目的 观察杏贝止咳颗粒联合甲泼尼龙治疗小儿重症支原体肺炎的临床疗效。方法 选取2018年12月—2023年8月在合肥市第二人民医院治疗的重症支原体肺炎患儿共90例，按照随机数字表法分成对照组和治疗组，每组各45例。对照组静脉滴注注射用甲泼尼龙琥珀酸钠，第1、2天剂量是1.5 mg/kg，1次/d；第3天剂量改成1 mg/kg，之后1周内根据患儿病情逐渐降低剂量。治疗组在对照组基础上口服杏贝止咳颗粒，1袋/次，3次/d。两组患儿均治疗10 d。观察两组患儿临床疗效，比较治疗前后两组患儿症状改善时间，肺功能指标用力肺活量（FVC）、1秒用力呼气容积（FEV₁）、呼气峰流速（PEF），血清T细胞亚群CD4^＋、CD8^＋、白细胞介素-6（IL-6）和IL-1β水平。结果 治疗后，与对照组总有效率（77.78%）比较，治疗组总有效率（95.56%）显著升高（P＜0.05）。治疗后，与对照组对比，治疗组患儿肺部湿啰音和喘息消失时间以及咳嗽缓解时间均显著缩短（P＜0.05）。治疗后，两组重症支原体肺炎患儿FVC、FEV₁、PEF显著增加（P＜0.05），且治疗组以上指标增加更加显著（P＜0.05）。治疗后，两组CD4^＋水平明显增加，而CD8^＋水平显著降低（P＜0.05），且治疗组以上指标改善更加显著（P＜0.05）。治疗后，两组患儿血清IL-6和IL-1β水平显著降低（P＜0.05），且治疗组降低更显著（P＜0.05）。结论 杏贝止咳颗粒联合甲泼尼龙治疗小儿重症支原体肺炎的疗效显著，能显著缩短症状体征的改善时间，改善患儿的肺功能和免疫紊乱，减轻炎症反应。

Objective To investigate the efficacy of Xingbei Zhike Grains combined with methylprednisolone in treatment of severe mycoplasma pneumonia in children. Methods A total of 90 children with severe mycoplasma pneumonia treated in Hefei Second People's Hospital from December 2018 to August 2023 were selected and divided into control group and treatment group according to random number table method, with 45 cases in each group. Children in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 1.5 mg/kg for the first and second day, once daily, the dose was adjusted to 1 mg/kg from the third day. After that, the dose gradually decreased according to the children’s condition within one week. Children in the treatment group were po administered with Xingbei Zhike Grains on the basis of the control group, 1 bag/time, three times daily. Children in two groups were treated for 10 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, lung function indexes FVC, FEV₁, PEF, levels of T-lymphocyte subsets CD4⁺ and CD8⁺, serum levels of IL-6 and IL-1β in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (95.56%) was significantly higher than that of the control group (77.78%, P < 0.05). After treatment, compared with the control group, the disappearance time of lung wet rale and wheezing and the relief time of cough in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, FVC, FEV₁ and PEF in children with severe mycoplasma pneumonia were significantly increased in two groups, and the above indexes increased more significantly in the treatment group (P < 0.05). After treatment, the level of CD4⁺ was significantly increased, while the levels of CD8⁺, IL-6 and IL-1β were significantly decreased in two groups (P< 0.05), and the above indexes were improved more significantly in the treatment group (P < 0.05). Conclusion Xingbei Zhike Granules combined with methylprednisolone is effective in the treatment of severe mycoplasma pneumonia in children, which can significantly shorten the improvement time of symptoms and signs, improve pulmonary function and immune disorder, and reduce inflammatory reaction.

R974

安徽省卫生健康委科研立项项目（AHWJ2021b102）