目的 探讨强力枇杷露联合克拉霉素治疗慢性支气管炎急性发作期的临床疗效。方法 纳入2023年5月—2025年12月首都医科大学附属北京友谊医院收治的86例慢性支气管炎急性发作期患者，使用随机数字表法分为对照组和治疗组，每组各43例。对照组口服克拉霉素片，0.5 g/次，2次/d。在此基础上，治疗组口服强力枇杷露，15 mL/次，3次/d。疗程均为7 d。比较两组临床疗效和主要症状/体征缓解时间，治疗前后呼吸困难、咳嗽和咳痰量表（BCSS）评分、肺功能指标[第1秒用力呼气量（FEV1）、残气量/肺总量（RV/TLC）、最大呼气中期流速（MMEF）、用力肺活量（FVC）]、中性粒细胞与淋巴细胞比值（NLR）、血沉（ESR）、C反应蛋白（CRP）、痰液中白细胞计数（WBC）及血清降钙素原（PCT）水平。结果 治疗后，治疗组总有效率（95.35%）高于对照组（81.40%，P＜0.05）。治疗后，治疗组各项主要症状/体征的缓解时间均短于对照组（P＜0.05）。治疗后，两组呼吸困难、咳嗽、咳痰评分均降低（P＜0.05）；治疗组各项BCSS评分低于对照组（P＜0.05）。治疗后，两组FEV1、MMEF、FVC均升高（P＜0.05），RV/TLC降低（P＜0.05）；治疗组肺功能指标均优于对照组（P＜0.05）。治疗后，两组NLR、ESR、CRP和痰液中WBC及血清PCT水平均下降（P＜0.05）；治疗组上述指标均低于对照组（P＜0.05）。结论 强力枇杷露联合克拉霉素治疗慢性支气管炎急性发作期，能有效抑制患者机体炎症反应及气道炎症，促进肺功能改善及症状减轻，缩短症状缓解时间，且安全性良好。

Objective To explore the clinical efficacy of Qiangli Pipa Syrup combined with clarithromycin in treatment of acute exacerbation of chronic bronchitis. Methods A total of 86 patients with acute exacerbation of chronic bronchitis admitted to Beijing Friendship Hospital, Capital Medical University, from May 2023 to December 2025 were enrolled. They were divided into a control group and a treatment group by the random number table method, with 43 cases in each group. Patients in the control group were po administered with Clarithromycin Tablets, 0.5 g per dose, twice daily. On the basis of the control group, patients in the treatment group were po administered with Qiangli Pipa Syrup, 15 mL per dose, three times daily. The course of treatment was 7 days in both groups. Clinical efficacy and the time to relief of main symptoms/signs were compared between the two groups. Before and after treatment, the Breathlessness, Cough, and Sputum Scale (BCSS) scores; pulmonary function indicators [forced expiratory volume in one second (FEV1), residual volume/total lung capacity (RV/TLC), maximal mid-expiratory flow (MMEF), forced vital capacity (FVC)]; neutrophil-to-lymphocyte ratio (NLR); erythrocyte sedimentation rate (ESR); C-reactive protein (CRP); sputum white blood cell (WBC) count; and serum procalcitonin (PCT) level were compared. Results After treatment, the total effective rate in the treatment group (95.35%) was higher than that in the control group (81.40%, P < 0.05). After treatment, the relief times of all main symptoms/signs in the treatment group were shorter than those in the control group (P < 0.05). After treatment, the scores for breathlessness, cough, and sputum were decreased in both groups (P < 0.05); all BCSS scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, FEV1, MMEF, and FVC increased and RV/TLC were decreased in both groups (P < 0.05); all pulmonary function indicators in the treatment group were better than those in the control group (P < 0.05). After treatment, NLR, ESR, CRP, sputum WBC count, and serum PCT level were decreased in both groups (P < 0.05); the above indicators in the treatment group were lower than those in the control group (P < 0.05). Conclusion Qiangli Pipa Syrup combined with clarithromycin in treatment of acute exacerbation of chronic bronchitis can effectively can effectively inhibit the patient’s systemic inflammatory response and airway inflammation, promote improvement in pulmonary function and alleviation of symptoms, shorten symptom relief time, and has a good safety profile.

R974