目的 探讨抗感颗粒联合更昔洛韦治疗儿童病毒性肺炎的临床疗效。方法 选取2018年6月—2021年6月阜阳市妇女儿童医院收治的60例病毒性肺炎患儿，按照随机数字表法分成对照组和治疗组，每组各30例。对照组静脉滴注更昔洛韦注射液，5 mg/kg加入注射用水，调整浓度为50 mg/mL，再加入至5%葡萄糖注射液100 mL，1次/12 h。治疗组在对照组基础上口服抗感颗粒，1～5岁，0.5袋/次；6～9岁，1袋/次；10～14岁，1.5袋/次，3次/d。两组患儿连续治疗14 d。观察两组患儿临床疗效，比较治疗前后两组患儿典型表现消失时间，潮气呼吸肺功能参数，肺炎胸片吸收评价量表评分，外周血T淋巴细胞亚群水平，血清可溶性细胞间黏附分子-1（sICAM-1）、白细胞介素-8（IL-8）和甲壳质酶蛋白-40（YKL-40）水平。结果 治疗后，治疗组总有效率（96.67%）较对照组（73.33%）显著升高（P＜0.05）。治疗后，治疗组各项典型表现消失时间较对照组显著缩短（P＜0.05）。治疗后，两组单位体质量潮气量（VT/kg）、达峰时间比（TPTEF/TE）和吸气时间与呼气时间比值（Ti/Te）显著升高，而肺炎胸片吸收评价量表评分显著降低（P＜0.05），且治疗组比对照组改善更显著（P＜0.05）。治疗后，两组患者外周血CD3⁺、CD4⁺水平及CD4⁺/CD8⁺均显著高于治疗前（P＜0.05），且治疗组比对照组升高更显著（P＜0.05）。治疗后，两组血清sICAM-1、IL-8和YKL-40水平均显著低于治疗前（P＜0.05），且治疗组比对照组降低更显著（P＜0.05）。结论 抗感颗粒联合更昔洛韦治疗患儿病毒性肺炎具有确切的临床疗效，是尽快缓解患儿临床表现、改善肺功能及稳定病情的安全有效途径，并能进一步进增强免疫功能和减轻炎症反应。

Objective To investigate the clinical efficacy of Kanggan Granules combined with ganciclovir in treatment of viral pneumonia in children. Methods Children (60 cases) with viral pneumonia in Fuyang Women and Children’s Hospital from June 2018 to June 2021 were divided into control and treatment group by the random number table method, and each had 30 cases. Children in the control group was iv administered with Ganciclovir Injection, 5 mg/kg added into injection water, adjusted the concentration to 50 mg/mL, then added into 5% glucose injection 100 mL, twice daily. Children in the treatment group were po administered with Kanggan Granules on the basis of the control group, 0.5 bag/time for 1 to 5 years old children, 1 bag/time for 6 to 9 years old, 1.5 bag/time for 10 to 14 years old, three times daily. Children in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, and the typical manifestations disappearance time, tidal respiration lung function, pneumonia chest radiograph absorption assessment scale scores, T lymphocyte subsets in peripheral blood, serum sICAM-1, IL-8, and YKL-40 levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (96.67%) was significantly higher than that of the control group (73.33%) (P < 0.05). After treatment, the disappearance time of typical manifestations in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, VT/kg, TPTEF/TE and Ti/Te in two groups were significantly increased, while the scores of pneumonia chest X-ray absorption evaluation scale was significantly decreased (P < 0.05), and the improvement in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in peripheral blood of the two groups were significantly higher than those before treatment (P < 0.05), and the level in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the levels of serum sICAM-1, IL-8, and YKL-40 in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). Conclusion Kanggan Granules combined with ganciclovir in treatment of viral pneumonia in children has definite clinical effect, and it is a safe and effective way to alleviate the clinical manifestation, improve pulmonary function and stabilize the condition as soon as possible, and can further enhance the immune function and reduce the inflammatory reaction.

R975;R985

安徽省教育厅省级质量工程重点项目（2019xqsxzx98）