目的 探讨小儿肺热咳喘颗粒联合利巴韦林治疗风热闭肺型小儿病毒性肺炎（VP）的临床疗效。方法 选取2024年8月—2025年7月邢台市中心医院收治的100例风热闭肺型VP患儿，随机分为对照组和治疗组，每组各50例。对照组静脉滴注利巴韦林注射液，10～15 mg/kg利巴韦林注射液溶于100 mL生理盐水，2次/d。治疗组在对照基础上口服小儿肺热咳喘颗粒，年龄≤3岁，4 g/次，3次/d，3岁＜年龄≤7岁，4 g/次，4次/d，7岁＜年龄≤14岁，8 g/次，3次/d。两组患儿连续治疗7 d。评估两组临床疗效，比较治疗前后两组临床症状好转时间，中医证候评分、胸片吸收评分和临床肺部感染评分，及炎性因子肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）白细胞介素-8（IL-8）和肠道细菌数量。结果 治疗后，治疗组患儿总有效率为98.00%，较对照组的86.00%明显升高（P＜0.05）。治疗后，治疗组患儿肺部啰音消失、咳嗽消失、体温恢复、病毒核酸转阴时间均较对照组明显缩短（P＜0.05）。治疗后，两组患儿中医证候、胸片吸收及临床肺部感染评分较治疗前明显降低（P＜0.05），且治疗后治疗组评分较对照组降低更为明显（P＜0.05）。治疗后，两组患儿TNF-α、IL-6、IL-8水平均较治疗前明显降低（P＜0.05），且治疗后治疗组患儿炎性因子水平较对照组降低更为明显（P＜0.05）。治疗后，两组患儿肠杆菌及肠球菌基因拷贝数均较治疗前显著减少，而乳杆菌及双歧杆菌基因拷贝数均较显著升高（P＜0.05），且治疗组患儿肠杆菌和肠球菌基因拷贝数，乳杆菌及双歧杆菌基因拷贝数均显著好于对照组（P＜0.05）。结论 小儿肺热咳喘颗粒联合利巴韦林治疗风热闭肺型小儿VP疗效及安全性均较高，可有效调节肠道菌群数量，减轻炎性反应，改善患儿肺部症状。

Objective To investigate the clinical efficacy of Xiao'er Feire Kechuan Granules combined with ribavirin in treatment of pediatric viral pneumonia (VP) of wind-heat obstructing lung syndrome. Methods A total of 100 children with VP of wind-heat obstructing lung syndrome admitted to Xingtai Central Hospital from August 2024 to July 2025 were randomly divided into control group and treatment group, 50 cases each. The control group was given intravenous ribavirin injection (10 — 15 mg/kg dissolved in 100 mL normal saline, twice daily). The treatment group was additionally given oral Xiao'er Feire Kechuan Granules on the basis of the control group, with dosage adjusted by age. Both groups were treated continuously for 7 days. Clinical efficacy, symptom improvement time, scores of TCM syndromes, chest radiograph absorption and CPIS, inflammatory factors (TNF-α, IL-6, IL-8) and intestinal flora counts were compared between two groups. Results The clinical effective rate of the treatment group (98.00%) was significantly higher than that of the control group (86.00%, P < 0.05). The symptom improvement time of the treatment group was significantly shorter (P < 0.05). After treatment, the scores of TCM syndromes, chest radiograph absorption and CPIS, and levels of inflammatory factors in the treatment group were significantly lower than those in the control group (P < 0.05). The intestinal flora of the treatment group was significantly better than that of the control group (P < 0.05). Conclusion Xiao'er Feire Kechuan Granules combined with ribavirin is effective and safe in the treatment of pediatric VP of wind-heat obstructing lung syndrome, which can regulate intestinal flora, alleviate inflammation and improve pulmonary symptoms.

邢台市重点研发计划自筹项目（2024ZC202）