目的 探讨清热散结片联合左氧氟沙星滴耳液治疗化脓性中耳炎的临床效果。方法 选择2017年7月—2019年5月在商丘市第一人民医院治疗的化脓性中耳炎患者149例，随机分为对照组（75例）和治疗组（74例）。对照组患者给予左氧氟沙星滴耳液，6～10滴/次，3次/d。滴耳后再耳浴约10 min。治疗组在对照组基础上口服清热散结片，6片/次，3次/d。两组患者均连续治疗15 d。观察两组患者临床疗效，同时比较治疗前后两组患者血清白细胞介素-1β（IL-1β）、IL-8和肿瘤坏死因子-α（TNF-α）水平，以及听力改善程度、症状改善时间和病原菌清除情况。结果 治疗后，对照组和治疗组临床有效率分别为77.33%和93.24%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者IL-1β、IL-8和TNF-α水平显著降低（P<0.05），且治疗组患者明显比对照组低（P<0.05）。治疗后，治疗组听力改善程度、症状改善时间和病原菌清除情况明显优于对照组（P<0.05）。结论 清热散结片联合左氧氟沙星滴耳液治疗化脓性中耳炎，可显著改善患者临床症状、血清炎性因子，提高病原菌有效清除率，临床疗效较好，安全可靠。

Objective To investigate the clinical effect of Qingre Sanjie Tablets combined with Levofloxacin Hydrochloride Ear Drops in treatment of suppurative otitis media. Methods Patients (149 cases) with suppurative otitis media in Shangqiu First People's Hospital from July 2017 to May 2019 were randomly divided into control (75 cases) and treatment (74 cases) groups. Patients in the control group were administered with Levofloxacin Hydrochloride Ear Drops, 6 — 10 drops/time, three times daily, and then ear bath for about 10 min after ear dropping. Patients in the treatment group were po administered with Qingre Sanjie Tablets on the basis of the control group, 6 tablets/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacy was evaluated, and the serum level of IL-1β, IL-8 and TNF-α, and hearing improvement, symptom improvement time and pathogen clearance in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 77.33% and 93.24% respectively, and there were differences between two groups (P<0.05). After treatment, the serum level of IL-1β, IL-8 and TNF-α in two groups was significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the hearing improvement, symptom improvement time and pathogen clearance in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Qingre Sanjie Tablets combined with Levofloxacin Hydrochloride Ear Drops in treatment of suppurative otitis media can significantly improve the clinical symptoms, serum inflammatory factors, and enhance pathogen clearance, which has good clinical efficacy, safety and reliability.

R987