目的 探究連花清瘟顆粒聯(lián)合乳糖酸紅霉素治療兒童肺炎支原體大葉性肺炎的臨床療效。方法 選取2022年1月—2023月1月在皖西衛(wèi)生職業(yè)學院附屬醫(yī)院治療的肺炎支原體大葉性肺炎兒童90例，根據(jù)患兒治療方案之間的差異將其分成對照組（45例）和治療組（45例）。對照組靜脈滴注注射用乳糖酸紅霉素，按照30 mg/kg計算用量，每次采用250 mL生理鹽水溶解，1次/d；治療組患兒在對照組用藥基礎上口服連花清瘟顆粒，6 g/次，3次/d。兩組患兒均進行為期10 d的治療。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀消失時間，中醫(yī)證候評分和肺部影像學積分，及血清可溶性Toll樣受體4（sTLR4）、白細胞介素-17（IL-17）和D-二聚體（D-D）水平。結果 治療后，對照組和治療組總有效率分別為84.44%和95.56%（P＜0.05）。治療后，治療組患兒發(fā)熱、咳嗽、肌肉酸痛以及肺部濕啰音好轉時間均要明顯短于對照組（P＜0.05）。治療后，兩組患兒中醫(yī)證候評分和肺部影像學積分均顯著降低（P＜0.05），且治療組各評分明顯低于對照組（P＜0.05）。治療后，兩組患兒血清sTLR4、IL-17及D-D水平均顯著降低（P＜0.05），且治療組明顯低于對照組（P＜0.05）。結論 連花清瘟顆粒聯(lián)合乳糖酸紅霉素治療兒童肺炎支原體大葉性肺炎療效顯著，不僅能夠顯著改善患兒臨床癥狀并加快炎癥病變組織吸收，同時還能夠促進血清學指標的恢復且未增加不良反應。

Objective To explore the therapeutic effect of Lianhua Qingwen Granules combined with erythromycin lactobionate in treatment of mycoplasma pneumonia in children. Methods Children (90 cases) with mycoplasma pneumonia in West Anhui Health Vocational College from January 2022 to January 2023 were divided into control (45 cases) and treatment (45 cases) group based on different treatments. Children in the control group were iv administered with Erythromycin Lactobionate for injection, 30 mg/kg added into normal saline 250 mL, once daily. Children in the treatment group were po administered with Lianhua Qingwen Granules on the basis of the control group, 6 g/time, three times daily. Children in two groups were treated for 10 d. After treatment, the clinical evaluations were evaluated, the disappearance time of clinical symptoms, the scores of TCM syndrome and pulmonary imaging, the levels of serum sTLR4, IL-17 and D-D in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 84.44% and 95.56% respectively (P < 0.05). After treatment, the improvement time for fever, cough, muscle soreness and moist lung rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the TCM syndrome scores and lung imaging scores of children in two groups were significantly reduced (P < 0.05), and the scores in the treatment group were significantly lower than those in the control group (P < 0.05). After treatment, the serum sTLR4, IL-17 and D-D levels of children in two groups were significantly reduced (P < 0.05), and which were significantly lower in the treatment group than those in the control group (P < 0.05). Conclusion The combination of Lianhua Qingwen Granules and Erythromycin Lactobionate for injection has a significant therapeutic effect on the treatment of Mycoplasma pneumoniae lobar pneumonia in children. It can not only significantly improve the clinical symptoms of children and accelerate the absorption of inflammatory lesions, but also promote the recovery of serological indicators without increasing adverse reactions.

R974

安徽省衛(wèi)生健康委科研項目(AHWJ2021b119)