目的 探討小青龍口服液聯(lián)合重組人干擾素α2b治療小兒合胞病毒肺炎的臨床療效。方法 選取2018年5月—2021年5月商丘市第一人民醫(yī)院收治的98例合胞病毒肺炎患兒，按隨機(jī)數(shù)字表法分為對照組和治療組，每組各49例。對照組霧化吸入重組人干擾素α2b注射液，10萬～20萬IU/(kg∙次)，2次/d，每次將重組人干擾素α2b注射液加入0.9%氯化鈉注射液中稀釋至2 mL，再以6 L/min的氧流量霧化吸入，給藥時(shí)間約10 min/次。治療組在此基礎(chǔ)上口服小青龍口服液，5 mL/次，3次/d。兩組患兒療程均為7 d。觀察兩組的臨床療效，典型表現(xiàn)消失時(shí)間和血象復(fù)常時(shí)間。比較治療前后兩組肺炎胸片吸收評價(jià)量表評分、單位公斤體質(zhì)量潮氣量（V_T/kg）、潮氣呼吸呼氣峰流速（PTEF）及血清腫瘤壞死因子-α（TNF-α）、白細(xì)胞介素（IL）-1β、IL-4、可溶性細(xì)胞間黏附分子-1（sICAM-1）和γ干擾素（INF-γ）水平。結(jié)果 治療后，治療組總有效率是95.9%，顯著高于對照組的83.7%（P＜0.05）。治療后，治療組退熱時(shí)間、喘促消失時(shí)間、肺部啰音消失時(shí)間、痰鳴消失時(shí)間、咳嗽消失時(shí)間、血象復(fù)常時(shí)間均顯著短于對照組（P＜0.05）。治療后，兩組胸片吸收評價(jià)量表評分和PTEF均顯著低于治療前，V_T/kg均顯著高于治療前（P＜0.05）；且均以治療組改善更顯著（P＜0.05）。治療后，兩組血清TNF-α、IL-1β、IL-4和sICAM-1水平均顯著下降，血清INF-γ水平均顯著上升（P＜0.05）；且治療后，治療組患兒血清TNF-α、IL-1β、IL-4、sICAM-1水平低于對照組，INF-γ水平高于對照組（P＜0.05）。結(jié)論 小青龍口服液聯(lián)合重組人干擾素α2b治療小兒合胞病毒肺炎的總體效果確切，能迅速緩解患兒癥狀及體征、促進(jìn)外周血象的恢復(fù)，改善肺功能，并可進(jìn)一步下調(diào)血中TNF-α、IL-1β、IL-4和sICAM-1水平及上調(diào)血清INF-γ水平，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of Xiaoqinglong Oral Liquid combined with recombinant human interferon α2b in treatment of children with syncytial virus pneumonia. Methods A total of 98 children with syncytial virus pneumonia admitted to Shangqiu First People's Hospital from May 2018 to May 2021 were selected and divided into control group and treatment group according to random number table method, with 49 cases in each group. Children in the control group were given Recombinant Human Interferon α2b Injection, 1×10⁵- 2×10⁵ IU/(kg∙time), twice daily, and Recombinant Human Interferon α2b Injection was added into 0.9% sodium chloride injection and diluted to 2 mL each time, and then inhaled by atomization at 6 L/min of oxygen flow. The administration time was about 10 min/time. Patients in the treatment group were po administered with Xiaoqinglong Oral Liquid on the basis of the control group, 5 mL/time, 3 times daily. The treatment course of both groups was 7 d. The clinical efficacy, disappearance time of typical symptoms and recovery time of blood images were observed. The scores of absorption scale, V_T/kg body mass, PTEF, TNF-α, INTERleukin (IL)-1β, IL-4, sICAM, and interferon gamma (INF-γ) were compared before and after treatment. Results After treatment, the total effective rate of treatment group was 95.9%, significantly higher than that of control group 83.7% (P < 0.05). After treatment, the time of antipyretic, dyspnea, pulmonary rales, phlegm, cough and normal blood image in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the scores of absorption scale and PTEF of chest radiographs in two groups were significantly lower than before treatment, and V_T/kg were significantly higher than before treatment (P < 0.05). The improvement was more significant in the treatment group (P < 0.05). After treatment, the levels of TNF-α, IL-1β, IL-4 and sICAM-1 in serum were significantly decreased, while the level of INF-γ in serum was significantly increased in both groups (P < 0.05). After treatment, the serum levels of TNF-α, IL-1β, IL-4 and sICAM-1 in the treatment group were lower than those in the control group, and the level of INF-γ was higher than that in the control group (P < 0.05). Conclusion The overall effect of Xiaoqinglong Oral Liquid combined with recombinant human interferon α2b in treatment of children with syncytial virus pneumonia is definite. It can quickly relieve the symptoms and signs of children, and can promote the recovery of peripheral blood, improve lung function, and further can inhibit the levels of TNF-α, IL-1β, IL-4 and sICAM-1 in blood and up-regulate the level of serum INF-γ, which is worthy of clinical application.

R974

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃(2018020956)