目的 探討小兒荊杏止咳顆粒聯(lián)合乙酰半胱氨酸治療小兒急性支氣管炎的臨床療效。方法 回顧性選取2023年3月—2024年3月在河南省兒童醫(yī)院治療的急性支氣管炎患兒93例，按照用藥方案的差異分成對(duì)照組（46例）和治療組（47例）。對(duì)照組給予吸入用乙酰半胱氨酸溶液霧化治療，3 mL/次，2次/d；治療組在對(duì)照組基礎(chǔ)上口服小兒荊杏止咳顆粒，3～5歲患兒半袋/次，6～12歲患兒1袋/次，3次/d。兩組患兒均進(jìn)行為期7 d的治療。觀察兩組患兒臨床療效，比較治療前后兩組患兒臨床癥狀消失時(shí)間，急性呼吸道疾病和流感量表（CARIFs）評(píng)分和萊賽斯特生活質(zhì)量問卷（LCQ）評(píng)分，血清幾丁質(zhì)酶3樣蛋白1(YKL-40)、半胱氨酰白三烯（CysLTs）和鱗狀上皮細(xì)胞癌抗原（SCCA）水平。結(jié)果 經(jīng)治療，對(duì)照組和治療組患兒總有效率分別為82.61%和95.74%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。經(jīng)治療，治療組發(fā)熱、咳嗽、肺部濕啰音消失時(shí)間均明顯短于對(duì)照組（P<0.05）。經(jīng)治療，兩組患兒CARIFs評(píng)分較治療前顯著降低，而LCQ評(píng)分顯著升高（P<0.05），且治療組評(píng)分較對(duì)照組改善更顯著（P<0.05）。經(jīng)治療，兩組患兒血清YKL-40、CysLTs和SCCA水平較治療前明顯降低（P<0.05），且治療組血清指標(biāo)較對(duì)照組下降更顯著（P<0.05）。結(jié)論 小兒荊杏止咳顆粒聯(lián)合乙酰半胱氨酸治療小兒急性支氣管炎療效顯著，不僅能夠顯著縮短患兒臨床癥狀消失時(shí)間，同時(shí)還能夠改善患兒生存質(zhì)量并促進(jìn)血清學(xué)指標(biāo)的恢復(fù)。

Objective Exploring the clinical efficacy of Jingxing Zhike Granules combined with acetylcysteine in treatment of acute bronchitis in children. Methods The clinical data of children（93 cases） with acute bronchitis in Henan Children's Hospital from March 2023 to March 2024 were analyzed retrospectively. They were divided into control（46 cases） and treatment（47 cases） group based on different treatments. Children in the control group were administered with Acetylcysteine Solution for inhalation, 3 m L/time, twice daily. Children in the treatment group were po administered with Xiaoer Jingxing Zhike Granules, 0.5 bag/time for 3 — 5 years old children, 1 bag/time for 6 — 12 years old children, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the symptom disappearance time, CARIFs and LCQ scores, and the serum D-D, ICAM-1, TNF-α and IL-6 levels in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates of children in the control group and the treatment group were 82.61% and 95.74%, respectively, and the difference between the two groups was statistically significant（P＜0.05）. After treatment, the disappearance time of fever, cough and lung moist rales in treatment group was significantly shorter than that in control group（P＜0.05）. After treatment, the CARIFs scores of children in two groups were significantly lower than before treatment, while the LCQ scores were significantly higher（P＜0.05）, and the scores in the treatment group were improved more significantly than those in the control group（P＜0.05）. After treatment, the serum levels of YKL-40, CysLTs and SCCA in two groups were significantly lower than before treatment（P＜0.05）, and the serum indicators in the treatment group were decreased more significantly than that in the control group（P＜0.05）. Conclusion The combination of Xiaoer Jingxing Zhike Granules and acetylcysteine has significant therapeutic effects on acute bronchitis in children. It can not only significantly shorten the time for clinical symptoms to disappear in children, but also improve their quality of life and promote the repair of serological indicators.

R974

河南省衛(wèi)生健康項(xiàng)目(LHCJ20230563)