目的 探討清宣止咳顆粒聯(lián)合注射用甲潑尼龍琥珀酸鈉治療兒童難治性支原體肺炎的效果。方法 選擇2022年11月—2023年9月在天津市人民醫(yī)院就診的92例難治性支原體肺炎兒童按照計算機隨機排列法分為對照組和治療組，各組包括46例。對照組靜脈滴注注射用甲潑尼龍琥珀酸鈉，每日劑量2 mg/kg，治療組在對照組基礎上溫水沖服清宣止咳顆粒，4～6歲3/4袋/次，7歲及以上1袋/次，3次/d。兩組兒童持續(xù)治療7 d。比較兩組的治療效果、癥狀消失時間、肺功能、肺部癥狀和血清指標。結果 治療后，對照組的總有效率為80.43%，治療組的總有效率為95.65%，組間差異顯著（P＜0.05）。治療后，治療組患兒發(fā)熱、咳嗽、痰鳴音、喘息消失時間比對照組短（P＜0.05）。治療后，兩組的潮氣量、達峰時間比、用力肺活量均顯著升高（P＜0.05）；治療后，治療組的潮氣量、達峰時間比、用力肺活量均高于對照組（P＜0.05）。治療后，兩組的肺部超聲評分（LUS）比治療前?。?i>P＜0.05），且治療組LUS評分比對照組更?。?i>P＜0.05）。治療后，兩組的血清C-反應蛋白（CRP）、白細胞介素-25（IL-25）、T細胞免疫球蛋白黏蛋白分子3（TIM-3）、D-二聚體水平低于治療前（P＜0.05）；治療后，治療組的血清CRP、IL-25、TIM-3、D-二聚體低于對照組（P＜0.05）。結論 清宣止咳顆粒聯(lián)合注射用甲潑尼龍琥珀酸鈉可提高兒童難治性支原體肺炎的臨床療效，提高肺功能，降低臨床癥狀、肺部癥狀和炎癥程度。

Objective To explore the clinical efficacy of Qingxuan Zhike Granules combined with Methylprednisolone Sodium Succinate for injection in treatment of refractory mycoplasma pneumonia in children. Methods Children (92 cases) with refractory mycoplasma pneumonia in Tianjin Union Medical Center from November 2022 to September 2023 were divided into control and treatment groups according to the computer random arrangement method, and each group had 46 cases. Children in the control group were iv administered with Methylprednisolone Sodium Succinate for injection, 2 mg/kg daily. Children in the treatment group were po administered with Qingxuan Zhike Granules on the basis of the control group, 3/4 bag each time for 4 - 6 years old, 1 bag each time for 7 years old and above, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical efficacies, symptom disappearance time, lung function, lung symptoms, and serum indicators in two groups were compared. Results After treatment, the total effective rate of the control group was 80.43%, and the total effective rate of the treatment group was 95.65%, with significant differences between the groups (P < 0.05). After treatment, the disappearance times of fever, cough, sputum sounds, and wheezing in the treatment group was shorter than that in the control group (P< 0.05). After treatment, the tidal volume, peak time ratio, and forced lung capacity of two groups were significantly increased (P < 0.05), and the tidal volume, peak time ratio, and forced lung capacity of the treatment group were higher than those of the control group (P < 0.05). After treatment, LUS score of two groups was smaller than that before treatment (P< 0.05), and LUS score of the treatment group was smaller than that of the control group (P < 0.05). After treatment, the serum levels of CRP, IL-25, TIM-3, and D-dimer in two groups were lower than those before treatment (P < 0.05), and the serum levels of CRP, IL-25, TIM-3, and D-dimer in the treatment group were lower than those in the control group (P < 0.05).Conclusion Qingxuan Zhike Granules combined with Methylprednisolone Sodium Succinate for injection can improve the efficacy of pediatric refractory mycoplasma pneumonia in children, improve lung function, and reduce clinical symptoms, lung symptoms, and inflammation.

R974