【目的】 观察子午流注择时穴位贴敷治疗痰热闭肺证小儿肺炎喘嗽的临床疗效。【方法】 将 2023年 1月至 2024年 4月吉 林省中医药科学院第一临床医院收治的300例痰热闭肺证小儿肺炎喘嗽患者，按随机数字表法随机分为观察组和对照组，每 组各150例，2组患儿均给予西医常规对症治疗。对照组给予头孢呋辛钠静脉滴注；观察组在对照组治疗的基础上，给予子 午流注择时穴位贴敷治疗。治疗后，评价2组临床疗效，观察2组患儿治疗前后中医证候积分的变化情况，以及临床症状的 肺啰音消失时间、体温恢复时间、心率恢复时间和X线恢复正常时间的情况。比较2组患者治疗前后红细胞计数（RBC）、白 细胞计数（WBC）、血小板计数（PLT）以及 C 反应蛋白（CRP）水平的变化情况。并评价 2组的安全性及不良反应的发生情况。 【结果】（1）观察组总有效率为 94.67%（142/150），对照组为 84.67%（127/150）。观察组疗效优于对照组，差异有统计学意义 （P < 0.05）。（2）治疗后，2组患儿的中医证候积分明显改善（P < 0.05），且观察组在改善中医证候积分方面明显优于对照组， 差异有统计学意义（P < 0.05）。（3）治疗后，观察组肺啰音消失时间、体温恢复时间、心率恢复时间、X线恢复正常时间优于 对照组，差异有统计学意义（P < 0.05）。（4）治疗后，2组患儿的RBC、WBC、PLT及CRP水平明显改善（P < 0.05），且观察组 在改善 RBC、WBC、PLT 及 CRP 水平方面明显优于对照组，差异有统计学意义（P < 0.05）。（5）观察组不良反应发生率为 10.67%；对照组为16.00%；观察组与对照组的不良反应发生率比较，差异无统计学意义（P > 0.05）。【结论】 子午流注择时穴 位贴敷治疗痰热闭肺证小儿肺炎喘嗽，能有效改善患儿的临床症状，促进患儿肺部功能的恢复，缓解炎症反应，且不良反 应低，安全性高，疗效显著。

Objective To observe the clinical efficacy of Ziwu Liuzhu （midnight-midday ebb and flow， the movement of qi and blood in the meridians following heavenly-stems and earthly-branches cycle）timing point application in treating pediatric pneumonic cough of phlegm-heat obstructing lung syndrome. Methods A total of 300 cases of children with pediatric pneumonic cough of phlegm-heat obstructing lung syndrome admitted to the First Clinical Hospital of Jilin Academy of Traditional Chinese Medicine from January 2023 to April 2024 were randomly divided into observation group and control group according to random number table method，150 cases in each group，and both groups of children were given the conventional symptomatic treatment with western medicine， while the control group was given Cefuroxime Sodium intravenous drip. The observation group was treated with Ziwu Liuzhu timing point application on the basis of treatment of the control group. After treatment，the clinical efficacy of the two groups was evaluated，and the changes in traditional Chinese medicine（TCM）syndrome scores before and after treatment were observed，and the symptoms such as disappearance time of lung rale，recovery time of body temperature，recovery time of heart rate，and return to normal time of X-ray findings of the two groups were observed. The changes of red blood cell count（RBC），white blood cell count（WBC），platelet count（PLT）and C-reactive protein（CRP）levels before and after treatment were compared between the two groups. The safety and occurrence of adverse reactions in the two groups were also evaluated. Results（1）The total effective rate was 94.67%（142 / 150）in the observation group and 84.67%（127 / 150）in the control group. The efficacy of the observation group was superior to that of the control group， the difference being statistically significant（P < 0.05）.（2）After treatment，the TCM syndrome scores of the children in the two groups were improved significantly （P < 0.05），and the improvement in the observation group was significantly superior to that in the control group， the difference being statistically significant（P < 0.05）.（3）After treatment，the observation group was superior to the control group in the disappearance time of lung rales，recovery time of body temperature，recovery time of heart rate，and return to normal time of X-ray findings，the difference being statistically significant（P < 0.05）. （4）After treatment， the RBC， WBC， PLT and CRP levels of the children in the two groups were improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（5）The incidence rate of adverse reactions in the observation group was 10.67%， and that in the control group was 16.00%； the intergroup comparison showed that the difference being not statistically significant（P > 0.05）. Conclusion Ziwu Liuzhu timing point application in treating pediatric pneumonic cough of phlegm-heat obstructing lung syndrome can effectively improve the children 􀆳 s clinical symptoms， promote their recovery of lung function， alleviate the inflammatory reaction，which is safety，and with less adverse reaction.

R246.9

国家中医药管理局基金2022年中医药古籍文献和特色技术传承专项项目（编号：GZY-KJS-2022-030）