目的 探讨清咳平喘颗粒联合乙酰半胱氨酸对痰热闭肺型大叶性肺炎（LP）患儿的治疗效果。方法 回顾性选取我院收治的118例痰热闭肺型LP患儿（选例时间：2023年1月~2025年11月）为研究对象，根据治疗方案分为参照组（59例，采用乙酰半胱氨酸治疗）、联合组（59例，采用清咳平喘颗粒联合乙酰半胱氨酸治疗）。对比两组临床疗效、不良反应及治疗前、后肺功能［潮气量（VT）、达峰时间比（TPTEF/TE）、吸呼比（Ti/Te）、达峰容积比（VPEF/VE）］、中医证候、免疫功能、炎症因子［白细胞介素-8（IL-8）、趋化因子配体3（CCL3）、肿瘤坏死因子-α（TNF-α）、高迁移率族蛋白B1（HMGB1）］水平。结果 联合组总有效率为96.61%，高于参照组的83.05%（P＜0.05）；与参照组相比，治疗后联合组各中医证候积分均较低（P＜0.05）；联合组治疗后VT、TPTEF/TE、Ti/Te、VPEF/VE水平均较参照组高（P＜0.05）；联合组治疗后CD8+水平较参照组低，CD3+、CD4+、CD4+/CD8+水平较参照组高（P＜0.05）；治疗后联合组血清IL-8、CCL3、TNF-α、HMGB1水平均较参照组低（P＜0.05）；不良反应发生情况组间比较，无明显差异（P＞0.05）。结论 清咳平喘颗粒联合乙酰半胱氨酸可提高痰热闭肺型LP患儿治疗效果，减轻临床症状，改善肺功能、免疫功能，降低机体炎症反应程度。

Objective To explore the therapeutic efficacy of Qingke Pingchuan granules combined with acetylcysteine on children with lobar pneumonia (LP) of phlegm-heat obstructing lung type. Methods A total of 118 children with LP of phlegm-heat obstructing lung type admitted to our hospital from January 2023 to November 2025 were retrospectively selected as the research subjects. According to different treatment regimens, they were divided into the control group (59 cases, treated with acetylcysteine) and the combined group (59 cases, treated with Qingke Pingchuan granules combined with acetylcysteine). The clinical efficacy, adverse reactions, as well as the levels of pulmonary function indicators [tidal volume (VT), time to peak tidal expiratory flow ratio (TPTEF/TE), inspiration-expiration ratio (Ti/Te), volume to peak tidal expiratory flow ratio (VPEF/VE)], traditional Chinese medicine (TCM) syndrome scores, immune function and inflammatory factors [interleukin-8 (IL-8), C-C motif chemokine ligand 3 (CCL3), tumor necrosis factor-α (TNF-α), high mobility group box 1 protein (HMGB1)] before and after treatment were compared between the two groups. Results The total effective rate of the combined group was 96.61%, which was higher than 83.05% of the control group (P<0.05). After treatment, the TCM syndrome scores of the combined group were lower than those of the control group (P<0.05). The levels of VT, TPTEF/TE, Ti/Te and VPEF/VE in the combined group were higher than those in the control group after treatment (P<0.05). After treatment, the level of CD8? in the combined group was lower, while the levels of CD3?, CD4? and CD4?/CD8? were higher than those in the control group (P<0.05). The serum levels of IL-8, CCL3, TNF-α and HMGB1 in the combined group were significantly lower than those in the control group after treatment (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion The combination of Qingke Pingchuan granules and acetylcysteine can enhance the therapeutic efficacy on children with LP of phlegm-heat obstructing lung type, relieve clinical symptoms, improve pulmonary function and immune function, and reduce systemic inflammatory response.

