目的 观察小儿肺热咳喘颗粒联合哌拉西林钠舒巴坦钠治疗小儿喘息性支气管肺炎的临床疗效。方法 选取2020年5月—2023年3月中山市小榄人民医院收治的122例喘息性支气管肺炎患儿，按随机数字表法将所有患者分为对照组和治疗组，每组各61例。对照组静脉滴注注射用哌拉西林钠舒巴坦钠，根据患儿体质量按75 mg/kg将本品溶于0.9%氯化钠注射液100 mL，每12小时1次。治疗组患者在对照组治疗基础上开水冲服小儿肺热咳喘颗粒，4 g/次，6个月～3岁者3次/d，3～6岁者4次/d。两组疗程均为7 d。观察两组的临床疗效及肺部湿啰音、4大主症的消失时间。比较治疗前后两组肺炎胸片吸收评价量表（PCRAES）评分、潮气呼吸肺功能指标及全血中性粒细胞与淋巴细胞比值（NLR）和血清C反应蛋白（CRP）、补体C3、降钙素原（PCT）水平。结果 治疗后，治疗组患者总有效率是96.72%，较之对照组的86.89%显著提高（P＜0.05）。治疗后，治疗组肺部湿啰音及喘促、发热、咳嗽、痰鸣的消失时间均较对照组显著缩短（P＜0.05）。治疗后，两组PCRAES评分均显著降低，而潮气量（TV/kg）、达峰时间比（TPTEF/TE）、达峰容积比（VPEF/VE）均显著增加（P＜0.05）；治疗后，治疗组PCRAES评分和潮气呼吸肺功能指标改善优于对照组（P＜0.05）。治疗后，两组全血NLR和血清CRP、补体C3、PCT水平均显著降低（P＜0.05），且以治疗组降低更显著（P＜0.05）。结论 小儿肺热咳喘颗粒联合哌拉西林钠舒巴坦治疗小儿喘息性支气管肺炎取得了较好的临床疗效，能减轻临床症状及肺功能损害，调节机体炎症反应和免疫功能，值得临床推广应用。

Objective To observe the clinical efficacy of Xiaoer Feire Kechuan Granules combined with piperacillin sodium and sulbactam sodium in treatment of asthmatic bronchopneumonia in children. Methods A total of 122 children with asthmatic bronchopneumonia admitted to Zhongshan Xiaolan People’s Hospital from May 2020 to March 2023 were selected and divided into control group and treatment group according to random number table method, with 61 cases in each group. Patients in the control group were iv administered with Piperacillin Sodium and Sulbactam Sodium for injection, the product was dissolved in 0.9% sodium chloride injection100 mL at 75 mg/kg according to the child’s body weight, once every 12 h. Patients in the treatment group were po administered with Xiaoer Feire Kechuan Granules with boiled water on the basis of the control group, 4 g/time, 3 times daily for 6 months to 3 years old, 4 times daily for 3 to 6 years old. Patients in two groups were treated for 7 d. After treatment, the clinical effect and the disappearance time of pulmonary moist rales and 4 major symptoms were observed in the two groups. The scores of chest film Absorption Evaluation Scale (PCRAES), lung function indexes of tidal respiration, whole blood neutrophil to lymphocyte ratio (NLR), serum C-reactive protein (CRP), complement C3 and procalcitonin (PCT) were compared between two groups before and after treatment. Results After treatment, the total effective rate of treatment group was 96.72%, which was significantly higher than that of control group (86.89%) (P < 0.05). After treatment, the disappearance time of lung moist rales, wheezing, fever, cough and phlegm in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, PCRAES scores in both groups were significantly decreased, but tidal volume (TV/kg), TPTEF/TE and VPEF/VE were significantly increased (P< 0.05). After treatment, PCRAES score and moisture respiratory lung function indexes in the treatment group were better than those in control group (P < 0.05). After treatment, the levels of whole blood NLR and serum CRP, complement C3 and PCT in both groups were significantly decreased (P< 0.05), and the reduction was more significant in treatment group (P< 0.05). Conclusion Xiaoer Feire Kechuan Granules combined with piperacillin sodium and sulbactam sodium can obtain good clinical effect in treatment of asthmatic bronchopneumonia in children, and can reduce clinical symptoms and lung function damage, regulate inflammatory response and immune function, which is worthy of clinical application.

R974；R985

中山市医学科研项目(2020A020413)