目的 探討小兒定喘口服液聯(lián)合甲潑尼龍治療重癥支氣管哮喘的臨床療效。方法 選取2015年2月-2016年2月在西電集團(tuán)醫(yī)院呼吸內(nèi)科接受治療的小兒重癥支氣管哮喘患者86例，隨機(jī)分成對(duì)照組和治療組，每組各43例。對(duì)照組患兒靜脈滴注注射用甲潑尼龍琥珀酸鈉，1 mg/kg加入到5%葡萄糖溶液250 mL中，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服小兒定喘口服液，3~6歲患兒10 mL/次，7~10歲患兒15 mL/次，10歲以上患兒20 mL/次，均為3次/d。所有患兒均連續(xù)治療2周。比較兩組臨床療效、肺功能變化、動(dòng)脈血?dú)庵笜?biāo)、臨床癥狀和體征消失時(shí)間以及腫瘤壞死因子α（TNF-α）、白介素-8（IL-8）和免疫球蛋白E（IgE）表達(dá)水平。結(jié)果 治療后，對(duì)照組和治療組總有效率分別為81.40%和95.35%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組一秒用力呼氣容積（FEV1）、最大呼氣流量（PEF）、用力肺活量（FVC）和FEV₁/FVC均較同組治療前顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)顯著高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組氧分壓（pO₂）和血氧飽和度（SpO₂）升高，二氧化碳分壓（pCO₂）較治療前下降，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)顯著優(yōu)于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組患兒喘憋消失時(shí)間和肺部哮鳴音消失時(shí)間短于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患兒TNF-α、IL-8和IgE表達(dá)水平均下降，同組治療前后差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)水平低于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 小兒定喘口服液聯(lián)合甲潑尼龍治療重癥支氣管哮喘的療效顯著，可有效改善患兒肺功能及降低血清炎性因子水平，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacies of Xiao'er Dingchuan Oral Liquid combined with methylprednisolone in treatment of severe bronchial asthma. Methods Children (86 cases) with severe bronchial asthma in Department of Respiratory, Xi'an XD Group Hospital from February 2015 to February 2016 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 1 mg/kg added into 5% glucose solution 250 mL, once daily. Patients in the treatment group were po administered with Xiao'er Dingchuan Oral Liquid on the basis of the control group, 10 mL/time for 3-6 years old children, 15 mL/time for 7-10 years old children, 20 mL/time for children over 10 years old, three times daily. The patients in two groups were treated for 2 weeks. After treatment, the efficacy was evaluated, and pulmonary function changes, arterial blood gas indexes, disappeared time of clinical symptoms and signs, tumor necrosis factor α (TNF-α), interleukin-8 (IL-8), and immunoglobulin E (IgE) in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.40% and 95.35%, respectively, and there were differences between two groups (P<0.05). After treatment, FEV1, PEF, FVC, and FEV₁/FVC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, pO₂ and SpO₂ in two groups were significantly increased, and pCO₂ was decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, disappeared time of shortness of breath and wheezing of children in treatment group were shorter than those in the control group, with significant difference between two groups (P<0.05). After treatment, TNF-α, IL-8, and IgE in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the decreased degree of the observational indexes in the treatment group was better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Xiao'er Dingchuan Oral Liquid combined with methylprednisolone has a significant clinical efficacy in treatment of severe bronchial asthma, can significantly improve lung function, and reduce inflammatory factors level in serum, which has a certain clinical application value.