目的 探討清熱散結片聯(lián)合左氧氟沙星滴耳液治療化膿性中耳炎的臨床效果。方法 選擇2017年7月—2019年5月在商丘市第一人民醫(yī)院治療的化膿性中耳炎患者149例，隨機分為對照組（75例）和治療組（74例）。對照組患者給予左氧氟沙星滴耳液，6～10滴/次，3次/d。滴耳后再耳浴約10 min。治療組在對照組基礎上口服清熱散結片，6片/次，3次/d。兩組患者均連續(xù)治療15 d。觀察兩組患者臨床療效，同時比較治療前后兩組患者血清白細胞介素-1β（IL-1β）、IL-8和腫瘤壞死因子-α（TNF-α）水平，以及聽力改善程度、癥狀改善時間和病原菌清除情況。結果 治療后，對照組和治療組臨床有效率分別為77.33%和93.24%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組患者IL-1β、IL-8和TNF-α水平顯著降低（P<0.05），且治療組患者明顯比對照組低（P<0.05）。治療后，治療組聽力改善程度、癥狀改善時間和病原菌清除情況明顯優(yōu)于對照組（P<0.05）。結論 清熱散結片聯(lián)合左氧氟沙星滴耳液治療化膿性中耳炎，可顯著改善患者臨床癥狀、血清炎性因子，提高病原菌有效清除率，臨床療效較好，安全可靠。

Objective To investigate the clinical effect of Qingre Sanjie Tablets combined with Levofloxacin Hydrochloride Ear Drops in treatment of suppurative otitis media. Methods Patients (149 cases) with suppurative otitis media in Shangqiu First People's Hospital from July 2017 to May 2019 were randomly divided into control (75 cases) and treatment (74 cases) groups. Patients in the control group were administered with Levofloxacin Hydrochloride Ear Drops, 6 — 10 drops/time, three times daily, and then ear bath for about 10 min after ear dropping. Patients in the treatment group were po administered with Qingre Sanjie Tablets on the basis of the control group, 6 tablets/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical efficacy was evaluated, and the serum level of IL-1β, IL-8 and TNF-α, and hearing improvement, symptom improvement time and pathogen clearance in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups was 77.33% and 93.24% respectively, and there were differences between two groups (P<0.05). After treatment, the serum level of IL-1β, IL-8 and TNF-α in two groups was significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the hearing improvement, symptom improvement time and pathogen clearance in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Qingre Sanjie Tablets combined with Levofloxacin Hydrochloride Ear Drops in treatment of suppurative otitis media can significantly improve the clinical symptoms, serum inflammatory factors, and enhance pathogen clearance, which has good clinical efficacy, safety and reliability.

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