目的 探究复方福尔可定联合多西环素治疗大环内酯类耐药支原体肺炎的临床效果。方法 选取2022年4月—2024年4月在无为市人民医院治疗的大环内酯类耐药的支原体肺炎患儿82例，根据患儿治疗方案差异分成对照组（41例）和治疗组（41例）。对照组患儿口服盐酸多西环素片，体质量≤45 kg儿童每12 h取本品2.2 mg/kg口服，体质量＞45 kg儿童每12 h取本品100 mg口服。治疗组在对照组基础上口服复方福尔可定口服溶液，10 mL/次，3次/d。两组患儿连续治疗7 d。观察两组患儿临床疗效，比较治疗前后两组患儿临床主要症状消失时间，中医证候评分和小儿病情危重程度（PCIS）评分，及血清乳酸脱氢酶（LDH）、C-反应蛋白（CRP）和D-二聚体（D-D）水平。结果 治疗后，对照组和治疗组总有效率分别为80.49%和95.12%，两组比较差异具有统计学意义（P＜0.05）。治疗后，治疗组患儿发热、咳嗽、喘息以及肺部啰音消失时间均要明显短于对照组（P＜0.05）。治疗后，两组患儿中医证候评分均显著下降，而PCIS评分均明显升高（P＜0.05），且治疗组评分显著优于对照组（P＜0.05）。治疗后，两组患者血清LDH、CRP和D-D水平均显著降低（P＜0.05），且治疗组各指标显著低于对照组（P＜0.05）。结论 复方福尔可定联合多西环素对大环内酯类耐药支原体肺炎患儿治疗效果显著，不仅能够显著改善患儿临床症状消失时间和中医证候评分，同时还能够促进血清学指标的恢复。

Objective Exploring the therapeutic effect of compound pholcodine combined with doxycycline in treatment of macrolide-resistant Mycoplasma pneumonia. Methods Children (82 cases) with macrolide-resistant Mycoplasma pneumonia in Wuwei People’s Hospital from April 2022 to April 2024 were divided into control (41 cases) and treatment (41 cases) group based on different treatments. Children in the control group were po administered with Doxycycline Hyclate Tablets, children weighing ≤ 45 kg taken 2.2 mg/kg every 12 h, and children weighing > 45 kg taken 100 mg every 12 h. Children in the treatment group were po administered with Compound Pholcodine Oral Solution on the basis of the control group, 10 mL/time, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the disappearance time of clinical main symptoms, the scores of TCM syndrome and PCIS, the serum LDH, CRP, and D-D levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 80.49% and 95.12%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the disappearance time of fever, cough, wheezing, and pulmonary rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the TCM syndrome scores of children in two groups were significantly decreased, while the PCIS scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum LDH, CRP, and D-D levels of patients in two groups were significantly reduced (P < 0.05), and all indicators in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of compound forcodeine and doxycycline has a significant therapeutic effect on children with macrolide resistant Mycoplasma pneumoniae. It can not only significantly improve the disappearance time of clinical symptoms and traditional Chinese medicine syndrome scores, but also promote the recovery of serological indicators.

R974

安徽省自然科学基金资助项目(2008085QH429)