目的 探讨清宣止咳颗粒联合头孢呋辛钠治疗小儿支气管肺炎的临床疗效。方法 选取2022年3月—2024年4月在上海市金山区中西医结合医院治疗的支气管肺炎患儿92例，按照随机数字表法分为对照组（46例）和治疗组（46例）。对照组患儿静脉滴注注射用头孢呋辛钠，40 mg/kg加入生理盐水100 mL，2次/d。在对照组的基础上，治疗组口服清宣止咳颗粒，5岁≤年龄≤6岁，3/4包/次，6岁＜年龄≤10岁，1包/次，3次/d。两组患儿用药7 d。观察两组患者临床疗效，比较治疗前后两组患者症状、体征好转时间，咳嗽症状评分，及白细胞介素-17（IL-17）、C反应蛋白（CRP）、血清淀粉样蛋白A（SAA）和血清降钙素原（PCT）水平。结果 治疗后，治疗组总有效率为97.83%，明显高于对照组（80.43%，P＜0.05）。治疗后，治疗组发热、咳嗽、气促、肺部湿啰音好转时间较对照组明显缩短（P＜0.05）。治疗后，两组患儿症状评分比治疗前明显降低（P＜0.05），且治疗后治疗组评分均明显低于对照组（P＜0.05）。治疗后，两组患儿IL-17、SAA、PCT和CRP水平均明显降低（P＜0.05），且治疗后治疗组患儿的炎性因子水平均明显低于对照组（P＜0.05）。结论 清宣止咳颗粒与头孢呋辛钠协同治疗，能有效缓解患儿支气管肺炎症状，促使机体炎性反应减弱。

Objective To observe the clinical efficacy of Qingxuan Zhike Granules combined with cefuroxime sodium in treatment of pediatric bronchopneumonia. Methods Children (92 cases) with bronchopneumonia in Shanghai Jinshan TCM-Integrated Hospital from March 2022 to April 2024 were divided into control (46 cases) and treatment (46 cases) group according to random number table method. Children in control group were iv administered with Cefuroxime Sodium for injection, 40 mg/kg added into normal saline100 mL, twice daily. Children in treatment group were po administered with Qingxuan Zhike Granules, 5 years old ≤ age ≤6 years old, 3/4 bag/time, 6 years old < age ≤10 years old, 1 bag/time, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the symptom improvement time, the cough symptom scores, and the levels of IL-17, SAA, PCT, and CRP in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was 97.83%, which was significantly higher than that in the control group (80.43%, P < 0.05). After treatment, the improvement time of fever, cough, shortness of breath, and moist rales in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, the symptom scores of children in two groups were significantly lower than those before treatment (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 levels of IL-17, SAA, PCT, and CRP in two groups were significantly reduced (P < 0.05), and the levels of inflammatory factors in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion he synergistic treatment of cefuroxime sodium and Qingxuan Zhike Granules can effectively alleviate the symptoms of bronchopneumonia in children, which can weaken the inflammatory response of the body.

R974;R985

上海市金山区中西医结合医院科研课题(2020-1)