目的 觀察杏貝止咳顆粒聯(lián)合甲潑尼龍治療小兒重癥支原體肺炎的臨床療效。方法 選取2018年12月—2023年8月在合肥市第二人民醫(yī)院治療的重癥支原體肺炎患兒共90例，按照隨機(jī)數(shù)字表法分成對(duì)照組和治療組，每組各45例。對(duì)照組靜脈滴注注射用甲潑尼龍琥珀酸鈉，第1、2天劑量是1.5 mg/kg，1次/d；第3天劑量改成1 mg/kg，之后1周內(nèi)根據(jù)患兒病情逐漸降低劑量。治療組在對(duì)照組基礎(chǔ)上口服杏貝止咳顆粒，1袋/次，3次/d。兩組患兒均治療10 d。觀察兩組患兒臨床療效，比較治療前后兩組患兒癥狀改善時(shí)間，肺功能指標(biāo)用力肺活量（FVC）、1秒用力呼氣容積（FEV₁）、呼氣峰流速（PEF），血清T細(xì)胞亞群CD4^＋、CD8^＋、白細(xì)胞介素-6（IL-6）和IL-1β水平。結(jié)果 治療后，與對(duì)照組總有效率（77.78%）比較，治療組總有效率（95.56%）顯著升高（P＜0.05）。治療后，與對(duì)照組對(duì)比，治療組患兒肺部濕啰音和喘息消失時(shí)間以及咳嗽緩解時(shí)間均顯著縮短（P＜0.05）。治療后，兩組重癥支原體肺炎患兒FVC、FEV₁、PEF顯著增加（P＜0.05），且治療組以上指標(biāo)增加更加顯著（P＜0.05）。治療后，兩組CD4^＋水平明顯增加，而CD8^＋水平顯著降低（P＜0.05），且治療組以上指標(biāo)改善更加顯著（P＜0.05）。治療后，兩組患兒血清IL-6和IL-1β水平顯著降低（P＜0.05），且治療組降低更顯著（P＜0.05）。結(jié)論 杏貝止咳顆粒聯(lián)合甲潑尼龍治療小兒重癥支原體肺炎的療效顯著，能顯著縮短癥狀體征的改善時(shí)間，改善患兒的肺功能和免疫紊亂，減輕炎癥反應(yīng)。

Objective To investigate the efficacy of Xingbei Zhike Grains combined with methylprednisolone in treatment of severe mycoplasma pneumonia in children. Methods A total of 90 children with severe mycoplasma pneumonia treated in Hefei Second People's Hospital from December 2018 to August 2023 were selected and divided into control group and treatment group according to random number table method, with 45 cases in each group. Children in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 1.5 mg/kg for the first and second day, once daily, the dose was adjusted to 1 mg/kg from the third day. After that, the dose gradually decreased according to the children’s condition within one week. Children in the treatment group were po administered with Xingbei Zhike Grains on the basis of the control group, 1 bag/time, three times daily. Children in two groups were treated for 10 d. After treatment, the clinical evaluations were evaluated, the symptom relief time, lung function indexes FVC, FEV₁, PEF, levels of T-lymphocyte subsets CD4⁺ and CD8⁺, serum levels of IL-6 and IL-1β in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (95.56%) was significantly higher than that of the control group (77.78%, P < 0.05). After treatment, compared with the control group, the disappearance time of lung wet rale and wheezing and the relief time of cough in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, FVC, FEV₁ and PEF in children with severe mycoplasma pneumonia were significantly increased in two groups, and the above indexes increased more significantly in the treatment group (P < 0.05). After treatment, the level of CD4⁺ was significantly increased, while the levels of CD8⁺, IL-6 and IL-1β were significantly decreased in two groups (P< 0.05), and the above indexes were improved more significantly in the treatment group (P < 0.05). Conclusion Xingbei Zhike Granules combined with methylprednisolone is effective in the treatment of severe mycoplasma pneumonia in children, which can significantly shorten the improvement time of symptoms and signs, improve pulmonary function and immune disorder, and reduce inflammatory reaction.

R974

安徽省衛(wèi)生健康委科研立項(xiàng)項(xiàng)目（AHWJ2021b102）