目的 探讨肺力咳合剂联合重组人干扰素α2b治疗小儿呼吸道合胞病毒肺炎的临床疗效。方法 选取2020年7月—2023年7月中国医科大学附属盛京医院收治的158例呼吸道合胞病毒肺炎患儿，随机分为对照组和治疗组，每组各79例。对照组雾化吸入重组人干扰素α2b注射液，10万IU/kg以0.9%氯化钠注射液稀释至2 mL，吸入约15 min，1次/d，氧流量为6 L/min。在对照组治疗基础上，治疗组口服肺力咳合剂，10 mL/次，3次/d。两组患儿连续治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者症状体征消失时间、呼吸道合胞病毒转阴时间、肺炎胸片吸收评价量表（PCRAES）评分，及呼吸频率（RR）、吸呼时间比（Ti/Te）、呼气峰流量（PTEF）、高迁移率族蛋白B1（HMGB1）、γ干扰素（IFN-γ）、嗜酸性粒细胞阳离子蛋白（ECP）和白细胞介素-6（IL-6）水平。结果 治疗后，治疗组总有效率（97.47%）明显高于对照组（89.87%），两组比较差异具有统计学意义（P＜0.05）。治疗后，治疗组患者各项症状体征消失时间和呼吸道合胞病毒转阴时间均明显短于对照组（P＜0.05）。治疗后，两组潮气呼吸肺功能指标RR、Ti/Te和PTEF较治疗前明显降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）；治疗后，两组PCRAES评分和血清HMGB1、ECP、IL-6水平明显低于同组治疗前，而血清IFN-γ水平明显升高（P＜0.05），且治疗组这些指标水平明显好于对照组（P＜0.05）。结论 肺力咳合剂联合重组人干扰素α2b治疗小儿呼吸道合胞病毒肺炎安全性好，能有效加速呼吸道合胞病毒清除和症状体征控制，抑制炎症反应，促进肺功能好转。

Objective To explore the clinical effect of Feilike Mixture combined with recombinant human interferon α2b in treatment of pediatric respiratory syncytial virus pneumonia. Methods Children (158 cases) with pediatric respiratory syncytial virus pneumonia in Shengjing Hospital of China Medical University from July 2020 to July 2023 were randomly divided into control and treatment group, and each group had 79 cases. Children in the control group were nebulization inhalation administered with Recombinant Human Interferon α2b Injection for 15 min, 100 000 IU/kg diluted to 2 mL with 0.9% sodium chloride injection, once daily, oxygen flow rate was 6 L/min. Children in the treatment group were po administered with Feilike Mixture on the basis of the control group, 10 mL/time, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the disappearance time of symptoms and signs and respiratory syncytial virus conversion time, the PCRAES scores, and the levels of RR, Ti/Te, PTEF, HMGB1, IFN-γ, ECP and IL-6 in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group (97.47%) was significantly higher than that in the control group (89.87%), and the difference between the two groups was statistically significant (P < 0.05). After treatment, the disappearance time of symptoms and signs and the time of respiratory syncytial virus turning negative in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the tidal breathing pulmonary function indicators RR, Ti/Te and PTEF in two groups were significantly lower than before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the PCRAES score and serum HMGB1, ECP, and IL-6 levels in two groups were significantly lower than before treatment in the same group, while the serum IFN-γ levels increased significantly (P < 0.05), and the levels of these indicators in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Recombinant human interferon α2b combined with Feilike Mixture is safe in treatment of pediatric respiratory syncytial virus pneumonia. It can effectively accelerate the clearance of respiratory syncytial virus and control of symptoms and signs, inhibit inflammatory reactions, and promote the improvement of lung function.

R974;R985

中山市医学科研项目(2020A020413)