目的 探讨小青龙口服液联合重组人干扰素α2b治疗小儿合胞病毒肺炎的临床疗效。方法 选取2018年5月—2021年5月商丘市第一人民医院收治的98例合胞病毒肺炎患儿，按随机数字表法分为对照组和治疗组，每组各49例。对照组雾化吸入重组人干扰素α2b注射液，10万～20万IU/(kg∙次)，2次/d，每次将重组人干扰素α2b注射液加入0.9%氯化钠注射液中稀释至2 mL，再以6 L/min的氧流量雾化吸入，给药时间约10 min/次。治疗组在此基础上口服小青龙口服液，5 mL/次，3次/d。两组患儿疗程均为7 d。观察两组的临床疗效，典型表现消失时间和血象复常时间。比较治疗前后两组肺炎胸片吸收评价量表评分、单位公斤体质量潮气量（V_T/kg）、潮气呼吸呼气峰流速（PTEF）及血清肿瘤坏死因子-α（TNF-α）、白细胞介素（IL）-1β、IL-4、可溶性细胞间黏附分子-1（sICAM-1）和γ干扰素（INF-γ）水平。结果 治疗后，治疗组总有效率是95.9%，显著高于对照组的83.7%（P＜0.05）。治疗后，治疗组退热时间、喘促消失时间、肺部啰音消失时间、痰鸣消失时间、咳嗽消失时间、血象复常时间均显著短于对照组（P＜0.05）。治疗后，两组胸片吸收评价量表评分和PTEF均显著低于治疗前，V_T/kg均显著高于治疗前（P＜0.05）；且均以治疗组改善更显著（P＜0.05）。治疗后，两组血清TNF-α、IL-1β、IL-4和sICAM-1水平均显著下降，血清INF-γ水平均显著上升（P＜0.05）；且治疗后，治疗组患儿血清TNF-α、IL-1β、IL-4、sICAM-1水平低于对照组，INF-γ水平高于对照组（P＜0.05）。结论 小青龙口服液联合重组人干扰素α2b治疗小儿合胞病毒肺炎的总体效果确切，能迅速缓解患儿症状及体征、促进外周血象的恢复，改善肺功能，并可进一步下调血中TNF-α、IL-1β、IL-4和sICAM-1水平及上调血清INF-γ水平，值得临床推广应用。

Objective To investigate the clinical efficacy of Xiaoqinglong Oral Liquid combined with recombinant human interferon α2b in treatment of children with syncytial virus pneumonia. Methods A total of 98 children with syncytial virus pneumonia admitted to Shangqiu First People's Hospital from May 2018 to May 2021 were selected and divided into control group and treatment group according to random number table method, with 49 cases in each group. Children in the control group were given Recombinant Human Interferon α2b Injection, 1×10⁵- 2×10⁵ IU/(kg∙time), twice daily, and Recombinant Human Interferon α2b Injection was added into 0.9% sodium chloride injection and diluted to 2 mL each time, and then inhaled by atomization at 6 L/min of oxygen flow. The administration time was about 10 min/time. Patients in the treatment group were po administered with Xiaoqinglong Oral Liquid on the basis of the control group, 5 mL/time, 3 times daily. The treatment course of both groups was 7 d. The clinical efficacy, disappearance time of typical symptoms and recovery time of blood images were observed. The scores of absorption scale, V_T/kg body mass, PTEF, TNF-α, INTERleukin (IL)-1β, IL-4, sICAM, and interferon gamma (INF-γ) were compared before and after treatment. Results After treatment, the total effective rate of treatment group was 95.9%, significantly higher than that of control group 83.7% (P < 0.05). After treatment, the time of antipyretic, dyspnea, pulmonary rales, phlegm, cough and normal blood image in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the scores of absorption scale and PTEF of chest radiographs in two groups were significantly lower than before treatment, and V_T/kg were significantly higher than before treatment (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the levels of TNF-α, IL-1β, IL-4 and sICAM-1 in serum were significantly decreased, while the level of INF-γ in serum was significantly increased in both groups (P < 0.05). After treatment, the serum levels of TNF-α, IL-1β, IL-4 and sICAM-1 in the treatment group were lower than those in the control group, and the level of INF-γ was higher than that in the control group (P < 0.05). Conclusion The overall effect of Xiaoqinglong Oral Liquid combined with recombinant human interferon α2b in treatment of children with syncytial virus pneumonia is definite. It can quickly relieve the symptoms and signs of children, and can promote the recovery of peripheral blood, improve lung function, and further can inhibit the levels of TNF-α, IL-1β, IL-4 and sICAM-1 in blood and up-regulate the level of serum INF-γ, which is worthy of clinical application.

R974

河南省医学科技攻关计划(2018020956)