目的 探討藍(lán)芩口服液聯(lián)合克拉霉素治療兒童肺炎支原體肺炎的臨床療效。方法 選取2023年8月—2024年6月復(fù)旦大學(xué)附屬華山醫(yī)院靜安分院收治的肺炎支原體肺炎患兒112例，按隨機(jī)數(shù)字表法將患者分為對照組和治療組，每組各56例。對照組患者口服克拉霉素干混懸劑，0.3 mL/kg（最大10 mL/次），2次/d。在對照組基礎(chǔ)上，治療組口服藍(lán)芩口服液，3次/d，1～3歲者每次1/3支，4～6歲者每次1/2支，7～14歲者每次1支。兩組患兒治療7 d。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)證候積分，潮氣呼吸肺功能指標(biāo)吸呼時(shí)間比（Ti/Te）、呼出75%潮氣量時(shí)的呼氣流量與呼氣峰流量比（TEF25/PTEF）、單位潮氣量（VT/kg）和達(dá)峰容積比（VPEF/VE），肺炎胸片吸收評價(jià)量表（PCRAES）評分，紅細(xì)胞分布寬度（RDW），及血清單核細(xì)胞趨化蛋白-4（MCP-4）、轉(zhuǎn)化生長因子-β1（TGF-β1）和可溶性白細(xì)胞介素-6受體（sIL-6R）水平。結(jié)果 治療后，治療組總有效率明顯高于對照組（96.43% vs 85.71%，P＜0.05）。治療后，兩組中醫(yī)證候積分（包括主癥積分、次癥積分、舌脈象積分、總積分）、Ti/Te、PCRAES評分、RDW和血清MCP-4、TGF-β1、sIL-6R水平均低于同組治療前（P＜0.05），且治療組均低于同期對照組（P＜0.05）。治療后，兩組TEF25/PTEF、VT/kg、VPEF/VE均高于同組治療前（P＜0.05），，且治療組均明顯高于同期對照組（P＜0.05）。結(jié)論 藍(lán)芩口服液聯(lián)合克拉霉素治療兒童肺炎支原體肺炎，能有效抑制肺部炎癥及機(jī)體炎癥損害，有效促進(jìn)癥狀緩解與肺功能好轉(zhuǎn)，且患兒耐受性較好。

Objective To investigate the clinical efficacy of Lanqin Oral Solution combined with clarithromycin in treatment of mycoplasmal pneumonia in children. Methods Children (112 cases) with mycoplasmal pneumonia in Jing’an Branch of Huashan Hospital, Fudan University from August 2023 to June 2024 were divided into control group and treatment group by random number table method, with 56 cases in each group. Children in the control group were po administered with Clarithromycin Granules for Oral Suspension, 0.3 mL/kg (the maximum dose was 10 mL/time), twice daily. Children in the treatment group were po administered with Lanqin Oral Solution on the basis of the control group, three times daily, children aged 1 — 3 years old 3.3 mL each time, 4 — 6 years old 5 mL each time, 7 — 14 years old 10 mL each time. Children in two groups were treated for 7 d. After treatment, the clinical evaluations were evaluated, and the TCM syndrome scores, tidal respiration and lung function indicators Ti/Te, TEF25/PTEF, VT/kg and VPEF/VE, PCRAES scores, RDW, and the levels of MCP-4, TGF-β1 and sIL-6R in two groups before and after treatment were compared. Results After treatment, the clinical total effective rate in the treatment group was significantly higher than that in the control group (96.43% vs 85.71%, P < 0.05). After treatment, the TCM syndrome scores (including main syndrome scores, secondary syndrome scores, tongue and pulse scores, and total scores), Ti/Te, PCRAES scores, RDW and serum MCP-4, TGF-β1, sIL-6R levels in two groups were lower than those before treatment in the same group (P < 0.05), and these levels in the treatment group were lower than those in the control group during the same period (P < 0.05). After treatment, TEF25/PTEF, VT/kg, and VPEF/VE in two groups were higher than those in the same group before treatment (P < 0.05), and which in the treatment group were significantly higher than those in the control group during the same period (P < 0.05). Conclusion The treatment of children with mycoplasmal pneumonia pneumonia with Lanqin Oral Solution combined with clarithromycin can effectively inhibit lung inflammation and body inflammation damage, effectively promote symptom relief and lung function improvement, and which has good tolerance in children.

R974

上海市靜安區(qū)衛(wèi)生科研項(xiàng)目（2021SQ06）