探讨五虎汤合葶苈大枣泻肺汤联合布地奈德雾化治疗小儿支气管肺炎痰热闭肺证的临床疗效及其对炎症反应 的影响。【方法】将70例支气管肺炎痰热闭肺证患儿随机分为观察组和对照组，每组各35例。对照组患儿给予布地奈德混悬 液雾化吸入治疗，观察组患儿在对照组的基础上给予五虎汤合葶苈大枣泻肺汤治疗，疗程为7 d。观察2组患儿治疗前后中 医证候积分及血清白细胞介素6（IL-6）、降钙素原（PCT）、超敏C反应蛋白（hs-CRP）等炎症因子水平的变化情况，并比较 2 组患儿的临床疗效、症状体征消失时间和不良反应发生率。【结果】（1）治疗7 d 后，观察组的总有效率为91.43% （32/35），对照组为71.43%（25/35），组间比较（χ2检验），观察组的疗效明显优于对照组（P＜0.05）。（2）治疗后，2组患儿的中 医证候积分均较治疗前明显降低（P＜0.05），且观察组的降低幅度明显优于对照组（P＜0.01）。（3）治疗后，观察组患儿的喘 息、咳嗽、肺部啰音、便秘、发烧等症状体征消失时间均较对照组明显缩短（P＜0.01）。（4）治疗后，2组患儿的血清IL-6、 PCT、hs-CRP水平均较治疗前明显降低（P＜0.05），且观察组的降低幅度均明显优于对照组（P＜0.01）。（5）观察组的不良反应 发生率为5.71%（2/35），对照组为8.57%（3/35），组间比较，差异无统计学意义（P＞0.05）。【结论】五虎汤合葶苈大枣泻肺汤 联合布地奈德雾化治疗小儿支气管肺炎痰热闭肺证疗效确切，可有效改善患儿的临床症状，减轻患儿的机体炎症反应。

To investigate the clinical efficacy of Wuhu Decoction plus Tingli Dazao Xiefei Decoction combined with Budesonide atomization for the treatment of pediatric bronchopneumonia with phlegm- heat obstructing the lung syndrome，and to observe its effect on inflammatory response. Methods Seventy children with bronchopneumonia of phlegm-heat obstructing the lung type were randomly divided into an observation group and a control group，with 35 cases in each group. The children in the control group were treated with atomized inhalation of Budesonide suspension，and the children in the observation group were treated with Wuhu Decoction plus Tingli Dazao Xiefei Decoction orally on the basis of treatment for the control group. Both groups were treated for a period of 7 days. The changes in the traditional Chinese medicine （TCM） syndrome scores and the serum levels of inflammatory factors of interleukin 6（IL-6）， procalcitonin（PCT）， and hypersensitive C-reactive protein （hs-CRP）in the two groups were observed before and after the treatment. Moreover，the clinical efficacy，time for the relief of symptoms and signs， and the incidence of adverse reactions in the two groups were compared. Results（1）After 7 days of treatment，the total effective rate of the observation group was 91.43%（32/35），and that of the control group was 71.43%（25/35）. The intergroup comparison（tested by chi-square test）showed that the therapeutic efficacy of the observation group was significantly superior to that of the control group（P＜0.05）. （2）After treatment，the TCM syndrome scores of the children in both groups were significantly lower than those before treatment（P＜0.05）， and the decrease in the observation group was significantly superior to that in the control group（P＜0.01）.（3）After treatment，the time for the relief of symptoms and signs such as wheezing， cough，lung rales，constipation and fever in the observation group was significantly shortened compared with that in the control group（P＜0.01）.（4）After treatment，the serum IL-6，PCT and hs-CRP levels in both groups were significantly lower than those before treatment（P＜0.05），and the reduction in the observation group was significantly superior to that in the control group（P＜0.01）.（5） The incidence of adverse reactions in the observation group was 5.71%（2/35）and that in the control group was 8.57%（3/35），while the difference was not statistically significant between the two groups（P＞0.05）. Conclusion Wuhu Decoction plus Tingli Dazao Xiefei Decoction combined with Budesonide atomization exert certain effect for the treatment of pediatric bronchopneumonia with phlegm-heat obstructing the lung syndrome， which can effectively relieve the clinical symptoms and alleviate the inflammatory response of the children.

R563.1+2

安徽省自然科学基金项目（编号：2108085QH348）