目的 探讨小儿清热利肺口服液联合头孢曲松钠治疗小儿急性支气管炎的临床效果。方法 选取2019年1月-2020年12月天津市静海区医院收治的154例急性支气管炎患儿为研究对象，采取随机数字表法将其随机分成治疗组（n=77）与对照组（n=77）。对照组静脉滴注注射用头孢曲松钠，每次将50 mg/kg（最大剂量为2 g）加入5%葡萄糖注射液50 mL中均匀混合后给药，0.5~1 h滴完，1次/d。治疗组在对照组基础上口服小儿清热利肺口服液，1~2岁给予5 mL/次、3~5岁给予10 mL/次、6~12岁给予15 mL/次，3次/d。所有患儿均连续治疗7 d。观察两组的临床疗效，比较两组呼吸道症状改善情况及退热效果，并比较治疗前后血清肿瘤坏死因子（TNF）-α、白细胞介素（IL）-17和C反应蛋白（CRP）水平。结果 治疗后，治疗组总有效率为96.1%，较对照组83.1%显著提高（P<0.05）。治疗组咳嗽、咳痰消失率分别为64.9%、57.1%，均显著高于对照组48.1%、40.3%（P<0.05）。治疗后，两组日间、夜间咳嗽症状积分及其总积分均显著降低（P<0.05）；且治疗后，治疗组咳嗽症状积分低于对照组（P<0.05）。治疗后，治疗组患儿退热起效时间和体温复常时间较对照组均显著缩短（P<0.05）。治疗后，两组血清TNF-α、IL-17及CRP水平均较治疗前显著下降（P<0.05）；且治疗后，治疗组血清学指标低于对照组（P<0.05）。结论 小儿清热利肺口服液联合头孢曲松钠对急性支气管炎患儿具有确切的临床疗效，可安全有效地减轻患儿症状，且退热效果显著，并能显著抑制患儿体内炎症反应，值得临床推广应用。

Objective To investigate the clinical effect of Xiaoer Qingre Lifei Oral Liquid combined with ceftriaxone sodium in treatment of acute bronchitis in children. Methods A total of 154 children with acute bronchitis admitted to Jinghai Hospital of Tianjin from January 2019 to December 2020 were selected as the study subjects, and they were randomly divided into treatment group (n=77) and control group (n=77) by random number table method. Children in the control group were iv administered with Ceftriaxone Sodium for injection, 50 mg/kg (maximum dosage 2 g) was added into 5% glucose injection 50 mL each time, and then evenly mixed. The infusion was finished 0.5-1 h, once daily. Children in the treatment group were po administered with Xiaoer Qingre Lifei Oral Liquid on the basis of the control group, 5 mL/time for 1-2 years old, 10 mL/time for 3-5 years old, 15 mL/time for 6-12 years old, three times daily. All patients were treated for 7 d. The clinical efficacy of the two groups were observed, the improvement of respiratory symptoms and antipyretic effect of the two groups were compared, and the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-17 and C-reactive protein (CRP) before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.1%, significantly higher than that of the control group (83.1%) (P<0.05). The disappearance rates of cough and sputum in the treatment group were 64.9% and 57.1%, respectively, which were significantly higher than those in the control group (48.1% vs. 40.3%, P<0.05). After treatment, daytime and night cough symptom scores and their total scores were significantly decreased in two groups (P<0.05). After treatment, cough symptom score in treatment group was lower than that in control group (P<0.05). After treatment, the onset time of antipyretic and temperature recovery time in the treatment group were significantly shorter than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-17 and CRP in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the serum index of the treatment group was lower than that of the control group (P<0.05). Conclusion Xiaoer Qingre Lifei Oral Liquid combined with ceftriaxone sodium has satisfactory overall curative effect in treatment of acute bronchitis in children, can safely and effectively reduce the symptoms of children with a significant antipyretic effect, and can significantly inhibit the inflammatory response in children, which is worthy of clinical application.

R974

天津市卫计委科研项目（2017KZ044）