目的 探讨清宣止咳颗粒联合头孢克洛颗粒治疗儿童慢性支气管炎的临床疗效。方法 选取2020年5月-2021年12月在郴州市第一人民医院就诊的90例慢性支气管炎患儿,根据随机数字表法将所有患儿分为对照组和治疗组,每组各45例。对照组使用30mL左右温水冲服头孢克洛颗粒,20 mg/kg,分3次服用。治疗组在对照组治疗的基础上温水冲服清宣止咳颗粒,3次/d,1~3岁,0.5袋/次,4~6岁,0.75袋/次,7~14岁,1袋/次。两组患儿连续治疗7 d。观察两组的临床疗效,比较两组症状消失时间、氧合指数、血氧分压、血氧饱和度和血清中白细胞介素-6(IL-6)、前白蛋白(PA)、肿瘤坏死因子-α(TNF-α)水平。结果 治疗后,治疗组的总有效率为95.56%,明显高于对照组的总有效率82.22%,组间差异有统计学意义(P<0.05)。治疗后,治疗组患儿咳嗽、肺啰音、咯痰、喘息消失时间均短于对照组(P<0.05)。治疗后,两组的氧合指数、血氧分压、血氧饱和度较治疗前显著升高(P<0.05),治疗组氧合指数、血氧分压、血氧饱和度明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组的血清IL-6、TNF-α水平低于治疗前,血清PA水平高于治疗前(P<0.05);治疗组血清IL-6、TNF-α水平低于对照组,血清PA水平高于对照组(P<0.05)。结论 清宣止咳颗粒联合头孢克洛颗粒治疗儿童慢性支气管炎的疗效确切,可减轻临床症状,改善血气指标,降低炎症反应,且安全性良好。

Objective To investigate the clinical effect of Qingxuan Zhike Granules combined with Cefaclor Granules in treatment of chronic bronchitis in children. Methods Children (90 cases) with chronic bronchitis in Chenzhou First People’s Hospital from May 2020 to December 2021 were divided into control and treatment groups according to random number table method, and each group had 45 cases. Patients in the control group were po administered with Cefaclor Granules by about 30 mL warm water, 20 mg/kg, taken with three times. Patients in the treatment group were po administered with Qingxuan Zhike Granules on the basis of the control group, three times daily, 0.5 bag for 1-3 years old, 0.75 bag for 4-6 years old, and 1 bag for 7-14 years old. Patients in two groups were treated for 7 d. After treatment, the clinical efficacies were evaluated, and symptom disappearance time, oxygenation index, blood oxygen partial pressure and blood oxygen saturation, the levels of IL-6, PA, and TNF-α in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.56%, which was significantly higher than 82.22% of the control group (P＜0.05). After treatment, the disappearance times of cough, pulmonary rale, expectoration, and wheezing in the treatment group were shorter than those in the control group (P＜0.05). After treatment, the oxygenation index, blood oxygen partial pressure, and blood oxygen saturation of two groups were significantly higher than those before treatment (P＜0.05). The oxygenation index, blood oxygen partial pressure, and blood oxygen saturation of the treatment group were significantly higher than those of the control group (P＜0.05). After treatment, the serum levels of IL-6 and TNF-α in two groups were lower than those before treatment, but the serum level of PA was higher than those before treatment (P＜0.05). The serum levels of IL-6 and TNF-α in the treatment group were lower than those in the control group, but the serum level of PA in the treatment group was higher than those in the control group (P＜0.05). Conclusion Qingxuan Zhike Granules combined with Cefaclor Granules has definite efficacy in treatment of chronic bronchitis in children, can reduce clinical symptoms, improve blood gas indicators, and reduce inflammatory reaction, with good safety.

R974

湘南学院2021年度校级科研项目(2021XJ133)