Efficacy of methylprednisolone combined with ambroxol hydrochloride in the treatment of pediatric community-acquired pneumonia

Yan Ruoyuan; Liang Jinling; Liang Shuang

doi:10.3969/j.issn.1672-8157.2025.06.034

Abstract：Objective To observe the clinical efficacy of methylprednisolone combined with ambroxol hydrochloride in the treatment of pediatric community-acquired pneumonia(CAP).Methods The selected study subjects were 80 children with CAP who received treatment in the department of pediatrics of Nanyang First People's Hospital from January 2023 to December 2024,and the children were divided into two groups by random numer table method,each with 40 cases.Both groups were treated with symp-tomatic treatments such as cough suppression,asthma control and antipyresis.The control group was given intravenous infusion of azithromycin and ambroxol hydrochloride,and the combined group was given intravenous infusion of methylprednisolone sodium succinate on the basis of the control group.The treatment course of both groups was 7 days,with a total follow-up period of 10 days.The tidal volume per kilogram(Vt/kg),volume to peak tidal expiratory flow as a proportion of exhaled volume(VPTEF/VE),time to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),tumor necrosis factor α(TNF-α),C-reactive protein(CRP),and procalcitonin(PCT)before and after 7 days of treatment were compared between the two groups.The two groups were compared in terms of clinical effectiveness,the time for the clinical symptoms to subside,and the incidence of adverse reactions.Results The overall clinical effectiveness rate of children in the combined group was 95.00%(38/40),higher than that of the control group(77.50%(31/40))(χ2=5.165,P<0.05).The time for the symptoms of fever,cough and wheezing,and lung rales to subside in the combined group((3.61±1.07)d,(6.42±0.86)d,and(5.36±1.17)d,respectively)were shorter than those in the control group((5.48±1.13)d,(7.83±1.04)d,and(6.95±1.23)d,respectively)(t=7.600,6.608,5.924,all P<0.05).Vt/kg,VPTEF/VE,TPTEF/TE in the combined group((9.85±1.76)mL·kg-1,(52.53±6.28)%,(46.87±5.87)%,respectively)were higher than those in the control group((7.02±1.54)mL·kg-1,(45.63±6.15)%,(32.76±5.98)%)(t=7.653,4.965,10.650,all P<0.05).The levels of TNF-α,CRP,and PCT in the combined group((11.76±3.87)ng·L-1,(9.79±2.73)mg·L-1,and(0.27±0.04)ng·mL-1,respectively)were lower than those in the control group((16.32±4.65)ng·L-1,(15.87±3.73)mg·L-1,and(0.39±0.06)ng·mL-1)(t=4.767,8.319,10.525,all P<0.05).The in-cidence of adverse reactions showed no significant difference between the two groups(12.50%vs 7.50%)(χ2=0.139,P=0.709).Conclusion Methylprednisolone combined with ambroxol hydrochloride can shorten the time for the clinical symptoms to sub-side in children with CAP,effectively improve the lung function and reduce the levels of inflammatory factors in the children,with remarkable clinical efficacy and good safety.