目的 探討肺力咳合劑聯(lián)合重組人干擾素α2b治療小兒呼吸道合胞病毒肺炎的臨床療效。方法 選取2020年7月—2023年7月中國醫(yī)科大學(xué)附屬盛京醫(yī)院收治的158例呼吸道合胞病毒肺炎患兒，隨機分為對照組和治療組，每組各79例。對照組霧化吸入重組人干擾素α2b注射液，10萬IU/kg以0.9%氯化鈉注射液稀釋至2 mL，吸入約15 min，1次/d，氧流量為6 L/min。在對照組治療基礎(chǔ)上，治療組口服肺力咳合劑，10 mL/次，3次/d。兩組患兒連續(xù)治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀體征消失時間、呼吸道合胞病毒轉(zhuǎn)陰時間、肺炎胸片吸收評價量表（PCRAES）評分，及呼吸頻率（RR）、吸呼時間比（Ti/Te）、呼氣峰流量（PTEF）、高遷移率族蛋白B1（HMGB1）、γ干擾素（IFN-γ）、嗜酸性粒細(xì)胞陽離子蛋白（ECP）和白細(xì)胞介素-6（IL-6）水平。結(jié)果 治療后，治療組總有效率（97.47%）明顯高于對照組（89.87%），兩組比較差異具有統(tǒng)計學(xué)意義（P＜0.05）。治療后，治療組患者各項癥狀體征消失時間和呼吸道合胞病毒轉(zhuǎn)陰時間均明顯短于對照組（P＜0.05）。治療后，兩組潮氣呼吸肺功能指標(biāo)RR、Ti/Te和PTEF較治療前明顯降低（P＜0.05），且治療組明顯低于對照組（P＜0.05）；治療后，兩組PCRAES評分和血清HMGB1、ECP、IL-6水平明顯低于同組治療前，而血清IFN-γ水平明顯升高（P＜0.05），且治療組這些指標(biāo)水平明顯好于對照組（P＜0.05）。結(jié)論 肺力咳合劑聯(lián)合重組人干擾素α2b治療小兒呼吸道合胞病毒肺炎安全性好，能有效加速呼吸道合胞病毒清除和癥狀體征控制，抑制炎癥反應(yīng)，促進(jìn)肺功能好轉(zhuǎn)。

Objective To explore the clinical effect of Feilike Mixture combined with recombinant human interferon α2b in treatment of pediatric respiratory syncytial virus pneumonia. Methods Children (158 cases) with pediatric respiratory syncytial virus pneumonia in Shengjing Hospital of China Medical University from July 2020 to July 2023 were randomly divided into control and treatment group, and each group had 79 cases. Children in the control group were nebulization inhalation administered with Recombinant Human Interferon α2b Injection for 15 min, 100 000 IU/kg diluted to 2 mL with 0.9% sodium chloride injection, once daily, oxygen flow rate was 6 L/min. Children in the treatment group were po administered with Feilike Mixture on the basis of the control group, 10 mL/time, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the disappearance time of symptoms and signs and respiratory syncytial virus conversion time, the PCRAES scores, and the levels of RR, Ti/Te, PTEF, HMGB1, IFN-γ, ECP and IL-6 in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group (97.47%) was significantly higher than that in the control group (89.87%), and the difference between the two groups was statistically significant (P < 0.05). After treatment, the disappearance time of symptoms and signs and the time of respiratory syncytial virus turning negative in the treatment group were significantly shorter than those in the control group (P < 0.05). After treatment, the tidal breathing pulmonary function indicators RR, Ti/Te and PTEF in two groups were significantly lower than before treatment (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the PCRAES score and serum HMGB1, ECP, and IL-6 levels in two groups were significantly lower than before treatment in the same group, while the serum IFN-γ levels increased significantly (P < 0.05), and the levels of these indicators in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Recombinant human interferon α2b combined with Feilike Mixture is safe in treatment of pediatric respiratory syncytial virus pneumonia. It can effectively accelerate the clearance of respiratory syncytial virus and control of symptoms and signs, inhibit inflammatory reactions, and promote the improvement of lung function.

R974;R985

中山市醫(yī)學(xué)科研項目(2020A020413)