目的 探讨痰热清注射液联合阿奇霉素序贯治疗儿童支原体肺炎的临床研究。方法 选取2014年11月-2015年12月梧州市红十字会医院收治的肺炎支原体肺炎患儿94例，按照随机数字法分为对照组和治疗组，每组各47例。对照组静脉滴注乳糖酸阿奇霉素注射液10 mg/kg，1次/d，连续治疗5 d。待体温和血象指标恢复正常后，改为口服阿奇霉素片，0.25 g/次，1次/d，连续治疗6 d。治疗组在对照组治疗基础上静脉滴注痰热清注射液，0.3~0.5 mL/kg，加入0.9%氯化钠注射液150 mL中，1次/d，连续治疗11 d。观察两组的临床疗效，比较两组临床症状改善情况、肺功能和血清炎症因子水平变化。结果 治疗后，对照组和治疗组总有效率分别为76.60%、93.62%，两组总有效率比较差异有统计学意义（P<0.05）；治疗后，治疗组退热时间、肺啰音消失时间、肺部阴影消失时间、住院时间显著短于对照组，差异有统计学意义（P<0.05）。治疗后，两组1秒用力呼吸容积（FEV₁）、最大呼气流量（PEF）、FEV₁/用力肺活量（FVC）显著升高（P<0.05）；且治疗后治疗组这些观察指标显著高于对照组，差异具有统计学意义（P<0.05）。治疗后，两组TNF-α、IL-10水平均显著下降（P<0.05）；且治疗后治疗组这些观察指标显著低于对照组，差异有统计学意义（P<0.05）。结论 痰热清注射液联合阿奇霉素序贯治疗儿童支原体肺炎的疗效显著，能够显著改善临床症状和肺功能，降低血清炎症因子水平，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Tanreqing Injection combined with azithromycin in sequential treatment of children with mycoplasma pneumonia. Methods Children (94 cases) with mycoplasma pneumonia in Wuzhou Red Cross Hospital from November 2014 to December 2015 were divided into two groups, and each group had 47 cases. The patients in the control group were iv administered with Azithromycin Lactobionate Injection, 10 mg/kg, once daily, treated for 5 d. After body temperature and hemogram returned to normal, The patients in the control group were also po administered with Azithromycin Tablets, 0.25 mg/time, once daily, treated for 6 d. The patients in the treatment group were iv administered with Tanreqing Injection on the basis of the control group, 0.3-0.5 mL/kg, added in normal saline 150 mL, once daily, treated for 11 d. After treatment, the clinical efficacy was evaluated, and the improvement of clinical symptoms, pulmonary function, and serum inflammatory factors in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 76.60% and 93.62%, respectively, and there were differences between two groups (P<0.05). After treatment, disappeared time of fever, pulmonary rales, and lung shadow, and hospitalization time in treatment group were shorter than those in the control group, with significant difference between two groups (P<0.05). After treatment, FEV₁, PEF, and FEV₁/FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the pulmonary function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, TNF-α and IL-10 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the decreased degree of the serum inflammatory factor levels in the treatment group was lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tanreqing Injection combined with azithromycin has a significant clinical efficacy in treatment of children with mycoplasma pneumonia, can significantly improve clinical symptoms and pulmonary function, reduce serum inflammatory factors levels, which has a certain clinical application value.