目的 觀察小兒肺熱咳喘顆粒聯(lián)合哌拉西林鈉舒巴坦鈉治療小兒喘息性支氣管肺炎的臨床療效。方法 選取2020年5月—2023年3月中山市小欖人民醫(yī)院收治的122例喘息性支氣管肺炎患兒，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各61例。對照組靜脈滴注注射用哌拉西林鈉舒巴坦鈉，根據(jù)患兒體質(zhì)量按75 mg/kg將本品溶于0.9%氯化鈉注射液100 mL，每12小時1次。治療組患者在對照組治療基礎(chǔ)上開水沖服小兒肺熱咳喘顆粒，4 g/次，6個月～3歲者3次/d，3～6歲者4次/d。兩組療程均為7 d。觀察兩組的臨床療效及肺部濕啰音、4大主癥的消失時間。比較治療前后兩組肺炎胸片吸收評價量表（PCRAES）評分、潮氣呼吸肺功能指標及全血中性粒細胞與淋巴細胞比值（NLR）和血清C反應(yīng)蛋白（CRP）、補體C3、降鈣素原（PCT）水平。結(jié)果 治療后，治療組患者總有效率是96.72%，較之對照組的86.89%顯著提高（P＜0.05）。治療后，治療組肺部濕啰音及喘促、發(fā)熱、咳嗽、痰鳴的消失時間均較對照組顯著縮短（P＜0.05）。治療后，兩組PCRAES評分均顯著降低，而潮氣量（TV/kg）、達峰時間比（TPTEF/TE）、達峰容積比（VPEF/VE）均顯著增加（P＜0.05）；治療后，治療組PCRAES評分和潮氣呼吸肺功能指標改善優(yōu)于對照組（P＜0.05）。治療后，兩組全血NLR和血清CRP、補體C3、PCT水平均顯著降低（P＜0.05），且以治療組降低更顯著（P＜0.05）。結(jié)論 小兒肺熱咳喘顆粒聯(lián)合哌拉西林鈉舒巴坦治療小兒喘息性支氣管肺炎取得了較好的臨床療效，能減輕臨床癥狀及肺功能損害，調(diào)節(jié)機體炎癥反應(yīng)和免疫功能，值得臨床推廣應(yīng)用。

Objective To observe the clinical efficacy of Xiaoer Feire Kechuan Granules combined with piperacillin sodium and sulbactam sodium in treatment of asthmatic bronchopneumonia in children. Methods A total of 122 children with asthmatic bronchopneumonia admitted to Zhongshan Xiaolan People’s Hospital from May 2020 to March 2023 were selected and divided into control group and treatment group according to random number table method, with 61 cases in each group. Patients in the control group were iv administered with Piperacillin Sodium and Sulbactam Sodium for injection, the product was dissolved in 0.9% sodium chloride injection100 mL at 75 mg/kg according to the child’s body weight, once every 12 h. Patients in the treatment group were po administered with Xiaoer Feire Kechuan Granules with boiled water on the basis of the control group, 4 g/time, 3 times daily for 6 months to 3 years old, 4 times daily for 3 to 6 years old. Patients in two groups were treated for 7 d. After treatment, the clinical effect and the disappearance time of pulmonary moist rales and 4 major symptoms were observed in the two groups. The scores of chest film Absorption Evaluation Scale (PCRAES), lung function indexes of tidal respiration, whole blood neutrophil to lymphocyte ratio (NLR), serum C-reactive protein (CRP), complement C3 and procalcitonin (PCT) were compared between two groups before and after treatment. Results After treatment, the total effective rate of treatment group was 96.72%, which was significantly higher than that of control group (86.89%) (P < 0.05). After treatment, the disappearance time of lung moist rales, wheezing, fever, cough and phlegm in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, PCRAES scores in both groups were significantly decreased, but tidal volume (TV/kg), TPTEF/TE and VPEF/VE were significantly increased (P< 0.05). After treatment, PCRAES score and moisture respiratory lung function indexes in the treatment group were better than those in control group (P < 0.05). After treatment, the levels of whole blood NLR and serum CRP, complement C3 and PCT in both groups were significantly decreased (P< 0.05), and the reduction was more significant in treatment group (P< 0.05). Conclusion Xiaoer Feire Kechuan Granules combined with piperacillin sodium and sulbactam sodium can obtain good clinical effect in treatment of asthmatic bronchopneumonia in children, and can reduce clinical symptoms and lung function damage, regulate inflammatory response and immune function, which is worthy of clinical application.

R974；R985

中山市醫(yī)學科研項目(2020A020413)