目的 探讨儿童清肺口服液联合环酯红霉素治疗儿童肺炎支原体肺炎的临床疗效。方法 选取2021年12月—2023年12月北京市通州区妇幼保健院收治的124例肺炎支原体肺炎患儿，按随机数字表法将患者分为对照组和治疗组，每组各62例。对照组予以环酯红霉素干混悬剂，15 mg/kg，加入适量凉开水冲调，摇匀后使用，每间隔12 h用药1次。治疗组在此基础上口服儿童清肺口服液，3次/d，其中1岁≤年龄≤6岁者1支/次，年龄>6岁者2支/次。两组疗程均为7 d。观察两组临床疗效，主要临床表现消失时间，比较两组治疗前后临床肺部感染评分（CPIS）、肺炎胸片吸收评价量表评分（PCRAES）、和外周血血小板与淋巴细胞比值（PLR）、CD3⁺CD56⁺自然杀伤（NK）细胞和血清补体C4、肿瘤坏死因子-α（TNF-α）水平。结果 治疗后，治疗组总有效率是95.16%，显著高于对照组的83.87%（P<0.05）。治疗后，治疗组退热时间和咳嗽、痰壅、气喘、肺部啰音消失时间显著短于对照组（P<0.05）。治疗后，两组CPIS、PCRAES评分都低于治疗前（P<0.05）；治疗后，治疗组CPIS、PCRAES评分都低于对照组（P<0.05）。治疗后，两组外周血PLR、CD3⁺CD56⁺NK细胞和血清补体C4、TNF-α水平都低于治疗前（P<0.05）；治疗后，治疗组这些指标低于对照组（P<0.05）。结论 儿童清肺口服液联合环酯红霉素治疗儿童肺炎支原体肺炎可有效加快患儿症状减轻，促进肺部感染和机体炎症控制，安全性较高，稳定病情效果较好，值得临床推广应用。

Objective To explore the clinical efficacy of Ertong Qingfei Oral Liquid combined with erythromycin cyclocarbonate in treatment of mycoplasma pneumoniae in children.Methods A total of 124 children with mycoplasma pneumonia admitted to Beijing Tongzhou Maternal and Child Health Hospital from December 2021 to December 2023 were selected and divided into control group and treatment group according to random number table method,with 62 cases in each group.Children in control group were given Erythromycin Cyclocarbonate for Suspension,15 mg/kg,added appropriate amount of cold water to rinse,shaked well,once every 12 h.Children in treatment group were po administered with Ertong Qingfei Oral Liquid on the basis of control group,3 times daily,1 year≤children≤6 years,1 piece/time,children＞6 years,2 pieces/time.Children in two groups were treated for 7 d.After treatment,the clinical efficacy,main clinical manifestations disappeared time were observed.The levels of CPIS score,PCRAES score,PLR,CD3⁺CD56⁺NK cells,serum complement C4,and TNF-α in two groups before and after treatment were compared.Results After treatment,the total effective rate of treatment group was 95.16%,which was significantly higher than that of control group （83.87%）（P＜0.05）.After treatment,the time of fever remission and disappearance of cough,phlegm obstruction,asthma and pulmonary rales in the treatment group were significantly shorter than those in control group （P＜0.05）.After treatment,CPIS and PCRAES scores in both groups were lower than those before treatment （P＜0.05）.After treatment,CPIS and PCRAES scores in treatment group were lower than those in control group （P＜0.05）.After treatment,the levels of peripheral blood PLR,CD3⁺CD56⁺NK cells and serum complement C4 and TNF-α in two groups were lower than before treatment （P＜0.05）.After treatment,these indexes in treatment group were lower than those in control group （P＜0.05）.Conclusion Ertong Qingfei Oral liquid combined with erythromycin cyclocarbonate in treatment of mycoplasma pneumoniae in children can effectively accelerate the reduction of symptoms,promote the control of lung infection and body inflammation with high safety and stable disease effect,which is worthy of clinical promotion and application.

R974

北京市通州区科技计划项目(KJ2022CX051)