目的 探讨清宣止咳颗粒联合注射用甲泼尼龙琥珀酸钠治疗儿童难治性支原体肺炎的效果。方法 选择2022年11月—2023年9月在天津市人民医院就诊的92例难治性支原体肺炎儿童按照计算机随机排列法分为对照组和治疗组，各组包括46例。对照组静脉滴注注射用甲泼尼龙琥珀酸钠，每日剂量2 mg/kg，治疗组在对照组基础上温水冲服清宣止咳颗粒，4～6岁3/4袋/次，7岁及以上1袋/次，3次/d。两组儿童持续治疗7 d。比较两组的治疗效果、症状消失时间、肺功能、肺部症状和血清指标。结果 治疗后，对照组的总有效率为80.43%，治疗组的总有效率为95.65%，组间差异显著（P＜0.05）。治疗后，治疗组患儿发热、咳嗽、痰鸣音、喘息消失时间比对照组短（P＜0.05）。治疗后，两组的潮气量、达峰时间比、用力肺活量均显著升高（P＜0.05）；治疗后，治疗组的潮气量、达峰时间比、用力肺活量均高于对照组（P＜0.05）。治疗后，两组的肺部超声评分（LUS）比治疗前小（P＜0.05），且治疗组LUS评分比对照组更小（P＜0.05）。治疗后，两组的血清C-反应蛋白（CRP）、白细胞介素-25（IL-25）、T细胞免疫球蛋白黏蛋白分子3（TIM-3）、D-二聚体水平低于治疗前（P＜0.05）；治疗后，治疗组的血清CRP、IL-25、TIM-3、D-二聚体低于对照组（P＜0.05）。结论 清宣止咳颗粒联合注射用甲泼尼龙琥珀酸钠可提高儿童难治性支原体肺炎的临床疗效，提高肺功能，降低临床症状、肺部症状和炎症程度。

Objective To explore the clinical efficacy of Qingxuan Zhike Granules combined with Methylprednisolone Sodium Succinate for injection in treatment of refractory mycoplasma pneumonia in children. Methods Children (92 cases) with refractory mycoplasma pneumonia in Tianjin Union Medical Center from November 2022 to September 2023 were divided into control and treatment groups according to the computer random arrangement method, and each group had 46 cases. Children in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 2 mg/kg daily. Children in the treatment group were po administered with Qingxuan Zhike Granules on the basis of the control group, 3/4 bag each time for 4 - 6 years old, 1 bag each time for 7 years old and above, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical efficacies, symptom disappearance time, lung function, lung symptoms, and serum indicators in two groups were compared. Results After treatment, the total effective rate of the control group was 80.43%, and the total effective rate of the treatment group was 95.65%, with significant differences between the groups (P < 0.05). After treatment, the disappearance times of fever, cough, sputum sounds, and wheezing in the treatment group was shorter than that in the control group (P< 0.05). After treatment, the tidal volume, peak time ratio, and forced lung capacity of two groups were significantly increased (P < 0.05), and the tidal volume, peak time ratio, and forced lung capacity of the treatment group were higher than those of the control group (P < 0.05). After treatment, LUS score of two groups was smaller than that before treatment (P< 0.05), and LUS score of the treatment group was smaller than that of the control group (P < 0.05). After treatment, the serum levels of CRP, IL-25, TIM-3, and D-dimer in two groups were lower than those before treatment (P < 0.05), and the serum levels of CRP, IL-25, TIM-3, and D-dimer in the treatment group were lower than those in the control group (P < 0.05).Conclusion Qingxuan Zhike Granules combined with Methylprednisolone Sodium Succinate for injection can improve the efficacy of pediatric refractory mycoplasma pneumonia in children, improve lung function, and reduce clinical symptoms, lung symptoms, and inflammation.

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