Objective  To explore the clinical efficacy of azithromycin sequential therapy (AST) combined with infantile massage (IM) in children with chronic cough after mycoplasma pneumoniae infection (CCAMP) phlegm-heat closed lung syndrome (PHCLS), and provide a new scheme for the clinical diagnosis and treatment of CCAMP.

Methods  The study retrospectively collected children with CCAMP-PHCLS diagnosed in the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2022 to March 2023. According to the treatment regimes, the children were divided into AST group and AST+IM group. The differences in cough symptoms integral and inflammatory factors (IL-6, PCT and CRP) between the two groups of CCAMP-PHCLS children were observed and compared. In addition, the total time to disappearance of clinical symptoms/signs, negative conversion of serum MP antibody (MP-IgM), total treatment response rate and incidence of adverse reactions were compared between the two groups.

Results  A total of 98 CCAMP-PHCLS children were collected, 49 in each group. There were no significant differences between the AST+IM group and AST group in daytime cough symptoms points, nighttime cough symptoms points, serum IL-6 content, serum PCT content, and serum CRP content before treatment (P>0.05). After treatment, the daytime cough symptoms, serum IL-6, serum PCT and serum CRP in both groups significantly decreased compared to before treatment, and the above indicators in the AST+IM group were lower than those in the AST group (P<0.05). In terms of clinical characteristics, CCAMP-PHCLS children lost cough, fever and lung rales in the AST+IM group were shorter than the AST group (P<0.05), and the MP-IgM conversion rate was significantly higher than the AST group (P<0.05). In addition, in terms of clinical efficacy and safety, the total response rate of CCAMP-PHCLS in the AST+IM group was significantly higher than that in the AST group (P<0.05), while the incidence of adverse reactions of CCAMP-PHCLS in the AST+IM group was significantly lower than that in the AST group (P<0.05).

Conclusion  IM combined with AST has significant efficacy and high safety in children with CCAMP. The potential possible mechanism is that IM mediate production of inflammatory factors, and improves airway inflammation, thus alleviating clinical symptoms and signs.

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