目的 探讨小儿热速清颗粒联合多西环素治疗小儿肺炎支原体肺炎的临床疗效。方法 选取2024年1月—2025年6月北京市通州区妇幼保健院收治的156例肺炎支原体肺炎患儿的病例资料进行回顾性分析，按治疗方案不同分为对照组和治疗组，每组各78例。对照组静脉滴注注射用盐酸多西环素，100 mg加入200～250 mL的5%葡萄糖注射液，0.4～0.5 mg/mL。在对照组基础上，治疗组口服小儿热速清颗粒，4～7岁患儿1袋/次，7～14岁患儿2袋/次，3次/d。两组患儿疗程均为7 d。观察两组临床疗效，比较治疗前后两组病情缓解时间，中医症状总积分、临床肺部感染评分（CPIS）和儿少主观生活质量问卷（ISLQ）评分、肺功能指标[用力肺活量（FVC）、第1秒用力呼气容积（FEV1）、呼气峰流速（PEF）、50%用力肺活量时的用力呼气流量（FEF50）、最大呼气中段流量（MMEF），及全身免疫炎症指数（SII）、C反应蛋白与白蛋白比值（CAR）、纤维蛋白原（FIB）和血清乳酸脱氢酶（LDH）水平。结果 治疗后，治疗组总有效率（96.15%）明显高于对照组（85.90%）（P＜0.05）。治疗后，治疗组退热时间、咳嗽缓解时间、气喘缓解时间、痰壅缓解时间、肺部啰音缓解时间均较对照组显著缩短（P＜0.05）。治疗后，两组中医症状总积分和CPIS评分都低于同组治疗前，两组ISLQ评分都高于同组治疗前（P＜0.05），且治疗组这些评分均优于对照组（P＜0.05）。治疗后，两组患者肺功能指标FVC、FEV1、PEF、FEF50、MMEF均较治疗前升高（P＜0.05），且治疗组这些肺功能指标均高于对照组（P＜0.05）。治疗后，两组SII、CAR、FIB和血清LDH水平都低于治疗前（P＜0.05），且治疗组都低于对照组（P＜0.05）。结论 采用小儿热速清颗粒联合多西环素治疗小儿肺炎支原体肺炎，可有效加速症状及肺部感染缓解，促进病情、肺功能和生活质量改善，进一步抑制机体过度免疫炎症反应、改善凝血功能和营养代谢状态，减轻肺组织损伤，安全性良好，提升整体疗效。

Objective To investigate the clinical efficacy of Xiaoer Resuqing Granules combined with doxycycline in the treatment of Mycoplasma pneumoniae pneumonia in children. Methods A retrospective analysis was performed on the clinical data of 156 children diagnosed with Mycoplasma pneumoniae pneumonia who were admitted to Tongzhou Maternal and Child Health Hospital of Beijing from January 2024 to June 2025. All patients were divided into a control group and a treatment group according to different therapeutic regimens, with 78 cases in each group. The control group received intravenous infusion of doxycycline hydrochloride, wherein 100 mg doxycycline was diluted in 200 — 250 mL 5% glucose injection to achieve a final concentration of 0.4 — 0.5 mg/mL. On the basis of the conventional doxycycline treatment, the treatment group was additionally administered oral Xiaoer Resuqing Granules three times daily, with one sachet per dose for children aged 4 — 7 years and two sachets per dose for children aged 7 — 14 years. The treatment course lasted 7 days for both groups. The overall clinical efficacy was evaluated. Symptom remission time, total traditional Chinese medicine (TCM) symptom scores, Clinical Pulmonary Infection Score (CPIS), and Inventory of Subjective Life Quality (ISLQ) were compared before and after treatment. Pulmonary function indicators including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), peak expiratory flow (PEF), forced expiratory flow at 50% of FVC (FEF50), and maximal mid-expiratory flow (MMEF) were detected. In addition, systemic immune-inflammation index (SII), C-reactive protein/albumin ratio (CAR), fibrinogen (FIB), and serum lactate dehydrogenase (LDH) levels were measured. Results Post-treatment evaluation revealed that the treatment group exhibited a significantly higher overall response rate than the control group (96.15% vs 85.90%, P< 0.05). After treatment, the time for fever reduction, cough relief, asthma relief, sputum clearance, and lung rales reduction in treatment group were significantly shorter than those in control group (P < 0.05). After treatment, both groups presented decreased total TCM symptom scores and CPIS scores, as well as elevated ISLQ scores (P < 0.05), with more significant improvements observed in the treatment group (P < 0.05). All pulmonary function parameters (FVC, FEV1, PEF, FEF50, MMEF) were substantially increased in both groups after intervention, and the treatment group demonstrated superior pulmonary function recovery (P < 0.05). Furthermore, serum SII, CAR, FIB and LDH levels were significantly reduced in both groups post-treatment, with the treatment group showing lower levels of these inflammatory and metabolic biomarkers (P < 0.05). Conclusion The combination of Xiaoer Resuqing Granules and doxycycline is effective for pediatric Mycoplasma pneumoniae pneumonia. This synergistic treatment can accelerate the relief of clinical symptoms and pulmonary infection, improve pulmonary function and children’s quality of life, inhibit excessive immune-inflammatory responses, optimize coagulation function and nutritional metabolism, and alleviate lung tissue damage with favorable safety, thereby significantly improving the overall therapeutic efficacy.

R974

北京市通州区科技计划项目（WS2025005）