目的 观察清咳平喘颗粒联合头孢克洛和盐酸氨溴索治疗儿童急性支气管炎的临床疗效。方法 前瞻性将 2020 年 8月-2021 年 12 月上海市(复旦大学附属)公共卫生临床中心收治的急性支气管炎患儿 166 例纳入研究,采用随机数字表法,分为对照组和试验组。对照组给予头孢克洛干混悬剂和盐酸氨溴索口服溶液治疗,试验组在对照组基础上联用清咳平喘颗粒,均治疗 7 d。观察比较两组患儿临床症状改善状况及治疗效果。观察两组患儿用药期间咳嗽、咳痰、发热、肺部啰音情况;观察两组患儿治疗前后血清炎症因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化及咳嗽中医证候积分,统计不良反应发生情况。结果 最终共 160 例患儿完成研究,对照组和试验组各 80 例,试验组总有效率(87.50%)显著高于对照组(80.00%)(P<0.05);治疗后试验组咳嗽、咳痰、发热、肺部啰音症状消失时间均显著短于对照组,差异均有统计学意义(P<0.05)。两组治疗后咳嗽中医证候积分以及炎症因子均较本组治疗前降低(P<0.05),且试验组降低更明显(P<0.05)。两组患儿不良反应发生率分别为 5.00%、3.75%,无统计学意义(P>0.05)。结论 清咳平喘颗粒联合头孢克洛干混悬剂和盐酸氨溴索口服溶液治疗儿童急性支气管炎有协同作用,可明显改善患儿临床症状,降低炎症因子水平,缩短患儿病程,提高疗效。

Objective To observe the clinical effect of Qingke Pingchuan Granules combined with cefaclor and ambroxol hydrochloride on acute bronchitis in children. Methods A total of 166 children with acute bronchitis were randomly divided into observation group (n=83) and control group (n=83). The the control group was treated with cefaclor dry suspension and ambroxol hydrochloride oral solution, while the observation group was treated with the qingke pingchuan granules on top of the control group for seven days. The improvement of clinical symptoms and treatment effects were compared between the two groups. Cough, expectoration, fever and lung rales were observed.Observe the changes of WBC, hs-CRP, PCT, serum inflammatory factors (IL-1β, IL-6, TNF-α, hs-CRP) and TCM syndrome score of cough before and after treatment, and count the adverse reactions. Results A total of 160 children completed the study, 80 cases in the control group and 80 cases in the observation group. The total effective rate of the observation group (87.50%) was significantly higher than that of the control group (80.00%) (P<0.05); After treatment, the indexes of cough, expectoration, fever and lung rale in the two groups were significantly improved compared with those before treatment (P<0.05). The clinical therapeutic effects of cough, expectoration, fever and lung rale in the observation group were significantly better than those in the control group, and the differences were statistically significant (P<0.05). The TCM syndrome score of cough and inflammatory factors in the two groups after treatment were lower than those before treatment (P<0.05), and the decrease was more obvious in the observation group (P<0.05). The incidence of adverse reactions in children in the control and observation groups was 5.00% and 3.75%, respectively, with no statistical significance (P > 0.05). Conclusion The synergistic effect of qingke pingchuan granules combined with cefaclor dry suspension and ambroxol hydrochloride oral solution in the treatment of acute bronchitis in childrensignificantly improves clinical symptoms, shortens the treatment process, improves, the treatment effect.

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