目的 探讨炎热清颗粒联合阿奇霉素治疗小儿毛细支气管炎的临床疗效。方法 选取2019年12月—2020年12月周口永善医院收治的100例小儿毛细支气管炎患儿，采用随机数表法将患儿分成对照组和治疗组，每组50例。对照组口服阿奇霉素颗粒，体质量≤15 kg，0.1 g/次，1次/d；15 kg<体质量≤25 kg，0.2 g/次，1次/d。治疗组在对照组的治疗基础上口服炎热清颗粒，3 g/次，3次/d。两组患儿连续治疗5 d。观察两组的临床疗效和临床症状消失时间，比较两组炎症因子指标在治疗前后的变化情况。结果 治疗组总有效率为96.0%，显著高于对照组的84.0%（P<0.05）。治疗后，治疗组退热时间、干湿性啰音消失时间、喘憋消失时间、咳嗽痰响消失时间和住院时间明显短于对照组（P<0.05）。治疗后，两组患儿干扰素-γ（INF-γ）水平显著高于治疗前水平，但肿瘤坏死因子α（TNF-α）、白细胞介素-10（IL-10）、白细胞介素-2（IL-2）平明显低于治疗前（P<0.05）；治疗后，治疗组血清炎症因子水平改善优于对照组（P<0.05）。结论 炎热清颗粒联合阿奇霉素治疗小儿毛细支气管炎效果显著，可有效缓解患儿的临床症状，降低炎症因子，具有一定的临床应用价值。

Objective To investigate the curative effect of Yanreqing Granules combined with azithromycin in treatment of pediatric bronchiolitis. Methods A total of 100 children with bronchiolitis admitted to Zhoukou Yongshan Hospital from December 2019 to December 2020 were selected. The children were divided into control group and treatment group by random number table method, with 50 cases in each group. Patients in the control group were po administered with Azithromycin Granules, body weight ≤15 kg, 0.1 g/time, once daily, 15 kg po administered with Yanreqing Granules on the basis of the control group, 3 g/time, three times daily. Patients in two groups were treated for 5 d. After treatment, clinical efficacy and disappearance time of clinical symptoms was evaluated, and the changes of inflammatory cytokines before and after treatment were compared between the two groups. Results The total effective rate of the treatment group was 96.0%, which was significantly higher than that of the control group (84.0%, P<0.05). After treatment, the fever abatement time, dry and wet rale disappeared time, wheezing disappeared time, cough, and phlegm disappeared time and hospitalization time in the treatment group were significantly shorter than those in the control group (P<0.05). After treatment, the level of interferon-γ (INF-γ) in two groups was significantly higher than that before treatment, but tumor necrosis factor α (TNF-α), interleukin-10 (IL-10), and interleukin-2 (IL-2) were significantly lower than that before treatment (P<0.05). After treatment, the improvement of serum inflammatory cytokines in treatment group was better than that in control group (P<0.05). Conclusion Yanreqing Granules combined with azithromycin has significant effect in treatment of pediatric bronchiolitis, and can effectively alleviate the clinical symptoms of children, reduce inflammatory factors, which has a certain value of clinical application.

R985

河南省医学科技攻关计划项目（LHGJ20190971）