目的 探究连花清瘟颗粒联合乳糖酸红霉素治疗儿童肺炎支原体大叶性肺炎的临床疗效。方法 选取2022年1月—2023月1月在皖西卫生职业学院附属医院治疗的肺炎支原体大叶性肺炎儿童90例，根据患儿治疗方案之间的差异将其分成对照组（45例）和治疗组（45例）。对照组静脉滴注注射用乳糖酸红霉素，按照30 mg/kg计算用量，每次采用250 mL生理盐水溶解，1次/d；治疗组患儿在对照组用药基础上口服连花清瘟颗粒，6 g/次，3次/d。两组患儿均进行为期10 d的治疗。观察两组患者临床疗效，比较治疗前后两组患者临床症状消失时间，中医证候评分和肺部影像学积分，及血清可溶性Toll样受体4（sTLR4）、白细胞介素-17（IL-17）和D-二聚体（D-D）水平。结果 治疗后，对照组和治疗组总有效率分别为84.44%和95.56%（P＜0.05）。治疗后，治疗组患儿发热、咳嗽、肌肉酸痛以及肺部湿啰音好转时间均要明显短于对照组（P＜0.05）。治疗后，两组患儿中医证候评分和肺部影像学积分均显著降低（P＜0.05），且治疗组各评分明显低于对照组（P＜0.05）。治疗后，两组患儿血清sTLR4、IL-17及D-D水平均显著降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。结论 连花清瘟颗粒联合乳糖酸红霉素治疗儿童肺炎支原体大叶性肺炎疗效显著，不仅能够显著改善患儿临床症状并加快炎症病变组织吸收，同时还能够促进血清学指标的恢复且未增加不良反应。

Objective To explore the therapeutic effect of Lianhua Qingwen Granules combined with erythromycin lactobionate in treatment of mycoplasma pneumonia in children. Methods Children (90 cases) with mycoplasma pneumonia in West Anhui Health Vocational College from January 2022 to January 2023 were divided into control (45 cases) and treatment (45 cases) group based on different treatments. Children in the control group were iv administered with Erythromycin Lactobionate for injection, 30 mg/kg added into normal saline 250 mL, once daily. Children in the treatment group were po administered with Lianhua Qingwen Granules on the basis of the control group, 6 g/time, three times daily. Children in two groups were treated for 10 d. After treatment, the clinical evaluations were evaluated, the disappearance time of clinical symptoms, the scores of TCM syndrome and pulmonary imaging, the levels of serum sTLR4, IL-17 and D-D in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 84.44% and 95.56% respectively (P < 0.05). After treatment, the improvement time for fever, cough, muscle soreness and moist lung rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the TCM syndrome scores and lung imaging scores of children in two groups were significantly reduced (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum sTLR4, IL-17 and D-D levels of children in two groups were significantly reduced (P < 0.05), and which were significantly lower in the treatment group than those in the control group (P < 0.05). Conclusion The combination of Lianhua Qingwen Granules and Erythromycin Lactobionate for injection has a significant therapeutic effect on the treatment of Mycoplasma pneumoniae lobar pneumonia in children. It can not only significantly improve the clinical symptoms of children and accelerate the absorption of inflammatory lesions, but also promote the recovery of serological indicators without increasing adverse reactions.

R974

安徽省卫生健康委科研项目(AHWJ2021b119)