目的 探讨小儿荆杏止咳颗粒联合乙酰半胱氨酸治疗小儿急性支气管炎的临床疗效。方法 回顾性选取2023年3月—2024年3月在河南省儿童医院治疗的急性支气管炎患儿93例，按照用药方案的差异分成对照组（46例）和治疗组（47例）。对照组给予吸入用乙酰半胱氨酸溶液雾化治疗，3 mL/次，2次/d；治疗组在对照组基础上口服小儿荆杏止咳颗粒，3～5岁患儿半袋/次，6～12岁患儿1袋/次，3次/d。两组患儿均进行为期7 d的治疗。观察两组患儿临床疗效，比较治疗前后两组患儿临床症状消失时间，急性呼吸道疾病和流感量表（CARIFs）评分和莱赛斯特生活质量问卷（LCQ）评分，血清几丁质酶3样蛋白1(YKL-40)、半胱氨酰白三烯（CysLTs）和鳞状上皮细胞癌抗原（SCCA）水平。结果 经治疗，对照组和治疗组患儿总有效率分别为82.61%和95.74%，两组比较差异具有统计学意义（P<0.05）。经治疗，治疗组发热、咳嗽、肺部湿啰音消失时间均明显短于对照组（P<0.05）。经治疗，两组患儿CARIFs评分较治疗前显著降低，而LCQ评分显著升高（P<0.05），且治疗组评分较对照组改善更显著（P<0.05）。经治疗，两组患儿血清YKL-40、CysLTs和SCCA水平较治疗前明显降低（P<0.05），且治疗组血清指标较对照组下降更显著（P<0.05）。结论 小儿荆杏止咳颗粒联合乙酰半胱氨酸治疗小儿急性支气管炎疗效显著，不仅能够显著缩短患儿临床症状消失时间，同时还能够改善患儿生存质量并促进血清学指标的恢复。

Objective Exploring the clinical efficacy of Jingxing Zhike Granules combined with acetylcysteine in treatment of acute bronchitis in children. Methods The clinical data of children（93 cases） with acute bronchitis in Henan Children's Hospital from March 2023 to March 2024 were analyzed retrospectively. They were divided into control（46 cases） and treatment（47 cases） group based on different treatments. Children in the control group were administered with Acetylcysteine Solution for inhalation, 3 m L/time, twice daily. Children in the treatment group were po administered with Xiaoer Jingxing Zhike Granules, 0.5 bag/time for 3 — 5 years old children, 1 bag/time for 6 — 12 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, CARIFs and LCQ scores, and the serum D-D, ICAM-1, TNF-α and IL-6 levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates of children in the control group and the treatment group were 82.61% and 95.74%, respectively, and the difference between the two groups was statistically significant（P＜0.05）. After treatment, the disappearance time of fever, cough and lung moist rales in treatment group was significantly shorter than that in control group（P＜0.05）. After treatment, the CARIFs scores of children in two groups were significantly lower than before treatment, while the LCQ scores were significantly higher（P＜0.05）, and the scores in the treatment group were improved more significantly than those in the control group（P＜0.05）. After treatment, the serum levels of YKL-40, CysLTs and SCCA in two groups were significantly lower than before treatment（P＜0.05）, and the serum indicators in the treatment group were decreased more significantly than that in the control group（P＜0.05）. Conclusion The combination of Xiaoer Jingxing Zhike Granules and acetylcysteine has significant therapeutic effects on acute bronchitis in children. It can not only significantly shorten the time for clinical symptoms to disappear in children, but also improve their quality of life and promote the repair of serological indicators.

R974

河南省卫生健康项目(LHCJ20230563)