目的 探討小兒清熱利肺口服液聯(lián)合頭孢曲松鈉治療小兒急性支氣管炎的臨床效果。方法 選取2019年1月-2020年12月天津市靜海區(qū)醫(yī)院收治的154例急性支氣管炎患兒為研究對(duì)象，采取隨機(jī)數(shù)字表法將其隨機(jī)分成治療組（n=77）與對(duì)照組（n=77）。對(duì)照組靜脈滴注注射用頭孢曲松鈉，每次將50 mg/kg（最大劑量為2 g）加入5%葡萄糖注射液50 mL中均勻混合后給藥，0.5~1 h滴完，1次/d。治療組在對(duì)照組基礎(chǔ)上口服小兒清熱利肺口服液，1~2歲給予5 mL/次、3~5歲給予10 mL/次、6~12歲給予15 mL/次，3次/d。所有患兒均連續(xù)治療7 d。觀察兩組的臨床療效，比較兩組呼吸道癥狀改善情況及退熱效果，并比較治療前后血清腫瘤壞死因子（TNF）-α、白細(xì)胞介素（IL）-17和C反應(yīng)蛋白（CRP）水平。結(jié)果 治療后，治療組總有效率為96.1%，較對(duì)照組83.1%顯著提高（P<0.05）。治療組咳嗽、咳痰消失率分別為64.9%、57.1%，均顯著高于對(duì)照組48.1%、40.3%（P<0.05）。治療后，兩組日間、夜間咳嗽癥狀積分及其總積分均顯著降低（P<0.05）；且治療后，治療組咳嗽癥狀積分低于對(duì)照組（P<0.05）。治療后，治療組患兒退熱起效時(shí)間和體溫復(fù)常時(shí)間較對(duì)照組均顯著縮短（P<0.05）。治療后，兩組血清TNF-α、IL-17及CRP水平均較治療前顯著下降（P<0.05）；且治療后，治療組血清學(xué)指標(biāo)低于對(duì)照組（P<0.05）。結(jié)論 小兒清熱利肺口服液聯(lián)合頭孢曲松鈉對(duì)急性支氣管炎患兒具有確切的臨床療效，可安全有效地減輕患兒癥狀，且退熱效果顯著，并能顯著抑制患兒體內(nèi)炎癥反應(yīng)，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Xiaoer Qingre Lifei Oral Liquid combined with ceftriaxone sodium in treatment of acute bronchitis in children. Methods A total of 154 children with acute bronchitis admitted to Jinghai Hospital of Tianjin from January 2019 to December 2020 were selected as the study subjects, and they were randomly divided into treatment group (n=77) and control group (n=77) by random number table method. Children in the control group were iv administered with Ceftriaxone Sodium for injection, 50 mg/kg (maximum dosage 2 g) was added into 5% glucose injection 50 mL each time, and then evenly mixed. The infusion was finished 0.5-1 h, once daily. Children in the treatment group were po administered with Xiaoer Qingre Lifei Oral Liquid on the basis of the control group, 5 mL/time for 1-2 years old, 10 mL/time for 3-5 years old, 15 mL/time for 6-12 years old, three times daily. All patients were treated for 7 d. The clinical efficacy of the two groups were observed, the improvement of respiratory symptoms and antipyretic effect of the two groups were compared, and the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-17 and C-reactive protein (CRP) before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.1%, significantly higher than that of the control group (83.1%) (P<0.05). The disappearance rates of cough and sputum in the treatment group were 64.9% and 57.1%, respectively, which were significantly higher than those in the control group (48.1% vs. 40.3%, P<0.05). After treatment, daytime and night cough symptom scores and their total scores were significantly decreased in two groups (P<0.05). After treatment, cough symptom score in treatment group was lower than that in control group (P<0.05). After treatment, the onset time of antipyretic and temperature recovery time in the treatment group were significantly shorter than those in the control group (P<0.05). After treatment, the levels of TNF-α, IL-17 and CRP in two groups were significantly decreased compared with before treatment (P<0.05). After treatment, the serum index of the treatment group was lower than that of the control group (P<0.05). Conclusion Xiaoer Qingre Lifei Oral Liquid combined with ceftriaxone sodium has satisfactory overall curative effect in treatment of acute bronchitis in children, can safely and effectively reduce the symptoms of children with a significant antipyretic effect, and can significantly inhibit the inflammatory response in children, which is worthy of clinical application.

R974

天津市衛(wèi)計(jì)委科研項(xiàng)目（2017KZ044）