目的 探讨乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗慢性阻塞性肺疾病疗效及对患者肺功能的影响。方法 以2020年4月—2022月4月在本院诊治的84例慢性阻塞性肺疾病患者作为研究对象,根据1∶1简单分配原则把患者分为联合组与对照组各42例。对照组行传统治疗,联合组在对照组治疗的基础上,再给予乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗,联合组与对照组都治疗观察4周。检测患者的疗效、肺功能与血清超敏C反应蛋白（hs-CRP）与降钙素原（PCT）含量变化情况。结果 联合组治疗后的总有效率与对照组相比有提高（P<0.05）。治疗后,联合组与对照组的第一秒用力呼气容积占用力肺活量百分比（FEV₁/FVC）、第一秒用力呼气容积占预计值百分比（FEV₁%）更高（P<0.05）,且联合组与对照组对比有提高（P<0.05）。联合组治疗后的疾病影响、活动能力、症状部分等SGRQ生活质量评分与对照组相比降低（P<0.05）。联合组与对照组治疗后的血清 hs-CRP与 PCT含量低于治疗前（P<0.05）,联合组与对照组相比也降低（P<0.05）。结论 乙酰半胱氨酸泡腾片联合布地格福气雾剂治疗慢性阻塞性肺疾病能有效抑制hs-CRP、PCT的表达,能促进改善患者的肺功能,提高治疗效果与生活质量。

Objective To investigate the efficacy of acetylcysteine effervescent tablets combined with budigraf aerosol in the treatment of chronic obstructive pulmonary disease（COPD）and its effect on the pulmonary function of patients．Methods From April 2020 to April 2022,a total of 84 patients with COPD diagnosed and treated in our hospital were selected as the research objects,and the patients were divided into the combination group and the control group with 42 cases in each group,according to the 1∶1 simple allocation principle．The control group were given traditional treatment,and the combination group were given acetylcysteine effervescent tablets combined with budigraf aerosol additionally．Both the combined group and the control group were observed for 4 weeks．The efficacy of patients,lung function and serum hypersensitive C-reactive protein（hs-CRP）and procalcitonin（PCT）levels were detected．Results The total effective rates after treatment in the combination group were higher than the control group（P<0.05）．After treatment,The forced expiratory volume in 1 second/forced vital capacity（FEV₁/FVC）,FEV₁% value of the two groups were higher（P<0.05）,and the combination group had greater improvement（P<0.05）．The SGRQ quality of life scores,such as disease impact,activity ability,and symptom in the combination group were lower（P<0.05）．After treatment,the serum high-sensitivity C-reactive protein（hs-CRP）and procalcitonin（PCT）levels in the two groups were significantly lower（P<0.05）,and the combined group decreased more（P<0.05）．Conclusions Acetylcysteine effervescent tablets combined with budigraf aerosol in the treatment of COPD can effectively inhibit the expression of hs-CRP,PCT,promote the improvement of lung function,improve the treatment effect and quality of life．

目的 研究低分子肝素联用乙酰半胱氨酸治疗间质性肺炎的疗效观察以及对其安全性进行评估。方法 选取间质性肺炎患者96例,随机分为对照46例及观察组50例,对照组予以常规治疗,观察组患者在对照组基础上联合加用低分子肝素和乙酰半胱氨酸,两组患者均接受为期3个月的疗程。比较治疗前后两组患者的临床症状、各项肺功能指标。结果 治疗后观察组患者呼吸困难自评分数和治疗前对比有改善(P＜ 0. 05),而治疗前后对照组无改变。 治疗后观察组的肺功能各项指标(VC% pred、FVC% pred、FEV1% pred、TLC% pred)比治疗前高;对照组经治疗后各项分功能指标的改善程度较治疗前差异不明显(P＞ 0.05); 且治疗后观察组的VC% pred、FVC% pred比对照组高。观察组在治疗后, HRCT 检测发现肺部出现磨玻璃影、网格影以及小叶间隔增厚的比例低于治疗前;而对照组以上指标治疗前后的改变比例差异无统计学意义 (P＞0.05) 。两组治疗后六分钟步行距离、血清Ⅲ型胶原水平较治疗前均有改善;但治疗后观察组的六分钟步行距离、血清Ⅲ型胶原水平高于对照组(P＜0.05)。治疗后两组患者没有发生明显不良反应。结论 联合应用低分子肝素、乙酰半胱氨酸来治疗间质性肺炎疗效显著,改善肺纤维化效果理想,且能帮助恢复患者的运动能力,研究过程中未发现明显不良反应,故提倡临床推广。