qi to prevent invasion by pathogenic factors＂(zheng qi cun nei, xie bu ke gan), ＂exuberant heat-toxin＂, and ＂failure of lung to disperse and descend＂, the article explores how TCM regulates the internal mechanism of immune imbalance through multiple pathways and targets, including clearing heat and detoxifying, dispersing the lung and resolving phlegm, and benefiting qi and nourishing yin. Furthermore, it discusses the potential advantages of integrated traditional Chinese and western medicine interventions in alleviating inflammation and improving prognosis. The aim is to provide new theoretical insights and clinical references for the early identification, immune regulation, and integrated Chinese and western prevention and treatment of SMPP.

关键词

肺炎支原体肺炎 / 重症 / 细胞因子风暴 / 免疫机制 / 中西医结合治疗 / 儿童

Key words

Mycoplasma pneumoniae pneumonia / Severe / Cytokine storm / Immune mechanism / Integrated traditional Chinese and western medicine treatment / Child

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基金资助

湖北陈孝平科技发展基金会资助项目(CXPJJH123004-034)