目的 探讨灯台叶颗粒联合环酯红霉素治疗类百日咳综合征的临床疗效。方法 选取2018年4月—2020年4月郑州大学附属儿童医院收治的120例类百日咳综合征患儿，随机分为对照组和治疗组，每组各60例。对照组口服环酯红霉素干混悬剂，15 mg/（kg·d），每12小时服用1次。治疗组在对照组基础上口服灯台叶颗粒，10 g/次，3次/d。两组均持续治疗14 d。观察两组的临床疗效，比较两组临床症状、体征缓解时间和住院时间，血清炎性因子、细胞免疫功能指标和不良反应。结果 治疗后，治疗组总有效率是95.00%，显著高于对照组的78.33%（P<0.05）。治疗后，治疗组肺部啰音消失时间、呼吸困难缓解时间、痉挛性咳嗽缓解时间及住院时间均显著短于对照组（P<0.05）。治疗后，两组血清白介素-6（IL-6）、白介素-4（IL-4）、干扰素-γ（IFN-γ）、肿瘤坏死因子-α（TNF-α）水平均显著降低（P<0.05）；治疗后治疗组血清炎性因子水平显著低于对照组（P<0.05）。治疗后，两组CD3⁺、CD4⁺、CD4⁺/CD8⁺均显著升高，但对照组CD8⁺显著升高，治疗组CD8⁺显著降低（P<0.05）；治疗后治疗组细胞免疫功能优于对照组（P<0.05）。治疗组不良反应发生率低于对照组（5.00%vs 20.00%）（P<0.05）。结论 灯台叶颗粒联合环酯红霉素治疗类百日咳综合征的临床疗效较好，可缓解患儿临床症状及体征，降低炎性因子，安全性较高，具有一定的临床推广应用价值。

Objective To investigate the effect of Dengtaiye Granules combined with cycloester erythromycin in treatment of pertussis like syndrome. Methods A total of 120 children with pertusse like syndrome admitted to Children's Hospital Affiliated to Zhengzhou University from April 2018 to April 2020 were randomly divided into control group and treatment group, with 60 children in each group. Children in the control group were po administered with Erythromycin Cyclic 11,12-Carbonate For Suspension, 15 mg/(kg∙d), once every 12 h. Children in the treatment group were po administered with Dengtaiye Granules on the basis of the control group, 10 g/time, three times daily. Children in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and clinical symptoms, signs remission time and hospital stay time, serum inflammatory factors and cellular immune function indicators were compared between two groups. Results After treatment, the total effective rate of the treatment group was 95.00%, significantly higher than that of the control group (78.33%, P<0.05). After treatment, the disappearance time of rhonchus in lung, relief time of dyspnea, relief time of spastic cough and hospital stay in the treatment group were significantly shorter than those in the control group (P<0.05). After treatment, serum levels of interleukin-6 (IL-6), interleukin-4 (IL-4), interferon-γ (IFN-γ) and tumor necrosis factor-α (TNF-α) were significantly decreased in both groups (P<0.05). After treatment, the level of serum inflammatory factors in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, CD3⁺, CD4⁺, and CD4⁺/CD8⁺ were significantly increased in both groups, but CD8⁺ was significantly increased in the control group and significantly decreased in the treatment group (P<0.05). After treatment, the cellular immune function of the treatment group was better than that of the control group (P<0.05). The incidence of adverse reactions in the treatment group was lower than that in the control group (5.00% vs 20.00%) (P<0.05). Conclusion Dengtaiye Granules combined with cycloester erythromycin has good clinical effect in treatment of pertussis like syndrome, and can alleviate the clinical symptoms and signs of children, and also can reduce inflammatory factors with a high safety, which has certain clinical application value.

R974

河南省医学科技攻关计划项目（2018020685）