目的 探討痰熱清注射液霧化吸入聯(lián)合孟魯司特鈉治療小兒肺炎的臨床療效。方法 回顧性選取2020年11月—2021年11月淮南朝陽醫(yī)院收治的72例小兒肺炎患者，根據(jù)治療方案不同，分為對照組和試驗組，每組36例。對照組采用常規(guī)西醫(yī)對癥治療，如平喘止咳、祛痰等，抗病毒藥物采用利巴韋林含片，按照患兒體質(zhì)量每次劑量為0.01 g·kg^-1，每天3次，同時口服孟魯司特鈉，每次5 mg，每天1次。試驗組在對照組基礎(chǔ)上加用痰熱清注射液，每次取痰熱清注射液2 mL加入0.9%氯化鈉注射液2 mL霧化吸入，每天2次。兩組患兒均治療1周。比較兩組患兒臨床療效、體溫恢復時間、咳嗽消失時間和肺部啰音消失時間；檢測兩組患兒治療前后淋巴細胞亞群（CD4⁺/CD8⁺）水平及血清白細胞介素-6（IL-6）及腫瘤壞死因子-α（TNF-α）水平。觀察兩組患兒治療過程中的不良反應(yīng)發(fā)生情況。結(jié)果 試驗組治療總有效率為97.22%，顯著高于對照組的91.67%（P<0.05）；試驗組顯效率為69.44%，也顯著高于對照組的44.44%（P<0.01）；試驗組患兒體溫恢復時間、咳嗽消失時間和肺部啰音消失時間均顯著短于對照組（P<0.05、0.01）。治療前，兩組患兒淋巴細胞亞群CD4⁺/CD8⁺及炎癥因子IL-6和TNF-α水平比較，差異無統(tǒng)計學意義（P>0.05）；治療后兩組患兒IL-6和TNF-α水平均顯著低于治療前（P<0.01）；淋巴細胞亞群CD4⁺/CD8⁺水平顯著高于治療前（P<0.01）。治療后，試驗組IL-6和TNF-α水平顯著低于對照組（P<0.05、0.01），淋巴細胞亞群CD4⁺/CD8⁺水平顯著高于對照組（P<0.01）。兩組患兒治療過程中發(fā)生的不良反應(yīng)有嘔吐、惡心和皮疹，兩組不良反應(yīng)總發(fā)生率相同，差異不顯著。結(jié)論 痰熱清注射液霧化吸入聯(lián)合孟魯司特鈉能有效治療小兒肺炎，效果優(yōu)于常規(guī)西醫(yī)治療，且不增加不良反應(yīng)，值得臨床推廣。

Objective To investigate the clinical efficacy of nebulized inhalation of Tanreqing Injection combined with montelukast sodium in treatment of children with pneumonia. Methods A total of 72 children with pneumonia admitted to Huainan Chaoyang Hospital from November 2020 to November 2021 were retrospectively selected. According to different treatment schemes, they were divided into control group and experimental group, with 36 cases in each group. Children in the control group were treated with conventional symptomatic western medicine, such as asthma relieving, cough relieving, expectorant, etc. The antiviral drugs were treated with Ribavirin Buccal Tablets, with a dose of 0.01 g·kg^-1 for each time, three times a day according to the body weight of the children, and at the same time, montelukast sodium were administrated orally, 5 mg each time, once a day. Children in The experimental group were added with Tanreqing Injection on the basis of the control group. Tanreqing Injection of 2 mL was added with 2 mL of 0.9% Sodium Chloride Injection for nebulized inhalation two times once day. Both groups were treated for one week. The clinical efficacy, body temperature recovery time, cough disappearance time and lung rale disappearance time were compared between the two groups. The levels of lymphocyte subsets (CD4⁺/CD8⁺), serum interleukin-6 (IL-6) and tumor necrosis factor- α (TNF- α) were measured before and after treatment. The adverse reactions of the two groups were observed. Results The total effective rate of the experimental group was 97.22%, which was significantly higher than that of the control group (91.67%, P<0.05). The effective rate of the experimental group was 69.44%, which was also significantly higher than that of the control group (44.44%, P<0.01). The recovery time of body temperature, the disappearance time of cough and the disappearance time of pulmonary rales in the experimental group were significantly shorter than those in the control group (P<0.05, 0.01). Before treatment, there were no significant difference between the two groups on lymphocyte subsets CD4⁺/CD8⁺ and inflammatory factors IL-6 and TNF-α (P > 0.05). After treatment, the levels of IL-6 and TNF-α in the two groups were significantly lower than those before treatment of two groups (P<0.01), and CD4⁺/CD8⁺ level of lymphocyte subsets were significantly higher than that before treatment of two groups (P<0.01). After treatment, the levels of IL-6 and TNF-α in the experimental group were significantly lower than those in the control group, and the level of CD4⁺/CD8⁺ level of lymphocyte subsets was significantly higher than that in the control group (P<0.01). The adverse reactions of the two groups during treatment included vomiting, nausea and rash. The total incidence of adverse reactions in the two groups was the same, and the difference was not significant. Conclusion The nebulized inhalation of Tanreqing Injection combined with montelukast sodium can effectively treat pediatric pneumonia. The effect is better than that of conventional western medicine, and does not increase adverse reactions. It is worthy of clinical promotion.

R974