目的 探討抗感顆粒聯(lián)合更昔洛韋治療兒童病毒性肺炎的臨床療效。方法 選取2018年6月—2021年6月阜陽(yáng)市婦女兒童醫(yī)院收治的60例病毒性肺炎患兒，按照隨機(jī)數(shù)字表法分成對(duì)照組和治療組，每組各30例。對(duì)照組靜脈滴注更昔洛韋注射液，5 mg/kg加入注射用水，調(diào)整濃度為50 mg/mL，再加入至5%葡萄糖注射液100 mL，1次/12 h。治療組在對(duì)照組基礎(chǔ)上口服抗感顆粒，1～5歲，0.5袋/次；6～9歲，1袋/次；10～14歲，1.5袋/次，3次/d。兩組患兒連續(xù)治療14 d。觀察兩組患兒臨床療效，比較治療前后兩組患兒典型表現(xiàn)消失時(shí)間，潮氣呼吸肺功能參數(shù)，肺炎胸片吸收評(píng)價(jià)量表評(píng)分，外周血T淋巴細(xì)胞亞群水平，血清可溶性細(xì)胞間黏附分子-1（sICAM-1）、白細(xì)胞介素-8（IL-8）和甲殼質(zhì)酶蛋白-40（YKL-40）水平。結(jié)果 治療后，治療組總有效率（96.67%）較對(duì)照組（73.33%）顯著升高（P＜0.05）。治療后，治療組各項(xiàng)典型表現(xiàn)消失時(shí)間較對(duì)照組顯著縮短（P＜0.05）。治療后，兩組單位體質(zhì)量潮氣量（VT/kg）、達(dá)峰時(shí)間比（TPTEF/TE）和吸氣時(shí)間與呼氣時(shí)間比值（Ti/Te）顯著升高，而肺炎胸片吸收評(píng)價(jià)量表評(píng)分顯著降低（P＜0.05），且治療組比對(duì)照組改善更顯著（P＜0.05）。治療后，兩組患者外周血CD3⁺、CD4⁺水平及CD4⁺/CD8⁺均顯著高于治療前（P＜0.05），且治療組比對(duì)照組升高更顯著（P＜0.05）。治療后，兩組血清sICAM-1、IL-8和YKL-40水平均顯著低于治療前（P＜0.05），且治療組比對(duì)照組降低更顯著（P＜0.05）。結(jié)論 抗感顆粒聯(lián)合更昔洛韋治療患兒病毒性肺炎具有確切的臨床療效，是盡快緩解患兒臨床表現(xiàn)、改善肺功能及穩(wěn)定病情的安全有效途徑，并能進(jìn)一步進(jìn)增強(qiáng)免疫功能和減輕炎癥反應(yīng)。

Objective To investigate the clinical efficacy of Kanggan Granules combined with ganciclovir in treatment of viral pneumonia in children. Methods Children (60 cases) with viral pneumonia in Fuyang Women and Children’s Hospital from June 2018 to June 2021 were divided into control and treatment group by the random number table method, and each had 30 cases. Children in the control group was iv administered with Ganciclovir Injection, 5 mg/kg added into injection water, adjusted the concentration to 50 mg/mL, then added into 5% glucose injection 100 mL, twice daily. Children in the treatment group were po administered with Kanggan Granules on the basis of the control group, 0.5 bag/time for 1 to 5 years old children, 1 bag/time for 6 to 9 years old, 1.5 bag/time for 10 to 14 years old, three times daily. Children in two groups were treated for 14 d. After treatment, the clinical evaluation was evaluated, and the typical manifestations disappearance time, tidal respiration lung function, pneumonia chest radiograph absorption assessment scale scores, T lymphocyte subsets in peripheral blood, serum sICAM-1, IL-8, and YKL-40 levels in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group (96.67%) was significantly higher than that of the control group (73.33%) (P < 0.05). After treatment, the disappearance time of typical manifestations in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, VT/kg, TPTEF/TE and Ti/Te in two groups were significantly increased, while the scores of pneumonia chest X-ray absorption evaluation scale was significantly decreased (P < 0.05), and the improvement in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the levels of CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in peripheral blood of the two groups were significantly higher than those before treatment (P < 0.05), and the level in the treatment group was significantly higher than that in the control group (P < 0.05). After treatment, the levels of serum sICAM-1, IL-8, and YKL-40 in two groups were significantly lower than those before treatment (P < 0.05), and the decrease in the treatment group was more significant than that in the control group (P < 0.05). Conclusion Kanggan Granules combined with ganciclovir in treatment of viral pneumonia in children has definite clinical effect, and it is a safe and effective way to alleviate the clinical manifestation, improve pulmonary function and stabilize the condition as soon as possible, and can further enhance the immune function and reduce the inflammatory reaction.

R975;R985

安徽省教育廳省級(jí)質(zhì)量工程重點(diǎn)項(xiàng)目（2019xqsxzx98）