Integrative Traditional Chinese Medicine Strategies for Refractory Mycoplasma Pneumonia in Children: Clinical Challenges, Mechanisms, and Evidence-Based Insights

儿童难治性支原体肺炎的中医药综合治疗策略:临床挑战、机制及循证医学见解

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Abstract

Respiratory Mycoplasma Pneumonia (RMPP) in pediatric populations presents a significant therapeutic challenge, particularly due to the rising prevalence of macrolide-resistant strains and dysregulated immune responses. Traditional Chinese Medicine (TCM) offers a complementary therapeutic approach, focusing on restoring balance by addressing both underlying deficiencies, such as Qi and Yin deficiency, and excessive pathogenic factors, including inflammatory mediators ("heat toxin" in TCM theory) and mucus hypersecretion ("phlegm accumulation"). Key TCM herbs, including Scutellaria baicalensis and Isatis indigotica, demonstrate direct antimicrobial activity against Mycoplasma pneumoniae and exert immunomodulatory effects by reducing pro-inflammatory cytokines (e.g, TNF-α, IL-1, IL-6) and promoting the resolution of phlegm and mucus. These actions not only target infection but also alleviate airway obstruction and support lung function. Formulas such as Ma Xing Shi Gan Tang and Lianhua Qingwen have shown clinical efficacy when used in conjunction with antibiotics, resulting in accelerated fever resolution, reduced inflammatory markers, and enhanced radiographic improvement. Integrated treatment strategies combining TCM with conventional therapies have been shown to shorten symptom duration, decrease inflammatory biomarkers, and potentially reduce the need for corticosteroids. However, while the clinical evidence supporting TCM in RMPP management is promising, further research is needed to standardize treatment protocols, clarify the mechanistic underpinnings of TCM, and establish its role in integrated pediatric care. TCM offers a valuable adjunct to conventional treatments, enhancing therapeutic outcomes and reducing the risk of complications associated with prolonged antibiotic or corticosteroid use.

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