目的 探討冬菀止咳顆粒聯(lián)合頭孢克洛治療小兒急性支氣管炎的臨床療效。方法 選取2018年5月—2020年5月在鄭州市金水區(qū)總醫(yī)院就診的急性支氣管炎患兒98例，根據(jù)用藥的差別分為對照組（49例）和治療組（49例）。對照組口服頭孢克洛片，6.67 mg/kg，3次/d，嚴重者可增至13.33 mg/kg，但不得超過1 g/d；治療組在對照組的基礎(chǔ)上口服冬菀止咳顆粒，5 g/次，3次/d。兩組患者均經(jīng)7 d治療。觀察兩組患者臨床療效，同時比較治療前后兩組患者中醫(yī)癥候積分及血清超敏C反應(yīng)蛋白（hs-CRP）、腫瘤壞死因子-α（TNF-α）、白細胞介素-1β（IL-1β）、白細胞介素-10（IL-10）、γ干擾素（IFN-γ）和淀粉樣蛋白A（SAA）水平。結(jié)果 治療后，對照組患兒臨床有效率為81.63%，顯著低于治療組的97.96%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患兒中醫(yī)癥候積分顯著下降（P<0.05），且治療組明顯低于對照組（P<0.05）。治療后，兩組患兒血清hs-CRP、SAA、IL-1β、TNF-α水平均明顯下降，而IL-10和IFN-γ水平均明顯升高（P<0.05），且治療組患兒這些血清學(xué)指標顯著優(yōu)于對照組（P<0.05）。結(jié)論 冬菀止咳顆粒聯(lián)合頭孢克洛片可明顯改善小兒急性支氣管炎臨床癥狀，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Dongwan Zhike Granules combined with cefaclor in treatment of children with acute bronchitis. Methods Children (98 cases) with acute bronchitis in Zhengzhou Jinshui District General Hospital from May 2018 to May 2020 were divided into control (49 cases) and treatment (49 cases) groups according to different treatments. Children in the control group were po administered with Cefaclor Tablets, 6.67 mg/kg, three times daily, the dose can be increased to 13.33 mg/kg for the serious cases, but less than 1 g/d. Children in the treatment group were po administered with Dongwan Zhike Granules on the basis of the control group, 5 g/time, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the TCM symptom score, and the serum level of hs-CRP, SAA, IL-1β, TNF-α, IL-10 and IFN-γ in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.63%, which was significantly lower than 97.96% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the TCM symptom score in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, the serum levels of hs-CRP, SAA, IL-1β, and TNF-α in two groups were significantly decreased, but the levels of IL-10 and IFN-γ were significantly increased (P<0.05), and these indexes levels in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Dongwan Zhike Granules combined with cefaclor can significantly improve the clinical symptoms of children with acute bronchitis, which has a certain clinical application value.

R974

河南省醫(yī)學(xué)科技攻關(guān)計劃項目（201403258）