目的 探究復方福爾可定聯(lián)合多西環(huán)素治療大環(huán)內(nèi)酯類耐藥支原體肺炎的臨床效果。方法 選取2022年4月—2024年4月在無為市人民醫(yī)院治療的大環(huán)內(nèi)酯類耐藥的支原體肺炎患兒82例，根據(jù)患兒治療方案差異分成對照組（41例）和治療組（41例）。對照組患兒口服鹽酸多西環(huán)素片，體質(zhì)量≤45 kg兒童每12 h取本品2.2 mg/kg口服，體質(zhì)量＞45 kg兒童每12 h取本品100 mg口服。治療組在對照組基礎(chǔ)上口服復方福爾可定口服溶液，10 mL/次，3次/d。兩組患兒連續(xù)治療7 d。觀察兩組患兒臨床療效，比較治療前后兩組患兒臨床主要癥狀消失時間，中醫(yī)證候評分和小兒病情危重程度（PCIS）評分，及血清乳酸脫氫酶（LDH）、C-反應蛋白（CRP）和D-二聚體（D-D）水平。結(jié)果 治療后，對照組和治療組總有效率分別為80.49%和95.12%，兩組比較差異具有統(tǒng)計學意義（P＜0.05）。治療后，治療組患兒發(fā)熱、咳嗽、喘息以及肺部啰音消失時間均要明顯短于對照組（P＜0.05）。治療后，兩組患兒中醫(yī)證候評分均顯著下降，而PCIS評分均明顯升高（P＜0.05），且治療組評分顯著優(yōu)于對照組（P＜0.05）。治療后，兩組患者血清LDH、CRP和D-D水平均顯著降低（P＜0.05），且治療組各指標顯著低于對照組（P＜0.05）。結(jié)論 復方福爾可定聯(lián)合多西環(huán)素對大環(huán)內(nèi)酯類耐藥支原體肺炎患兒治療效果顯著，不僅能夠顯著改善患兒臨床癥狀消失時間和中醫(yī)證候評分，同時還能夠促進血清學指標的恢復。

Objective Exploring the therapeutic effect of compound pholcodine combined with doxycycline in treatment of macrolide-resistant Mycoplasma pneumonia. Methods Children (82 cases) with macrolide-resistant Mycoplasma pneumonia in Wuwei People’s Hospital from April 2022 to April 2024 were divided into control (41 cases) and treatment (41 cases) group based on different treatments. Children in the control group were po administered with Doxycycline Hyclate Tablets, children weighing ≤ 45 kg taken 2.2 mg/kg every 12 h, and children weighing > 45 kg taken 100 mg every 12 h. Children in the treatment group were po administered with Compound Pholcodine Oral Solution on the basis of the control group, 10 mL/time, three times daily. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, the disappearance time of clinical main symptoms, the scores of TCM syndrome and PCIS, the serum LDH, CRP, and D-D levels 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 80.49% and 95.12%, respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the disappearance time of fever, cough, wheezing, and pulmonary rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the TCM syndrome scores of children in two groups were significantly decreased, while the PCIS scores were significantly increased (P < 0.05), and the scores in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the serum LDH, CRP, and D-D levels of patients in two groups were significantly reduced (P < 0.05), and all indicators in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion The combination of compound forcodeine and doxycycline has a significant therapeutic effect on children with macrolide resistant Mycoplasma pneumoniae. It can not only significantly improve the disappearance time of clinical symptoms and traditional Chinese medicine syndrome scores, but also promote the recovery of serological indicators.

R974

安徽省自然科學基金資助項目(2008085QH429)