OBJECTIVE: To probe into the clinical efficacy of Maxing Shigan decoction in the adjuvant treatment of mycoplasma pneumonia in children

and to analyze its therapeutic mechanism. METHODS: Totally 110 children with mycoplasma pneumonia admitted into Qinhuangdao Hospital of Traditional Chinese Medicine from Jun. 2018 to Jun. 2020 were selected and randomly divided into two groups via the random number table

with 55 cases in each group. The control group was treated with azithromycin

while the research group was treated with modified Maxing Shigan decoction on the basis of the control group. The traditional Chinese medicine（ TCM） syndrome integral

pulmonary function indicators of tidal breathing[maximal expiratory flow（ MEF）

volume at peak tidal expiratory flow（ VPEF）

tidal volume（ VT）

ratio of volume at peak tidal expiratory flow to expiratory tidal volume（ VPEF/VE） ]

exhaled nitric oxide（ FeNO）

serum leukotriene B4（ LTB4） and eosinophil cationic protein（ ECP） levels before and after treatment were compared between two groups; the expression of forkhead transcription factors 3（ Foxp3） protein and Foxp3 mRNA

the contents of CD4

+

CD25

+

regulatory T cell（ Treg） and CD4

+

Foxp3

+

Treg in peripheral blood were compared between two groups

and the total effective rate was compared between two groups. RESULTS: After treatment

the TCM syndrome integral of fever

cough

chest pain and wheezing of the research group were significantly lower than those of the control group

the MEF

VPEF

VT and VPEF/VE levels of the research group were significantly higher than those of the control group

the FeNO

serum LTB4 and ECP levels of the research group were significantly lower than those of the control group

the expression of Foxp3 protein and Foxp3 mRNA

the contents of CD4

+

CD25

+

and CD4

+

Foxp3

+

Treg of the research group were significantly higher than those of the control group

with statistically significant differences（ P

<

0. 01）; the total effective rate of research group was96. 36%（ 53/55）

which was significantly higher than that of the control group（ 83. 64%

46/55）

with statistically significant difference（ P

<

0. 05）. CONCLUSIONS: The modified Maxing Shigan decoction in the adjuvant treatment of mycoplasma pneumonia in children can effectively improve the TCM syndrome integral and pulmonary function of children

inhibit airway inflammation

with remarkable efficacy; the mechanism may be related to the up-regulation of Foxp3 gene expression

promotion of synthesis and secretion of Treg

and enhancement of immune function.