目的 探讨蓝芩口服液联合克拉霉素治疗儿童肺炎支原体肺炎的临床疗效。方法 选取2023年8月—2024年6月复旦大学附属华山医院静安分院收治的肺炎支原体肺炎患儿112例，按随机数字表法将患者分为对照组和治疗组，每组各56例。对照组患者口服克拉霉素干混悬剂，0.3 mL/kg（最大10 mL/次），2次/d。在对照组基础上，治疗组口服蓝芩口服液，3次/d，1～3岁者每次1/3支，4～6岁者每次1/2支，7～14岁者每次1支。两组患儿治疗7 d。观察两组患者临床疗效，比较治疗前后两组患者中医证候积分，潮气呼吸肺功能指标吸呼时间比（Ti/Te）、呼出75%潮气量时的呼气流量与呼气峰流量比（TEF25/PTEF）、单位潮气量（VT/kg）和达峰容积比（VPEF/VE），肺炎胸片吸收评价量表（PCRAES）评分，红细胞分布宽度（RDW），及血清单核细胞趋化蛋白-4（MCP-4）、转化生长因子-β1（TGF-β1）和可溶性白细胞介素-6受体（sIL-6R）水平。结果 治疗后，治疗组总有效率明显高于对照组（96.43% vs 85.71%，P＜0.05）。治疗后，两组中医证候积分（包括主症积分、次症积分、舌脉象积分、总积分）、Ti/Te、PCRAES评分、RDW和血清MCP-4、TGF-β1、sIL-6R水平均低于同组治疗前（P＜0.05），且治疗组均低于同期对照组（P＜0.05）。治疗后，两组TEF25/PTEF、VT/kg、VPEF/VE均高于同组治疗前（P＜0.05），，且治疗组均明显高于同期对照组（P＜0.05）。结论 蓝芩口服液联合克拉霉素治疗儿童肺炎支原体肺炎，能有效抑制肺部炎症及机体炎症损害，有效促进症状缓解与肺功能好转，且患儿耐受性较好。

Objective To investigate the clinical efficacy of Lanqin Oral Solution combined with clarithromycin in treatment of mycoplasmal pneumonia in children. Methods Children (112 cases) with mycoplasmal pneumonia in Jing’an Branch of Huashan Hospital, Fudan University from August 2023 to June 2024 were divided into control group and treatment group by random number table method, with 56 cases in each group. Children in the control group were po administered with Clarithromycin Granules for Oral Suspension, 0.3 mL/kg (the maximum dose was 10 mL/time), twice daily. Children in the treatment group were po administered with Lanqin Oral Solution on the basis of the control group, three times daily, children aged 1 — 3 years old 3.3 mL each time, 4 — 6 years old 5 mL each time, 7 — 14 years old 10 mL each time. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, and the TCM syndrome scores, tidal respiration and lung function indicators Ti/Te, TEF25/PTEF, VT/kg and VPEF/VE, PCRAES scores, RDW, and the levels of MCP-4, TGF-β1 and sIL-6R in two groups before and after treatment were compared. Results After treatment, the clinical total effective rate in the treatment group was significantly higher than that in the control group (96.43% vs 85.71%, P < 0.05). After treatment, the TCM syndrome scores (including main syndrome scores, secondary syndrome scores, tongue and pulse scores, and total scores), Ti/Te, PCRAES scores, RDW and serum MCP-4, TGF-β1, sIL-6R levels in two groups were lower than those before treatment in the same group (P < 0.05), and these levels in the treatment group were lower than those in the control group during the same period (P < 0.05). After treatment, TEF25/PTEF, VT/kg, and VPEF/VE in two groups were higher than those in the same group before treatment (P < 0.05), and which in the treatment group were significantly higher than those in the control group during the same period (P < 0.05). Conclusion The treatment of children with mycoplasmal pneumonia pneumonia with Lanqin Oral Solution combined with clarithromycin can effectively inhibit lung inflammation and body inflammation damage, effectively promote symptom relief and lung function improvement, and which has good tolerance in children.

R974

上海市静安区卫生科研项目（2021SQ06）