目的 探討肺力咳合劑聯(lián)合重組人干擾素α1b治療兒童急性毛細(xì)支氣管炎的臨床療效。方法 選取2020年3月—2023年2月華北醫(yī)療健康集團(tuán)峰峰總醫(yī)院、東營(yíng)市東營(yíng)區(qū)人民醫(yī)院收治的96例急性毛細(xì)支氣管炎患兒，按隨機(jī)數(shù)字表法將所有患兒分為對(duì)照組和治療組，每組各48例。對(duì)照組霧化吸入注射用重組人干擾素α1b，2 μg/kg，2次/d。治療組在對(duì)照組基礎(chǔ)上口服肺力咳合劑，10 mL/次，3次/d。兩組療程均為7 d。觀察兩組的臨床療效及主要癥狀體征消失時(shí)間，比較治療前后兩組潮氣呼吸肺功能指標(biāo)、血氧飽和度（SpO₂）、呼出氣一氧化氮（FeNO）及血清細(xì)胞間黏附分子-1（ICAM-1）、白細(xì)胞介素-17（IL-17）、干擾素γ（INF-γ）、血清淀粉樣蛋白A（SAA）水平。結(jié)果 治療后，治療組總有效率是95.83%，較之對(duì)照組患兒的83.33%顯著提高（P＜0.05）。治療后，治療組發(fā)熱、咳嗽、痰鳴、喘促、肺部濕啰音的消失時(shí)間均顯著短于對(duì)照組（P＜0.05）。治療后，兩組呼吸頻率（RR）、吸呼比（Ti/Te）均顯著降低，而潮氣量（VT）均顯著增加（P＜0.05）；且治療后，治療組RR、Ti/Te低于對(duì)照組，VT高于對(duì)照組（P＜0.05）。治療后，兩組SpO₂均顯著升高，而FeNO水平均顯著降低（P＜0.05）；治療后，治療組SpO₂高于對(duì)照組，F(xiàn)eNO水平低于對(duì)照組（P＜0.05）。治療后，兩組患者血清ICAM-1、IL-17、SAA水平均顯著下降，而血清IFN-γ水平均顯著上升（P＜0.05）；且治療后，治療組血清ICAM-1、IL-17、SAA水平均顯著低于對(duì)照組，血清IFN-γ水平顯著高于對(duì)照組（P＜0.05）。結(jié)論 肺力咳合劑聯(lián)合重組人干擾素α1b治療急性毛細(xì)支氣管具有較好的臨床療效，能有效促進(jìn)其主要癥狀體征的減輕及肺通氣功能的改善，有效控制機(jī)體炎癥反應(yīng)，且患兒耐受性好，值得臨床推廣應(yīng)用。

Objective To investigate the therapeutic effect of Feilike Mixture combined with recombinant human interferon α1b in treatment of acute bronchiolitis in children. Methods A total of 96 children with acute bronchiolitis admitted to North China Medical Health Group Fengfeng General Hospital and Dongying District People’s Hospital of Dongying City from March 2020 to February 2023 were selected and divided into control group and treatment group according to random number table method, with 48 cases in each group. Patients in the control group were atomized inhaled Recombinant Human Interferon α1b for injection, 2 μg/kg, twice daily. Patients in the treatment group were po administered with Feilike Mixture on the basis of the control group, 10 mL/time, 3 times daily. The treatment course of both groups was 7 d. The clinical efficacy and disappearance time of main symptoms and signs of the two groups were observed. The pulmonary function indexes, blood oxygen saturation (SpO₂), exhaled nitric oxide (FeNO), serum intercellular adhesion molecule-1 (ICAM-1), interleukin-17 (IL-17), interferon gamma (INF-γ), and serum amyloid A (SAA) levels of the two groups were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 95.83%, which was significantly higher than that of the control group (83.33%) (P＜0.05). After treatment, the disappearance time of fever, cough, phlegm, shortness of breath, and lung moist rales in the treatment group was significantly shorter than that in the control group (P＜ 0.05). After treatment, respiratory rate (RR) and breathing-to-breath ratio (Ti/Te) were significantly decreased, while tidal volume (VT) was significantly increased in both groups (P＜0.05). After treatment, RR and Ti/Te in treatment group were lower than those in the control group, and VT was higher than those in the control group (P＜0.05). After treatment, SpO₂ was significantly increased, while FeNO level was significantly decreased in both groups (P＜0.05). After treatment, SpO2 in the treatment group was higher than that in the control group, and FeNO level was lower than that in the control group (P＜0.05). After treatment, serum ICAM-1, IL-17 and SAA levels were significantly decreased, while serum IFN-γ levels were significantly increased in both groups (P＜ 0.05). After treatment, the serum ICAM-1, IL-17 and SAA levels in treatment group were significantly lower than those in control group, and the serum IFN-γ levels were significantly higher than those in control group (P＜ 0.05). Conclusion Feilike Mixture combined with recombinant human interferon α1b has good clinical efficacy in treatment of acute bronchiolitis in children, can effectively promote the reduction of the main symptoms and signs and the improvement of lung ventilation function, and effectively control the inflammatory response of the body with good tolerance, which is worthy of clinical promotion and application.

R974

邯鄲市科技支撐計(jì)劃項(xiàng)目（22422083089ZC）