目的 探讨小儿荆杏止咳颗粒联合利巴韦林治疗小儿急性上呼吸道感染的临床疗效。方法 选取2022年5月—2024年5月承德市中心医院收治的急性上呼吸道感染患儿84例，依据用药情况将患儿分为对照组（42例）和治疗组（42例）。对照组患儿口服利巴韦林颗粒，50 mg/次，2次/d。在对照组的基础上，治疗组口服小儿荆杏止咳颗粒，3～5岁半袋/次；6岁以上1袋/次，3次/d。两组用药7 d观察治疗情况。观察两组患儿临床疗效，比较治疗前后两组患儿症状消失时间，睡眠质量，及血清淀粉样蛋白（SAA）、血清腺普脱氨酶（ADA）、前白蛋白（PA）和γ干扰素（IFN-γ）水平。结果 治疗后，治疗组总有效率为95.24%，明显高于对照组的78.57%（P＜0.05）。治疗后，与对照组比较，治疗组发热、头痛、咽痛、鼻塞等症状消失时间均明显缩短（P＜0.05）。治疗后，两组患儿睡眠质量评分明显降低（P＜0.05），且治疗组儿童睡眠习惯问卷表（CSHQ）评分降低更明显（P＜0.05）。治疗后，两组SAA和ADA水平明显降低，而PA和IFN-γ水平明显升高（P＜0.05），且治疗组SAA、ADA、PA和IFN-γ水平明显好于对照组（P＜0.05）。结论 小儿荆杏止咳颗粒联合利巴韦林治疗小儿急性上呼吸道感染，能明显改善患儿的呼吸道感染症状及体征，减弱局部炎症反应，增强机体免疫能力，有效提升睡眠质量。

Objective To explore the clinical effect of Xiao’er Jingxing Zhike Granules combined with ribavirin in treatment of acute upper respiratory tract infection in children. Methods Children (84 cases) with acute upper respiratory tract infection in Chengde Central Hospital from May 2022 to May 2024 were divided into control (42 cases) and treatment (42 cases) group based on different treatments. Children in the control group were po administered with Ribavirin Granules, 50 mg/time, twice daily. Children in the treatment group were po administered with Xiao'er Jingxing Zhike Granules on the basis of the control group, 0.5 bag/time for 3—5 years old children, 1 bag/time for more than 6 years old children, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the symptom disappearance time, CSHQ scores, the serological levels of SAA, ADA, PA and IFN-γ in two groups before and after treatment were compared. Results After treatment, the effective rate in the treatment group was 95.24%, which was significantly higher than that in the control group (78.57%, P < 0.05). After treatment, compared with the control group, the disappearance time for symptoms such as fever, headache, sore throat, and nasal congestion in the treatment group was significantly shortened (P < 0.05). After treatment, the sleep quality scores in two groups were significantly decreased (P < 0.05), and the CSHQ scores were decreased more significantly in the treatment group (P < 0.05). After treatment, the levels of SAA and ADA were significantly decreased intwo groups, while the levels of PA and IFN-γ were significantly increased (P < 0.05). The levels of SAA, ADA, PA and IFN-γ in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion The coordinated treatment of ribavirin and Xiao’er Jingxing Zhike Granules can significantly improve the symptoms and signs of respiratory infection in children, weaken local inflammatory reactions, enhance the body's immunity, and effectively improve the sleep quality of children.

R974

河北省医学科学研究重点课题项目(20191299);承德市科学技术与发展研究课题计划项目(202204A018)